Quick Summary
Ozempic (semaglutide) and Victoza (liraglutide) are both GLP-1 receptor agonists from Novo Nordisk approved for type 2 diabetes. Victoza, approved in 2010, is a once-daily injection, while Ozempic, approved in 2017, is a once-weekly injection. Both are based on modifications to the natural GLP-1 hormone, but semaglutide's molecular design provides substantially longer duration of action and greater receptor potency.
The SUSTAIN 10 trial compared semaglutide 1 mg weekly to liraglutide 1.2 mg daily over 30 weeks in patients with type 2 diabetes. Semaglutide achieved significantly greater HbA1c reduction (1.7% vs 1.0%) and weight loss (5.8 kg vs 1.9 kg). Although this trial used liraglutide's lower dose rather than the maximum 1.8 mg, other data across the SUSTAIN and LEAD trial programs consistently show semaglutide outperforming liraglutide in glycemic and weight outcomes. These results indicate that the newer agent offers a meaningful clinical advancement.
Victoza holds a notable distinction in cardiovascular outcomes: the landmark LEADER trial demonstrated a significant reduction in major adverse cardiovascular events, contributing to Victoza's FDA indication for cardiovascular risk reduction in type 2 diabetes patients. Ozempic has also shown cardiovascular benefit in the SUSTAIN 6 trial and holds the SELECT trial data supporting semaglutide's cardiovascular profile. Both medications share GLP-1 class side effects and safety warnings. Given Ozempic's superior efficacy and more convenient weekly dosing, it has largely supplanted Victoza in new prescriptions. Patients still taking Victoza may wish to discuss with their healthcare provider whether transitioning to semaglutide is appropriate for their situation.
Ozempic vs Victoza: Full Comparison
| Feature | Ozempic(semaglutide) | Victoza(liraglutide) |
|---|---|---|
| Active Ingredient | semaglutide | liraglutide |
| Drug Class | GLP-1 receptor agonist | GLP-1 receptor agonist |
| Manufacturer | Novo Nordisk | Novo Nordisk |
| FDA Approved | 2017-12-05 | 2010-01-25 |
| Approved Indications |
|
|
| Route | subcutaneous injection | subcutaneous injection |
| Frequency | Once weekly | Once daily |
| Starting Dose | 0.25 mg weekly | 0.6 mg daily |
| Maintenance Dose | 0.5 mg or 1 mg weekly | 1.2 mg or 1.8 mg daily |
| Max Dose | 2 mg weekly | 1.8 mg daily |
| Weight Loss (%) | 14.9% | 3.2% |
| A1C Reduction | 1.8% | 1.1% |
| Key Trial | SUSTAIN 6 / STEP 5 (off-label weight) (104 weeks) | LEADER (188 weeks) |
| List Price | $935-$1,029/month | $950-$1,100/month |
| With Insurance | $25-$150/month (varies by plan) | $25-$150/month (varies by plan) |
| Savings Card | $25/month (Novo Nordisk savings card, commercially insured) | $25/month (Novo Nordisk savings card, commercially insured) |
Side Effects: Ozempic vs Victoza
| Side Effect | Ozempic | Victoza |
|---|---|---|
| Nausea | 15-20% | 28% |
| Vomiting | 5-9% | 11% |
| Diarrhea | 8-12% | 17% |
| Constipation | 3-6% | 6% |
| Abdominal pain | 6-11% | Not reported |
| Injection site reaction | 0.2% | Not reported |
| Pancreatitis (rare) | <0.5% | <1% |
| Headache | Not reported | 9% |
| Decreased appetite | Not reported | 9% |
| Dyspepsia | Not reported | 7% |
Severity scale: 1 (mild) to 5 (serious). Based on FDA prescribing information and clinical trial data.
Related Comparisons
Frequently Asked Questions
Sources & References
FDA & Regulatory
Clinical Trial Records
Peer-Reviewed Literature
- Marso SP et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6). N Engl J Med 2016;375:1834-1844 — New England Journal of Medicine
- Ahren B et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin (SUSTAIN-2). Lancet Diabetes Endocrinol 2017 — Lancet Diabetes & Endocrinology
- Marso SP et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER). N Engl J Med 2016;375:311-322 — New England Journal of Medicine
Manufacturer Information
Professional Guidelines
Reference Entries
Additional References
- SUSTAIN 10 trial (Capehorn MS, et al. Diabetes Metab. 2020;46(2):100-109)
- LEADER trial (Marso SP, et al. N Engl J Med. 2016;375(4):311-322)
- Ozempic FDA prescribing information (Novo Nordisk)
- Victoza FDA prescribing information (Novo Nordisk)
This content is for informational purposes only and is not medical advice. Always consult your healthcare provider before making medication decisions. See our full medical disclaimer.