What is the strongest dose of Saxenda? The maximum recommended daily dose of Saxenda (liraglutide) for weight management in the UK is 3 mg, administered as a single subcutaneous injection. This represents the therapeutic ceiling proven effective in clinical trials and approved by the MHRA. Doses above 3 mg daily are not recommended and have not been studied for safety or efficacy. Patients reach this maintenance dose through a gradual five-week escalation schedule, starting at 0.6 mg and increasing weekly to improve tolerability. Understanding proper dosing is essential for safe, effective treatment under specialist supervision in accordance with NICE guidance.

What Is Saxenda and How Does It Work?

Saxenda (liraglutide 3 mg) is a prescription-only medicine licensed in the UK for weight management in adults with obesity (BMI ≥30 kg/m²) or those who are overweight (BMI ≥27 kg/m²) with weight-related health conditions. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which were originally developed for type 2 diabetes management but have proven effective for weight loss at higher doses.

The medication works through several complementary mechanisms. Liraglutide mimics the action of GLP-1, a naturally occurring hormone released by the intestines after eating. By activating GLP-1 receptors in the brain, particularly in areas that regulate appetite, Saxenda helps to:

• Reduce hunger and increase feelings of fullness (satiety)

• Slow gastric emptying, meaning food stays in the stomach longer

• Decrease food intake and appetite

Saxenda is administered as a once-daily subcutaneous injection using a pre-filled pen device. Patients inject the medication themselves into the abdomen, thigh, or upper arm. It is important to understand that Saxenda is not a standalone solution—it must be used as an adjunct to a reduced-calorie diet and increased physical activity as part of a comprehensive weight management programme.

Clinical trials have demonstrated that when combined with lifestyle modifications, Saxenda can help patients achieve clinically significant weight loss (typically defined as at least 5% of initial body weight). However, individual responses vary, and the medication is most effective when patients commit to long-term dietary and behavioural changes.

In the NHS, Saxenda is typically prescribed through specialist weight management services in accordance with NICE guidance (TA664). Treatment should only be initiated and supervised by healthcare professionals experienced in weight management.

Maximum Recommended Dose of Saxenda in the UK

The strongest and maximum recommended daily dose of Saxenda is 3 mg, administered as a single subcutaneous injection. This is the therapeutic dose proven effective for weight management in clinical trials and is the target maintenance dose for most patients. According to the UK Summary of Product Characteristics (SmPC) approved by the MHRA, doses above 3 mg daily are not recommended and have not been studied for safety or efficacy.

It is crucial to understand that patients do not start at this maximum dose. The 3 mg dose is reached through a gradual dose escalation schedule designed to improve gastrointestinal tolerability. The standard titration 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 mg once daily (maintenance dose)

This stepped approach allows the body to adapt to the medication and significantly reduces the risk of common side effects such as nausea, vomiting, and diarrhoea. Each weekly increase should only proceed if the previous dose has been well tolerated.

The 3 mg daily dose represents the ceiling for Saxenda therapy. Some patients may wonder whether taking more would produce greater weight loss, but there is no evidence to support this, and doing so would increase the risk of adverse effects without additional benefit. Healthcare professionals will not prescribe doses exceeding 3 mg daily, as this falls outside the licensed indication and evidence base.

If you miss a dose, take Saxenda as soon as you remember within 12 hours of when you usually take it. If more than 12 hours have passed, skip that dose and take your next dose as normal the following day. Do not take an extra dose or increase the dose to make up for a missed dose.

How to Safely Increase Your Saxenda Dose

Safe dose escalation is fundamental to successful Saxenda treatment. The gradual weekly increases are not merely suggestions—they are evidence-based recommendations designed to minimise side effects whilst allowing your body to adjust to the medication's effects on your digestive system and appetite regulation.

Follow the prescribed schedule precisely:

• Increase your dose only after completing a full week at the current level

• Do not skip dose levels or accelerate the titration schedule

• Take your injection at approximately the same time each day for consistency

• Rotate injection sites (abdomen, thigh, upper arm) to reduce injection site reactions

If you experience troublesome gastrointestinal side effects (nausea, vomiting, diarrhoea, or constipation) during dose escalation, discuss this with your prescriber before increasing to the next level. They may recommend:

• Delaying the increase by one additional week at your current dose

• Implementing dietary modifications (smaller, more frequent meals; avoiding high-fat foods)

• Temporarily reducing the dose if side effects become intolerable

It is important to note that the target maintenance dose is 3 mg daily. If you cannot tolerate the 3 mg dose despite slower escalation or temporary dose reductions, your healthcare provider may need to reassess whether Saxenda is suitable for you. According to NICE guidance, treatment should be discontinued if you do not achieve at least 5% weight loss after 12 weeks at the 3 mg daily dose.

