Missing a dose of Saxenda (liraglutide 3 mg) occasionally happens, but understanding how to manage this situation is essential for maintaining effective weight management treatment. Saxenda is a once-daily GLP-1 receptor agonist injection prescribed for adults with obesity or overweight with weight-related comorbidities. The medication works by regulating appetite and enhancing satiety through actions on the hypothalamus. According to MHRA-approved guidance, if you miss a dose within 12 hours of your usual time, take it immediately; if more than 12 hours have passed, skip that dose and resume your normal schedule the following day. Never double doses, and contact your GP if you miss three or more consecutive days, as you'll need to restart the dose escalation schedule.

What Happens If You Miss a Dose of Saxenda

Missing a single dose of Saxenda (liraglutide 3 mg) is not uncommon and does not typically cause immediate harm, but it does affect the continuity of treatment. Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist administered once daily via subcutaneous injection, designed to regulate appetite and support weight management in adults with obesity or overweight with weight-related comorbidities.

When you miss a dose, the medication's blood concentration gradually decreases. Liraglutide has a half-life of approximately 13 hours, meaning that after missing a dose, you may notice a return of appetite or reduced feelings of satiety as the drug's action on appetite-regulating centres in the hypothalamus wanes.

According to the MHRA-approved Summary of Product Characteristics (SmPC), if you miss a dose and remember within 12 hours of your usual injection time, administer the dose as soon as possible and continue with your regular schedule the following day. If more than 12 hours have passed, skip the missed dose entirely and resume your normal schedule the next day at your usual time. Never double up on doses to compensate for a missed injection, as this increases the risk of adverse effects such as nausea, vomiting, and hypoglycaemia (particularly in patients taking sulfonylureas or insulin for type 2 diabetes).

Importantly, if you miss three or more consecutive days of Saxenda, the SmPC instructions are clear: you must restart at the 0.6 mg dose and follow the weekly dose escalation schedule again (increasing by 0.6 mg weekly until reaching the 3.0 mg maintenance dose). Contact your GP or prescribing clinician before restarting treatment after a significant break.

When to Resume Saxenda After a Missed Dose

The timing of resuming Saxenda after a missed dose depends on how long the interruption has been. For a single missed dose where fewer than 12 hours have elapsed since your scheduled injection time, you should take the dose immediately and then return to your regular daily schedule. This approach helps maintain therapeutic drug levels and minimises disruption to appetite control.

If you realise you have missed a dose more than 12 hours after your usual injection time, the Saxenda SmPC advises skipping that dose completely. Resume your injections at the next scheduled time with your usual maintenance dose. This prevents overlapping doses and reduces the likelihood of gastrointestinal adverse effects, which are the most commonly reported side effects of Saxenda, including nausea (experienced by approximately 40% of patients in clinical trials according to the European Medicines Agency's assessment report), vomiting, diarrhoea, and constipation.

For interruptions of three or more consecutive days, the SmPC is explicit: you must restart Saxenda at 0.6 mg and follow the weekly dose escalation schedule again. This is because after this duration, your body may have cleared most of the medication, and reintroducing the full maintenance dose could trigger significant gastrointestinal side effects. Contact your healthcare provider before restarting after a significant break in treatment.

Patients should consider setting daily reminders on their mobile phones, using medication tracking apps, or injecting at the same time each day (many find mornings most convenient) to establish a consistent routine. If you frequently forget doses, discuss strategies with your prescribing clinician, as adherence is crucial for achieving and maintaining weight loss outcomes.

Risks of Skipping Saxenda Doses Regularly

Regular or frequent omission of Saxenda doses significantly compromises treatment efficacy and may lead to several clinical concerns. The primary risk is reduced weight loss effectiveness. Clinical trials show that consistent daily use of Saxenda, when combined with a reduced-calorie diet and increased physical activity, results in an average weight loss of 5–10% of initial body weight over 56 weeks, though individual results vary. Irregular dosing disrupts the medication's mechanism of action, which includes slowing gastric emptying, enhancing satiety, and reducing appetite through central nervous system pathways.

According to the SmPC, inconsistent use may lead to more pronounced gastrointestinal side effects when restarting treatment. When Saxenda is taken irregularly, the digestive system may not adapt to the medication's effects on gastric motility, potentially leading to nausea, vomiting, or abdominal discomfort when the medication is reintroduced.

Weight regain is another significant concern. Saxenda does not cure obesity but rather provides pharmacological support for weight management. When doses are frequently skipped, appetite regulation diminishes, often resulting in increased caloric intake. Research suggests that discontinuation of GLP-1 receptor agonists typically leads to weight regain, though the rate and extent vary between individuals.

From a safety perspective, irregular dosing may mask the medication's true tolerability profile, making it difficult for clinicians to assess whether side effects are due to the medication itself or inconsistent administration. Additionally, patients with type 2 diabetes using Saxenda alongside sulfonylureas or insulin face potential hypoglycaemia with irregular dosing patterns. If you have diabetes and are taking these medications, consult your healthcare provider about glucose monitoring and potential dose adjustments.

NICE guidance (TA664) recommends discontinuing Saxenda if patients do not achieve at least 5% weight loss after 12 weeks at the maintenance dose, making consistent use essential for demonstrating treatment response. Saxenda is available privately in the UK at varying costs, and poor adherence means patients may not achieve the therapeutic benefits that justify this expense.

How to Maintain Your Saxenda Schedule

Establishing and maintaining a consistent Saxenda injection routine is fundamental to treatment success. Choose a specific time each day that aligns with your daily routine—many patients prefer morning injections before breakfast, as this can be easily incorporated into existing habits. Saxenda can be administered at any time of day, with or without food, providing flexibility to suit individual schedules.

Practical strategies to improve adherence include:

• Set daily alarms or reminders on your smartphone, specifically labelled for your Saxenda injection

• Use medication tracking apps that send notifications and record when doses are taken

• Store your Saxenda pen in a visible location (whilst maintaining proper storage conditions)

• Pair injection time with an established daily activity, such as brushing your teeth or having your morning coffee

• Keep a medication diary or use a calendar to tick off each dose, providing visual confirmation of adherence

• Prepare injection supplies the night before if injecting in the morning, reducing barriers to administration

Rotate injection sites systematically (abdomen, thigh, or upper arm) to prevent injection site reactions and maintain comfort, which supports long-term adherence. If you experience persistent injection site reactions or discomfort that discourages regular use, consult your healthcare provider.

For proper storage, according to the SmPC: keep unopened pens refrigerated (2-8°C); after first use, the pen can be stored for up to 30 days either at room temperature (below 30°C) or refrigerated; protect from light by keeping the pen cap on; never freeze Saxenda, and discard if it has been frozen.

If you experience severe or persistent abdominal pain (which could indicate pancreatitis), symptoms of gallstones, persistent vomiting/dehydration, or allergic reactions, stop using Saxenda and seek immediate medical attention. Saxenda is not recommended during pregnancy or breastfeeding; if you become pregnant, stop using Saxenda and contact your healthcare provider.

If you experience side effects, report them through the MHRA Yellow Card Scheme.

If you find yourself frequently missing doses, have an honest conversation with your GP or prescribing clinician. They can help identify barriers to adherence and develop solutions. Alternative weight management strategies may be more appropriate if consistent daily injections prove unsustainable.

Frequently Asked Questions