If you've missed a dose of Saxenda (liraglutide), knowing how to respond correctly is essential for safe and effective weight management. Saxenda is a once-daily GLP-1 receptor agonist injection used alongside diet and exercise for weight loss in adults with obesity or overweight with weight-related health conditions. Missing doses can temporarily reduce appetite control, whilst taking incorrect doses may cause significant side effects. This article provides clear, evidence-based guidance on what to do when you miss your Saxenda injection, how to prevent future missed doses, and when to seek medical advice, aligned with UK prescribing information and MHRA safety guidance.

What to Do If You Miss a Dose of Saxenda

If you miss your daily dose of Saxenda (liraglutide), the recommended action depends on when you remember. If you notice within 12 hours of your usual injection time, you should administer the missed dose as soon as possible. However, if more than 12 hours have passed, you should skip the missed dose entirely and resume your normal schedule the following day at your regular time.

It is crucial that you never take two doses of Saxenda on the same day to compensate for a missed injection. Taking a double dose significantly increases your risk of experiencing adverse effects, particularly gastrointestinal symptoms such as severe nausea, vomiting, and diarrhoea. These side effects can be distressing and may lead to dehydration or other complications requiring medical attention.

If you have missed three or more consecutive days, you should restart at 0.6 mg once daily and follow the weekly dose escalation schedule again (increasing by 0.6 mg weekly until reaching your maintenance dose). This follows the official guidance to minimise side effects, as Saxenda requires gradual dose escalation.

When to seek medical advice:

• If you experience severe, persistent abdominal pain (possible pancreatitis) – stop Saxenda immediately and seek urgent medical attention

• If you experience severe nausea, vomiting, or abdominal pain after resuming Saxenda

• If you are uncertain about how to proceed after missing multiple doses

• If you have concerns about your blood glucose levels (particularly relevant for patients with type 2 diabetes)

Keeping a record of any missed doses and discussing patterns with your healthcare provider can help identify barriers to adherence and allow for personalised strategies to improve compliance with your treatment regimen.

If you experience any suspected side effects, you can report them through the MHRA Yellow Card scheme.

Understanding Saxenda Dosing Schedule and Timing

Saxenda is administered as a once-daily subcutaneous injection that can be given at any time of day, with or without meals. The flexibility in timing is one of the medication's advantages, but consistency is key—you should aim to inject Saxenda at approximately the same time each day to maintain steady therapeutic levels and establish a reliable routine.

The medication follows a structured dose-escalation schedule designed to improve gastrointestinal tolerability. Treatment typically begins at 0.6 mg daily for the first week, then increases weekly by 0.6 mg increments until reaching the maintenance dose of 3.0 mg daily by week five. This gradual titration allows your body to adapt to liraglutide's effects on gastric emptying and appetite regulation, significantly reducing the likelihood of severe nausea and vomiting.

Mechanism of action: Saxenda contains liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by mimicking the natural hormone GLP-1, which regulates appetite and food intake. Liraglutide slows gastric emptying, increases feelings of satiety, and reduces hunger signals in the hypothalamus. These combined effects support weight reduction when used alongside a reduced-calorie diet and increased physical activity.

The pharmacokinetics of liraglutide mean that steady-state concentrations are achieved after approximately three days of consistent daily dosing. A single missed dose may temporarily reduce appetite control but is not usually dangerous. The half-life of liraglutide is approximately 13 hours, which supports once-daily administration.

Patients should inject Saxenda into the abdomen, thigh, or upper arm, rotating injection sites to reduce local skin reactions or lumps. The injection can be administered at any time that suits your daily routine, whether morning, afternoon, or evening, provided you maintain consistency. Always use a new needle for each injection, never share pens with others, and dispose of used needles in a proper sharps container.

