With the FDA on the cusp of removing compounded semaglutide and tirzepatide — two popular and effective weight loss drugs — from the allowed compounding list, let’s introduce a powerful new competitor to the mix: liraglutide.
What is compounded liraglutide, how does it perform against big names like Ozempic and Mounjaro, and how does it help patients achieve sustained weight loss?
What is the ‘allowed compounding list’ and why does it matter for weight loss patients?
Americans who rely on compounded weight loss drugs as more affordable alternatives to Ozempic or Mounjaro should be aware that the FDA has instituted bans on compounded tirzepatide and semaglutide that go into effect March 19th and April 22nd, respectively.
As of those dates, these compounded drugs will no longer be included in the FDA’s allowed compounding list.
The removal of compounded semaglutide and tirzepatide will have massive effects on the market because the FDA provisions permit pharmaceutical compounding facilities to produce drugs in high demand that are deemed to be in shortage, as many weight loss drugs have been since 2022.
As such, the long and short of it is that specially compounded semaglutide and tirzepatide will no longer be available in the United States as of April and weight loss patients will only have access to the more expensive brand-name formulations of these drugs. The compounding pharmacies may find some legal loopholes to continue offering these medications. If they compound it, we will offer it!
However, the saving grace is that there exist alternatives to semaglutide and tirzepatide, brand-name or compounded, that work just as well for weight loss or, in some respects, possibly even better depending on you as the patient and your individual goals.
One such semaglutide/tirzepatide alternative is liraglutide, sold under the brand name Victoza in the United States.
In December of last year, due to shortages of GLP-1 agonists in the American market (you might have experienced difficulty accessing these drugs yourself recently), the U.S. Food and Drug Administration (FDA) “approved the first generic referencing Victoza (liraglutide injection) 18 milligram/3 milliliter, a glucagon-like peptide-1 (GLP-1) receptor agonist indicated to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes as an adjunct to diet and exercise.”
The agency also cited the ongoing supply shortage as its rationale for opening up the generic liraglutide market: “Liraglutide injection and certain other GLP-1 medications are currently in shortage. The FDA prioritizes assessment of generic drug applications for drugs in shortage to help improve patient access to these medications.”
Novo Nordisk, which manufactures Ozempic and Victoza (its branded liraglutide product), in an effort to maintain its grip on the market, has repeatedly sued to prevent compounding pharmacies from delivering more affordable, equally effective compounded liraglutide to patients who need it, in spite of ongoing shortages.
So, the regulatory situation is fluid. We may see some regulatory changes regarding liraglutide in the future similar to those handed down recently for semaglutide and tirzepatide by the FDA. We’ll keep you updated on any developments although experts say they don’t foresee any issues with liraglutide in the short term.
For now, compounded liraglutide remains available in the United States, and we have it in stock.
Liraglutide research: What is it and how does it work?
Like semaglutide and tirzepatide, liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, acting in the body the same way as the naturally occurring and critical hormone, GLP-1.
In fact, liraglutide is so similar to the GLP-1 that it shares a “97% amino acid homology to the human endogenous GLP-1,” the only difference being an arginine instead of lysine amino acid at position 34 of the peptide.
The physiological mechanisms behind liraglutide are somewhat complicated — given its interplay with the neurological, endocrine, and digestive systems — and could fill a physiology textbook.
But, in a nutshell, liraglutide promotes weight loss by binding to GLP-1 receptor sites in pancreatic beta-cells (hence the term”GLP-1 agonist”), which in turn stimulates the release of insulin by the beta cells. Higher insulin levels satiate hunger and decrease blood sugar levels following food intake.
(This positive effect on blood sugar regulation is why GLP-1 drugs were initially designed to help treat diabetes before researchers discovered their application for weight loss.)
For a more in-depth breakdown of the physiological mechanisms by which GLP-1 agonists promote weight loss in the human body, please see our lengthy and authoritative article on the topic: Tirzepatide vs. Semaglutide For Weight Loss.
Liraglutide benefits
As a potent GLP-1 agonist, liraglutide delivers the following weight loss benefits.
Enhanced blood sugar control
Liraglutide lowers blood glucose (blood sugar) levels, particularly right after a meal, called the postprandial spike. Maintaining a steady, healthy blood sugar level is essential to long-term weight management.
Slowed gastrointestinal (GI) motility
Liraglutide lows gastrointestinal (GI) motility— the movement of food through the digestive tract — thereby boosting feelings of fullness and limiting cravings.
Hypothalamus signaling for improved satiety
Liraglutide directly interacts with the GLP-1 receptors located in the hypothalamus — a small area of the brain that serves as one of the major “control rooms” for the hormone system and it intimately involved in metabolism.
Research demonstrates that GLP-1 agonists’ “interaction with GLP-1 receptors in the hypothalamus may mitigate sensations of hunger, alleviate food cravings, and enhance the feelings of satiety” and that “these multifaceted actions contribute to the comprehensive metabolic effects… in managing blood glucose levels and facilitating weight loss.”
What does the medical literature say about liraglutide for weight loss?
All of the above mechanisms combined, we have in compounded liraglutide an excellent therapeutic with an extensive track record of high performance and a wealth of tangible results documented in clinical trials.
Here, for example, are the findings of a large-scale literature review of the clinical trials investigating liraglutide for weight loss, published in Obesity Science & Practice:
“Liraglutide has been shown to be effective at inducing and sustaining weight loss in a population of obese patients including those with hypertension, dyslipidemia, type 2 diabetes and obstructive sleep apnea…
[Liraglutide] offers the unique benefit of improved glycemic control and its relatively few contraindications as compared with other weight loss agents make it an attractive option for patients, especially with comorbid type 2 diabetes or cardiovascular disease…
For now, liraglutide remains another important option in the physician’s toolkit to combat the growing obesity epidemic in the United States and abroad.”
Liraglutide side effects?
Up to half of the patients who receive liraglutide may experience some form of gastrointestinal symptoms, most of which are mild and can be easily managed by adjusting the dose and frequency of administration:
- Nausea
- Dizziness
- Upset stomach
Extremely rare but serious other side effects include heart swelling and inflamed pancreas (pancreatitis), kidney complications, and swelling of the deep layers of the skin (angioedema). These side effects are the same with semaglutide and tirzepatide.
Again, severe liraglutide side effects are exceedingly rare, as millions of Americans rely on GLP-1 agonists like liraglutide without encountering serious issues. The key to avoiding dangerous side effects is to consult with a trained, licensed professional rather than self-administering.
We’re always available to discuss any side effects our liraglutide patients experience and offering strategies to mitigate or eliminate them, so don’t hesitate to reach out for guidance.
Is compounded liraglutide affordable?
When patients are expending thousands of dollars a month for Ozempic (brand-name semaglutide) or Mounjaro (brand-name tirzepatide), they’re essentially paying a premium for a name on a box without regard to what matters most, which is the actual quality and efficacy of the drug.
The reality is that high-quality compounded liraglutide — of the caliber that we prescribe to our patients — works just as well as any big-name GLP-1 agonist drug at a fraction of the cost.
Compared to the big brand names, compounded liraglutide is, on average, 50-60% more cost-effective.
Whereas shelling out in excess of $1,000 per month is common for American patients without insurance taking Ozempic, the equivalent dosing of compounded liraglutide is available for much less. Contact us for pricing.
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