Forgetting to take Saxenda (liraglutide) is a common concern for patients using this daily injectable weight management medication. If you've missed a dose, the appropriate action depends on the timing of your next scheduled injection. Taking the correct steps helps maintain treatment effectiveness whilst minimising the risk of side effects such as nausea or vomiting. Understanding what to do when you forget to take Saxenda, how missed doses affect your treatment, and strategies to prevent future lapses are essential for successful weight management outcomes. This guide provides clear, evidence-based advice aligned with UK clinical practice.

What to Do If You Forget to Take Saxenda

If you forget to take your Saxenda (liraglutide) injection, the appropriate action depends on when you remember the missed dose. If the next planned dose is more than 12 hours away, take the missed dose now. If less than 12 hours remain until your next scheduled dose, skip the missed dose and take your next injection at the usual time. It is crucial that you never take a double dose to compensate for a missed injection, as this significantly increases the risk of adverse effects, particularly gastrointestinal symptoms such as severe nausea, vomiting, and diarrhoea.

If more than 3 days have elapsed since your last dose, you should restart at 0.6 mg and follow the dose escalation schedule again to minimise side effects, as your body may have become less accustomed to the medication.

If you have missed multiple doses or are uncertain about what to do, contact your GP, practice nurse, or specialist weight management service for personalised advice.

Patients should also be aware that missing doses may temporarily affect appetite suppression and weight management progress. However, one missed dose is unlikely to significantly impact your overall treatment outcomes. Keep a record of any missed doses and discuss patterns of non-adherence with your healthcare provider.

Seek urgent medical advice if you experience severe or persistent abdominal pain (possible pancreatitis), ongoing vomiting or diarrhoea with signs of dehydration, or any signs of an allergic reaction. Contact your GP, NHS 111, or in severe cases, call 999 or go to A&E.

How Missing Doses Affects Your Treatment

Saxenda works through a specific pharmacological mechanism that requires consistent daily administration to maintain therapeutic efficacy. Liraglutide, the active ingredient, is a glucagon-like peptide-1 (GLP-1) receptor agonist with a half-life of approximately 13 hours. This means the medication remains active in your system for a limited period, and regular daily dosing is essential to sustain adequate blood concentrations for appetite regulation and weight management.

When you miss a dose, the blood levels of liraglutide begin to decline, which may result in reduced appetite suppression. You may notice increased appetite and food cravings when treatment is interrupted. This can make it more challenging to adhere to dietary modifications and may slow weight loss progress during the period of interrupted treatment.

Missing multiple consecutive doses presents additional concerns. After several days without Saxenda, your body may lose its tolerance to the medication, meaning that gastrointestinal side effects may return or intensify when you resume treatment at your previous dose. Very common adverse effects include nausea, vomiting, diarrhoea, constipation, and abdominal discomfort. For this reason, if more than 3 days have elapsed since your last dose, you should restart at 0.6 mg and follow the dose escalation schedule again.

It's important to stay hydrated if you experience vomiting or diarrhoea. If you have diabetes and take insulin or sulfonylureas alongside Saxenda, be aware of the increased risk of hypoglycaemia (low blood sugar) and discuss dose adjustments with your healthcare provider.

From a clinical effectiveness perspective, inconsistent dosing may compromise your overall weight loss outcomes. NICE guidance on obesity management emphasises that pharmacological interventions like Saxenda are most effective when combined with lifestyle modifications and consistent medication adherence. Frequent missed doses may indicate the need to reassess your treatment plan, address barriers to adherence, or consider alternative weight management strategies.

Preventing Missed Doses of Saxenda

Establishing a consistent daily routine is the most effective strategy for preventing missed Saxenda doses. Choose a specific time each day that aligns naturally with your existing habits—many patients find success by linking their injection to an established daily activity such as brushing teeth, having breakfast, or preparing for bed. Saxenda can be administered at any time of day, with or without food, providing flexibility to accommodate individual schedules.

Practical strategies to improve adherence include:

• Setting daily alarms or reminders on your mobile phone, smartwatch, or other devices

• Using medication reminder apps specifically designed for injection therapies

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

• Maintaining a medication diary or calendar to track daily doses

• Preparing your injection supplies the night before if you inject in the morning

For patients who travel frequently or have irregular schedules, consider keeping your Saxenda pen in an insulated medication travel case with a temperature indicator. Before first use, store the pen in a refrigerator (2-8°C). Once in use, the pen can be stored at room temperature (below 30°C) or in a refrigerator for up to one month. Keep the pen cap on to protect from light, do not freeze, do not store with the needle attached, and discard the pen 1 month after first use.

Always dispose of used needles in a prescribed sharps bin, which you can obtain from your GP or pharmacy, and return according to local arrangements.

Addressing common barriers to adherence is equally important. If injection anxiety or discomfort contributes to missed doses, discuss alternative injection sites (abdomen, thigh, or upper arm) with your healthcare provider, as rotating sites can reduce localised reactions. Some patients benefit from using the pen's dose counter to track their progress, which provides visual confirmation of medication administration.

If you consistently struggle with daily injections despite these strategies, speak openly with your GP or weight management specialist. They can explore underlying issues such as needle phobia, side effect management, or whether your treatment expectations align with the realities of long-term medication use. In some cases, alternative weight management approaches may be more suitable for your circumstances and lifestyle.

Understanding Saxenda Dosing Schedule

Saxenda treatment follows a carefully structured dose escalation schedule designed to minimise gastrointestinal side effects whilst achieving the therapeutic maintenance dose. Understanding this schedule is essential for safe and effective use of the medication, particularly if you need to restart treatment after missing multiple doses.

The standard Saxenda dose escalation protocol is:

• Week 1: 0.6 mg once daily

• Week 2: 1.2 mg once daily

• Week 3: 1.8 mg once daily

• Week 4: 2.4 mg once daily

• Week 5 onwards: 3.0 mg once daily (maintenance dose)

This gradual increase allows your gastrointestinal system to adapt to liraglutide's effects on gastric emptying and appetite regulation. Each weekly increment should only proceed if you tolerate the current dose without significant adverse effects. If you experience persistent nausea, vomiting, or other troublesome symptoms, your healthcare provider may recommend remaining at your current dose for an additional week before escalating. If dose escalation is not tolerated even after extending a step, discuss with your prescriber about continuing, delaying, or discontinuing treatment.

The maintenance dose of 3.0 mg daily is the therapeutically effective dose for weight management, as established in clinical trials. According to NICE guidance (TA664), Saxenda should be continued only if patients achieve at least 5% weight loss after 12 weeks at the maintenance dose, combined with dietary modification and increased physical activity. Treatment should be discontinued if this threshold is not met, as continued use is unlikely to provide sufficient clinical benefit.

Important dosing considerations include:

Saxenda is administered as a subcutaneous injection using a pre-filled, multi-dose pen. Each pen contains 18 mg of liraglutide in 3 ml solution, providing doses from 0.6 mg to 3.0 mg in 0.6 mg increments. The pen is designed for single-patient use only and should never be shared, even if the needle is changed, due to infection risk.

Patients should be trained on proper injection technique, including needle attachment, dose selection, injection site preparation, and safe needle disposal in a sharps container. If you are uncertain about any aspect of Saxenda administration or dosing, contact your prescriber or specialist weight management service for clarification and additional training. Proper understanding of the dosing schedule is fundamental to achieving optimal treatment outcomes whilst minimising the risk of adverse effects.

If you experience any suspected side effects from Saxenda, report them via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk or the Yellow Card app).

Frequently Asked Questions