Risks of Taking Double Doses or Incorrect Timing

Taking a double dose of Saxenda or administering doses too close together poses significant health risks and should be strictly avoided. The most common consequences involve gastrointestinal adverse effects, which can be severe and debilitating. Patients who accidentally take excessive doses frequently experience intense nausea, persistent vomiting, severe abdominal pain, and diarrhoea. These symptoms can lead to dehydration, electrolyte imbalances, and may necessitate emergency medical treatment.

Hypoglycaemia risk is another important consideration. When Saxenda is used alone, the risk of hypoglycaemia is low. However, the risk increases significantly when Saxenda is taken alongside sulphonylureas or insulin. If you are taking these medications, your doctor may need to reduce your sulphonylurea or insulin dose to prevent low blood sugar episodes. Symptoms of hypoglycaemia include trembling, sweating, confusion, palpitations, and in severe cases, loss of consciousness.

GLP-1 receptor agonists like Saxenda have been associated with pancreatitis in some patients during routine use, though a causal relationship has not been established. Warning signs of pancreatitis include:

• Severe, persistent abdominal pain that may radiate to the back

• Nausea and vomiting that doesn't resolve

• Fever and rapid pulse

If you develop symptoms suggesting pancreatitis, stop taking Saxenda immediately and seek urgent medical attention.

If you accidentally take a double dose, contact NHS 111 or your GP immediately for advice. Call 999 or attend A&E if you experience severe vomiting, dehydration, confusion, or severe abdominal pain. Monitor yourself closely for adverse effects, particularly during the first 24 hours. Do not attempt to skip subsequent doses to "balance out" the error—simply return to your normal schedule as directed by healthcare professionals.

Incorrect timing between doses (taking them too close together) essentially creates the same risks as a double dose. Always ensure at least 24 hours between Saxenda injections to maintain safe therapeutic levels and minimise adverse effects.

Remember that Saxenda should not be used with other GLP-1 receptor agonists.

Preventing Missed Doses: Practical Tips and Reminders

Establishing reliable strategies to remember your daily Saxenda injection significantly improves treatment adherence and outcomes. Linking your injection to an established daily routine is one of the most effective approaches—consider administering Saxenda when you brush your teeth, have breakfast, or before bedtime. This habit-stacking technique creates a mental association that makes the injection feel like a natural part of your day.

Technology-based reminders offer excellent support for medication adherence:

• Set a daily alarm on your smartphone at your chosen injection time

• Use medication reminder apps that track doses and send notifications

• Enable calendar alerts with recurring daily events

• Consider smart home devices (like Alexa or Google Home) for verbal reminders

Many patients find success with visual cues placed in frequently visited locations. Keep your Saxenda pen in a consistent location where you'll see it at your designated injection time, while ensuring it's stored safely away from direct heat/sunlight and out of reach of children. Some people place a note on their bathroom mirror, refrigerator, or bedside table as a prompt.

Preparation and planning are essential, particularly when travelling or during schedule disruptions:

• Always carry your Saxenda pen when away from home

• Store backup pens according to manufacturer guidelines

• Set reminders that account for time zone changes when travelling

• Inform family members or housemates about your medication schedule so they can provide gentle reminders

Proper storage is crucial for maintaining medication effectiveness:

• Before first use: Store in a refrigerator (2°C to 8°C); do not freeze

• After first use: Can be kept at room temperature (below 30°C) or refrigerated for up to 1 month

• Always keep the pen cap on when not in use to protect from light

• Discard the pen 1 month after first use, even if some solution remains

Maintaining adequate supplies prevents missed doses due to running out of medication. Request prescription renewals at least one week before your current supply depletes. Keep track of how many doses remain in each pen—Saxenda pens contain multiple doses, and the dose counter helps monitor remaining medication.

If you frequently miss doses despite these strategies, discuss this openly with your healthcare provider. There may be underlying barriers to adherence that require addressing, or alternative weight management approaches might be more suitable for your circumstances. Your GP or specialist weight management service can provide additional support and resources tailored to your individual needs.

Frequently Asked Questions