Never adjust your Saxenda dose without medical guidance. Self-directed dose changes can compromise treatment effectiveness and increase the risk of adverse effects. If you have concerns about your current dose or are experiencing side effects, contact your prescribing clinician for advice rather than making changes independently.

Do not use Saxenda alongside other GLP-1 receptor agonist medications (such as Ozempic, Trulicity, or Byetta), as this can increase the risk of side effects.

What Happens If You Take Too Much Saxenda?

Saxenda overdose, whilst uncommon, can occur through accidental administration of too much medication or taking multiple doses in a single day. Understanding the potential consequences and knowing how to respond is essential for patient safety.

Symptoms of Saxenda overdose primarily involve gastrointestinal effects due to the medication's mechanism of action. According to the UK SmPC, these may include:

• Severe nausea and persistent vomiting

• Abdominal pain or cramping

• Diarrhoea, potentially leading to dehydration

• Hypoglycaemia (low blood sugar), particularly in patients also taking insulin or sulfonylurea medications

• Dizziness, weakness, or rapid heartbeat (secondary to dehydration)

The risk of hypoglycaemia is generally low unless Saxenda is used alongside other diabetes medications that lower blood glucose.

If you suspect you have taken too much Saxenda:

• Contact NHS 111 immediately or attend your local A&E department

• Do not take another dose until you have received medical advice

• Monitor for signs of hypoglycaemia if you take diabetes medications (shakiness, sweating, confusion, rapid heartbeat)

• Stay well hydrated if experiencing vomiting or diarrhoea

Seek urgent medical attention if you develop severe, persistent abdominal pain (with or without vomiting), as this could indicate pancreatitis, a rare but serious side effect of GLP-1 receptor agonists.

Medical management of Saxenda overdose is primarily supportive, focusing on symptom control and monitoring. There is no specific antidote. Healthcare professionals will monitor blood glucose levels, assess hydration status, and provide anti-emetic medications if needed. Most patients recover fully with appropriate supportive care, but medical assessment is essential to rule out serious complications and ensure safe recovery.

If you experience any suspected side effects from Saxenda, report them to the MHRA through the Yellow Card Scheme (yellowcard.mhra.gov.uk).

Who Should Not Use the Maximum Saxenda Dose?

Whilst the 3 mg daily dose is the standard maintenance target for Saxenda therapy, certain patient groups may require additional caution due to increased risk of adverse effects or specific contraindications.

Patients who should use Saxenda with particular caution include:

• Those with severe gastrointestinal disease: Individuals with gastroparesis or other severe gastrointestinal conditions require careful monitoring due to potential worsening of symptoms

• Elderly patients (aged 75 and over): The UK SmPC advises caution in this age group due to limited clinical data, though no specific dose adjustment is recommended

• Patients with renal impairment: Whilst no dose adjustment is officially required for mild to moderate renal impairment, those with severe renal impairment or end-stage renal disease have limited safety data and require careful monitoring

• Those at risk of dehydration: Patients experiencing gastrointestinal side effects should maintain adequate fluid intake to prevent dehydration

According to the UK SmPC, Saxenda is contraindicated in:

• Pregnancy (women should use contraception during treatment)

• Hypersensitivity to liraglutide or any excipients

Breastfeeding is not recommended during Saxenda treatment.

Additionally, NICE guidance recommends discontinuing Saxenda if patients do not achieve at least 5% weight loss after 12 weeks at the 3 mg daily dose, as continued treatment is unlikely to provide meaningful benefit. If the 3 mg dose cannot be tolerated despite slower titration and temporary dose adjustments, discontinuation should be considered rather than maintaining a lower dose long-term.

Regular monitoring is essential for all patients on Saxenda, particularly those at the maximum dose. Your healthcare provider should review your progress, side effects, and overall health status at regular intervals. If you develop severe, persistent abdominal pain (with or without vomiting), stop taking Saxenda and seek immediate medical attention, as this could indicate pancreatitis.

If you develop new health conditions whilst taking Saxenda, discuss these with your healthcare provider promptly to ensure your treatment remains safe and effective.

Frequently Asked Questions