Saxenda (liraglutide 3 mg) is a once-daily subcutaneous injection used for weight management in adults with obesity or overweight with weight-related comorbidities. Understanding the correct places to inject Saxenda is essential for optimal medication absorption, treatment effectiveness, and patient comfort. The three recommended injection sites—abdomen, thigh, and upper arm—each provide adequate subcutaneous tissue for proper drug delivery. Systematic rotation between these sites helps prevent tissue damage and ensures consistent therapeutic outcomes. This guide explains where and how to inject Saxenda safely, alongside practical advice on technique, site rotation, and managing common injection site reactions.

Recommended Injection Sites for Saxenda

Saxenda (liraglutide 3 mg) is a glucagon-like peptide-1 (GLP-1) receptor agonist administered via subcutaneous injection for weight management in adults with obesity or overweight with weight-related comorbidities. The medication is designed for self-administration using a pre-filled pen device, and selecting appropriate injection sites is essential for optimal absorption and patient comfort.

The three recommended injection sites for Saxenda are:

• Abdomen – the most commonly used site, offering a large surface area. Inject into the fatty tissue, avoiding the area immediately around the navel and any scars or bruises.

• Thigh – the front or outer aspect of the thigh provides convenient access, particularly for patients who prefer not to inject into the abdomen. Choose the upper two-thirds of the thigh for adequate subcutaneous tissue.

• Upper arm – the back of the upper arm (triceps area) can be used, though this site may be more challenging for self-injection and some patients may require assistance to ensure proper technique.

All three sites contain sufficient subcutaneous fatty tissue to allow proper absorption of liraglutide. The medication should be injected into the subcutaneous (fatty) tissue beneath the skin, not into a vein or muscle. Patients should avoid injecting into areas with visible veins, bruises, scars, stretch marks, or lumps. The injection can be administered at any time of day, with or without meals, though maintaining a consistent daily schedule helps establish routine adherence. Per the SmPC, Saxenda is used as an adjunct to a reduced-calorie diet and increased physical activity for weight management.

How to Prepare and Administer Saxenda Safely

Proper preparation and injection technique are crucial for ensuring medication efficacy, minimising discomfort, and reducing the risk of injection site complications. Before each injection, patients should follow a systematic approach to maintain safety and sterility.

Preparation steps include:

• Check the medication – examine the Saxenda pen to ensure the solution is clear and colourless. Do not use if the liquid appears cloudy, discoloured, or contains particles. Check the expiration date on the pen label.

• Gather supplies – you will need the Saxenda pen, a new disposable needle (supplied separately), and an alcohol wipe. Always use a new needle for each injection to maintain sterility and prevent needle blockage.

• Hand hygiene – wash your hands thoroughly with soap and water before handling the pen and injection supplies.

• Attach the needle – remove the pen cap, attach a new needle, and remove both the outer and inner needle caps. Perform a flow check (prime) before the first use of a new pen by dialling to the flow check symbol.

Administration technique:

Clean the chosen injection site with an alcohol wipe and allow it to dry completely. Pinch a fold of skin gently between your thumb and forefinger to lift the subcutaneous tissue away from underlying muscle. Insert the needle at a 90-degree angle using a quick, dart-like motion. Press and hold the dose button until the dose counter returns to zero, then continue holding for at least six seconds to ensure the full dose is delivered. Withdraw the needle straight out and apply gentle pressure with a clean tissue if needed—do not rub the site. Dispose of the used needle immediately in an approved sharps bin (available from your GP, pharmacy or local council). Do not dispose of needles in household waste.

The Saxenda pen should be stored in a refrigerator (2–8°C) before first use, then can be kept at room temperature (below 30°C) for up to one month. Do not freeze the pen and always keep the pen cap on when not in use to protect from light.

Rotating Injection Sites: Why It Matters

Systematic rotation of injection sites is a fundamental aspect of safe, long-term Saxenda therapy. Repeatedly injecting into the same location can lead to lipohypertrophy (fatty lumps under the skin) or lipoatrophy (loss of fatty tissue), both of which can affect medication absorption and cause cosmetic concerns. These changes in subcutaneous tissue structure may result in unpredictable liraglutide absorption, potentially compromising treatment effectiveness and weight management outcomes.

Benefits of proper site rotation include:

• Consistent absorption – healthy subcutaneous tissue ensures predictable medication uptake, maintaining stable therapeutic levels of liraglutide throughout treatment.

• Reduced tissue damage – allowing injection sites adequate recovery time prevents cumulative trauma and preserves tissue integrity.

• Decreased discomfort – rotating sites minimises tenderness, bruising, and pain associated with repeated injections in the same area.

• Prevention of lipodystrophy – avoiding the same injection points reduces the risk of developing lumps or indentations that can be permanent.

Implementing an effective rotation strategy:

Divide each recommended injection area (abdomen, thigh, upper arm) into multiple zones and keep a mental or written record of which site you used for each injection. For example, if using the abdomen, imagine dividing it into quadrants and rotate through these systematically. Maintain adequate spacing between consecutive injection points. Some patients find it helpful to alternate between different body areas (e.g., abdomen on Monday, right thigh on Tuesday, left thigh on Wednesday) whilst others prefer to use multiple sites within one area before moving to another. Regularly inspect all injection sites for any changes in appearance or texture, and avoid any areas showing signs of lipohypertrophy, bruising, or irritation until fully healed.

Common Side Effects at Injection Sites

Whilst Saxenda is generally well-tolerated, injection site reactions can occur, particularly during the initial weeks of treatment. Understanding these potential effects helps patients distinguish between normal, self-limiting reactions and those requiring medical attention. Most injection site reactions are mild, transient, and resolve without intervention.

Common injection site reactions include:

• Mild pain or stinging – brief discomfort during or immediately after injection is normal and typically subsides within minutes. Ensuring the alcohol has dried completely before injection and using proper technique can minimise this.

• Redness (erythema) – slight redness at the injection site lasting a few hours is common and usually indicates minor local irritation rather than infection.

• Bruising – small bruises may develop if the needle contacts a capillary. This is generally harmless but can be reduced by avoiding visible veins and applying gentle pressure (without rubbing) after injection.

• Itching – mild, temporary itching may occur and typically resolves spontaneously. Avoid scratching, which can introduce bacteria or cause further irritation.

• Small lumps or swelling – transient swelling at the injection site usually disappears within hours to days. Persistent lumps may indicate lipohypertrophy from inadequate site rotation.

The most common systemic side effects of Saxenda are gastrointestinal (nausea, diarrhoea, constipation, vomiting), which are related to the medication's mechanism of action rather than injection technique. These typically improve as treatment continues and dose escalation progresses gradually.

When to seek medical advice:

Contact your GP, pharmacist or prescriber if you experience persistent pain, increasing redness or warmth, discharge or pus from the injection site, fever, or signs of infection. Severe allergic reactions to Saxenda are rare but require immediate medical attention—call 999 or go to A&E if you experience difficulty breathing, severe rash, swelling of the face or throat, or rapid heartbeat. If you develop persistent lumps or notice changes in fat distribution at injection sites, discuss this with your prescriber, as adjusting your rotation pattern may be necessary. Any suspected adverse reactions should be reported via the MHRA Yellow Card Scheme to contribute to ongoing medication safety monitoring.

Frequently Asked Questions