Can’t Fill Your Saxenda Prescription? Here Are 6 Saxenda Alternatives for Weight Loss

In 2014, a once-daily injection called Saxenda (liraglutide) became the first glucagon-like peptide-1 (GLP-1) agonist approved by the FDA for chronic weight management. During initial clinical trials, people receiving Saxenda lost 8% of their body weight over 56 weeks (a little over a year). Fast-forward 10 years later, and GLP-1 agonists are a popular weight-management tool for many people.

Because it is popular, Saxenda is in short supply. If you’re having difficulty filling your Saxenda prescription, you may be looking for alternatives. A few factors to consider include dose frequency and route, effectiveness, and availability. Cost and additional benefits may be important too.

Below, we review six Saxenda alternatives and how they compare.

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1. Wegovy

Wegovy (semaglutide) is also an injectable GLP-1 agonist for chronic weight management. It works the same way as Saxenda. But unlike Saxenda, Wegovy needs to be injected only once a week. This means that dose adjustments are made on 4-week intervals, rather than weekly.

The Wegovy injection pen is also a little different from the Saxenda pen. Wegovy pens are single-use prefilled pens, meaning that each pen contains one dose. Saxenda pens contain multiple doses, and you need to select your dose each time.

People tend to lose more weight with Wegovy compared with Saxenda. In a 68-week study, people taking Wegovy lost nearly 16% of their starting weight, on average, compared with about 6% with Saxenda. If you need more help reaching your weight-loss goal, Wegovy may be a good option.

Wegovy also has proven cardiovascular benefits if you have heart disease. For adults with heart disease who are considered overweight or obese, Wegovy can help lower the risk of heart attack, stroke, and cardiovascular death. Saxenda is not approved for this use.

Wegovy (semaglutide) and Saxenda (liraglutide) are made by the same manufacturer, so certain Wegovy doses may also be in short supply.

2. Zepbound

Zepbound (tirzepatide) is the newest once-weekly injection for weight loss. It comes in a single-dose prefilled pen. Similar to Saxenda and Wegovy, Zepbound simulates the effects of a hormone called GLP-1. But it also simulates a second hormone called glucose-dependent insulinotropic polypeptide. This additional action may lead to even more weight loss.

During a 72-week clinical trial, people receiving the highest Zepbound dose (15 mg) lost nearly 21% of their starting body weight, on average. Zepbound and Saxenda haven’t been studied together, but individual studies suggest greater weight loss with Zepbound.

As of April 2024, most Zepbound doses should be available. Two doses (5 mg and 12.5 mg) may have limited availability through the end of April.

3. Contrave

Unlike the previous weight-loss medications, Contrave (naltrexone / bupropion) is an oral pill instead of an injection. And it’s not a GLP-1 agonist, either. If cost is an issue, oral weight-loss pills tend to have a lower price than the injectable options.

Contrave combines two medications: naltrexone (an opioid antagonist) and bupropion (an antidepressant). They work together on areas of the brain to reduce hunger and manage cravings. This can make it a good option if you experience emotional eating. Depending on the dose, the average weight loss with Contrave is usually 5% to 8%.

After the first week, Contrave is taken twice a day with food. But it shouldn’t be taken with a high-fat meal. This is different from Saxenda, which is injected once a day and can be taken without food.

As a tablet, Contrave can be a good option if you’re looking for a noninjectable alternative. But it isn’t right for everyone. Contrave isn’t recommended if you have a seizure disorder, have unmanaged high blood pressure, or regularly take opioids for pain.

Contrave and Saxenda share a few common side effects, including nausea and vomiting, constipation or diarrhea, and headaches. But Contrave can also cause sweating, sleeping problems, and dry mouth. Contrave can also interact with many other medications. Make sure your healthcare team has your full medication list before taking it.

4. Qsymia

Qsymia (phentermine / topiramate ER) is another oral alternative. It’s a combination tablet that contains phentermine (a stimulant) and topiramate (a seizure medication). Both medications have appetite-lowering effects. Phentermine (Adipex-P) is also available on its own for short-term use.

Depending on the dose, people taking Qsymia lose 5% to 10% of their body weight, on average. This is comparable to the weight loss you may see with Saxenda. But Qsymia can cause  different side effects, including numbness and tingling, dry mouth, and taste changes. It can also interfere with your sleep if you take it too close to bedtime. So it’s best to take it in the morning.

Qsymia is available only through a special risk-management program because it has a risk of birth defects. You may need to take a pregnancy test before starting Qsymia and monthly thereafter. If you’re able to get pregnant, you’ll need to take effective birth control during treatment.

Similar to Contrave, Qsymia isn’t a good alternative for everyone. It isn’t recommended for people who have glaucoma or an overactive thyroid. It can also interact with other medications, including birth control pills. Make sure to review your medications when considering switching.

Depending on your insurance coverage, Qsymia may also be more affordable than Saxenda.

5. Xenical

Xenical (orlistat) is an oral capsule that’s taken 3 times a day. It works by blocking your body’s ability to absorb fat, which is why you take it when you eat a meal containing fat. You can take Xenical at the same time as the meal or up to 1 hour after.

For some people, taking Xenical with a low-calorie diet for 1 year may result in a similar amount of weight loss as those who take Saxenda. But Xenical can cause unpleasant side effects due to extra fat moving through your digestive tract. These can include:

• Gas with spotting or discharge

• Oily spotting on underwear

• Oily or fatty stools

• More bowel movements and difficulty controlling bowel movements

Unlike Saxenda and its other alternatives, orlistat is available over the counter (OTC) as a lower-dose product called Alli. But even though it’s available OTC, it’s best to talk to your prescriber before taking Alli in place of Saxenda.

6. Plenity

Plenity is also used for weight management. But it isn’t a medication; it’s an FDA-approved prescription medical device. This is because it works by temporarily taking up space in your digestive tract.

Plenity is an oral capsule that contains cellulose (plant fiber) and citric acid. You’ll take 3 capsules with 16 oz of water, 20 minutes before lunch and dinner. When mixed with food and water in your digestive tract, these ingredients expand, causing you to feel full more quickly when you eat. If you have difficulty taking pills, Plenity may not be the best option for you.

During a 24-week study, the average weight loss with Plenity was about 6%. This is compared with about 4% weight loss in people who didn’t take Plenity (placebo group). But 27% of people in the Plenity group lost 10% or more of their starting body weight.

Both Saxenda and Plenity can cause side effects such as nausea, gas and bloating, and constipation. But for many people, these side effects tend to improve over time. Eating more slowly while taking Plenity may help manage discomfort.

As a medical device, Plenity isn’t available in retail pharmacies like other weight-loss medications. Your prescriber may need to send your prescription to a specific pharmacy that is able to fill Plenity.

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Written by:

Hope Chang, PharmD, AAHIVP

Hope Chang is a freelance writer and content reviewer for GoodRx. She attended Howard University College of Pharmacy in Washington, D.C. and completed post-graduate residency training at the University of California, Davis Medical Center.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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