Liraglutide Withdrawal and Discontinuation Syndrome: What to Expect When You Stop

Does liraglutide cause withdrawal?

No withdrawal or discontinuation syndrome is described in the current Saxenda or Victoza labels [1][3]. Weight regain after stopping was greater with liraglutide than with placebo in a trial of adolescents [2].

Liraglutide is an acylated human GLP-1 receptor agonist with 97% amino acid sequence homology to native GLP-1, stable against DPP-4 and neutral endopeptidase degradation, with a plasma half-life of about 13 hours after subcutaneous injection [1]. GLP-1 is a physiological regulator of appetite and calorie intake, GLP-1 receptors sit in brain areas involved in appetite regulation, and liraglutide delays gastric emptying [1].

What the trials show after stopping

Saxenda reaches peak concentration about 11 hours after a dose and has a half-life of about 13 hours [1]. Saxenda and Victoza are once-daily injections [1][3].

The change documented in a controlled trial after treatment ended is weight. In SCALE Teens, 251 adolescents with obesity were assigned to liraglutide 3 mg (125 participants) or placebo (126), alongside lifestyle therapy [2]. At week 56, BMI had fallen at least 5% in 43.3% of the liraglutide group versus 18.7% of the placebo group, and at least 10% in 26.1% versus 8.1% [2]. The trial then followed participants for 26 weeks off treatment, and weight regain after stopping was greater with liraglutide than with placebo [2].

SCALE Diabetes randomized 846 adults with overweight or obesity and type 2 diabetes to liraglutide 3.0 mg, 1.8 mg or placebo for 56 weeks, with a 12-week observational off-drug follow-up [6]. The weight-loss figures reported there for week 56 (6.0% with 3.0 mg, 4.7% with 1.8 mg and 2.0% with placebo) were measured before treatment ended, so they do not describe the period after stopping [6].

A larger regain figure comes from a semaglutide trial, not a liraglutide one. The STEP 1 extension included 327 participants; mean weight loss from week 0 to week 68 was 17.3% with semaglutide and 2.0% with placebo, and after treatment was withdrawn the semaglutide group regained 11.6 percentage points by week 120, leaving a net loss of 5.6% from week 0 [7]. The authors summarized this as regain of about two-thirds of prior weight loss [7].

For the other end of treatment, the Saxenda label has a stopping rule of its own: weight is evaluated at 16 weeks, and treatment is stopped if less than 4% of baseline body weight has been lost [1].

Victoza: labeled uses and LEADER

Victoza's labeled uses are glycemic control in adults and children aged 10 and older with type 2 diabetes, and reducing the risk of cardiovascular death, non-fatal heart attack or non-fatal stroke in adults with type 2 diabetes and established cardiovascular disease [3]. In LEADER, 9,340 adults with type 2 diabetes and high cardiovascular risk were followed for a median of 3.8 years; the primary composite occurred in 13.0% of the liraglutide group versus 14.9% of the placebo group (hazard ratio 0.87, 95% CI 0.78 to 0.97) [8].

The Victoza label flags hypoglycemia when liraglutide is combined with insulin or an insulin secretagogue such as a sulfonylurea, and says that when starting Victoza, the dose of the secretagogue or insulin may be reduced to lower the risk [3].

Mood and the suicidal ideation warning

In January 2026 the FDA asked the makers of Saxenda, Wegovy and Zepbound to remove suicidal ideation and behavior language from their labels, after a review that included a meta-analysis of 91 placebo-controlled GLP-1 receptor agonist trials (107,910 patients) and a claims cohort of 2,243,138 new users, finding no increased risk [4]. The current Saxenda label, effective 2026-02-25, contains no such warning [1], and the current Victoza label does not include a suicidal ideation or behavior warning [3].

Older versions of the Saxenda label did. The version dated 2024-01-26 told prescribers to monitor for depression or suicidal thoughts and to discontinue the drug if symptoms developed [9].

During treatment, depression was reported by 4% of adolescents on Saxenda versus 2.4% on placebo in the pediatric trial table [1].

Stopping, restarting and gaps between doses

The labels are specific about what to do after a gap in dosing. For Saxenda, if more than 3 days have passed since the last dose, the label says to restart at 0.6 mg and work back up through the titration schedule [1]. Saxenda's titration runs 0.6 mg daily for one week, then 1.2 mg, 1.8 mg, 2.4 mg, and 3 mg daily from week 5; the lower doses are for titration only, and the label says to discontinue if the 3 mg dose is not tolerated [1]. Victoza is titrated from 0.6 mg to 1.2 mg and, if more control is needed, to a maximum of 1.8 mg daily, with at least a week at each step [3].

Two situations in the labeling call for discontinuation. If acute pancreatitis is suspected, the labels say to discontinue and manage appropriately [1][3]. If a hypersensitivity reaction occurs, the labels say to discontinue [1][3].

Pregnancy is a third. The Saxenda label says to discontinue when pregnancy is recognized, and the Victoza label says the drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus [1][3].

Which liraglutide were you taking?

Generic liraglutide is FDA-approved. Generics that reference Saxenda carry the weight-management label — for example Teva (ANDA 214568), Biocon (ANDA 217063) and Cipla (ANDA 217234) — while generics that reference Victoza carry the type 2 diabetes label, including Hikma (ANDA 215503), Lupin, Meitheal/NorthStar and a Teva authorized generic [5]. The two labels differ in indication and dose: 3 mg daily for weight management, up to 1.8 mg daily for diabetes [1][3].