Ozempic vs. Victoza: Key differences, side effects, and cost comparison

In this article:

• Main differences
• Conditions treated
• Efficacy
• Cost comparison
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• Main differences
• Conditions treated
• Efficacy
• Cost comparison
• Side effects
• Interactions
• Warnings
• FAQs

If you have Type 2 diabetes mellitus, your endocrinologist or primary healthcare provider may have mentioned using an injectable prescription drug to help control your blood sugar, or blood glucose. Ozempic (semaglutide) and Victoza (liraglutide) are two brand-name drugs used along with diet and exercise to control blood sugar in people with Type 2 diabetes. Both Ozempic and Victoza are made by Novo Nordisk and are approved by the U.S. Food and Drug Administration (FDA). 

Ozempic and Victoza are injectable diabetes drugs but are not insulin. They are part of a class of drugs called glucagon-like peptide-1 agonists (GLP-1 agonists). Ozempic and Victoza work by helping prevent the liver from making and releasing too much sugar, and helping the pancreas with insulin secretion in response to high blood sugar. They also delay gastric emptying, which helps control both appetite and postprandial (after a meal) blood sugar levels. They may aid weight loss, and may help to reduce body weight. Ozempic and Victoza also help with hemoglobin A1c (HbA1c) reduction, which is a measure of glucose control over time. Although both medications are GLP-1 agonists, they have some differences, which we will discuss below. 

What are the main differences between Ozempic and Victoza?

Ozempic and Victoza are both brand-name GLP-1 agonists that are available in prefilled pens. Ozempic contains the active ingredient semaglutide, and Victoza contains liraglutide. Both are injected subcutaneously, under the skin of the abdomen (stomach), upper arm, or thigh. Ozempic is injected once weekly, and Victoza is injected every day.

*SC means subcutaneous injection, which is an injection under the skin.

Conditions treated by Ozempic and Victoza

Ozempic or Victoza can be used along with lifestyle changes such as diet and exercise to improve blood sugar control, also known as glycemic control, in people with Type 2 diabetes. According to the prescribing information, Ozempic can be used in adults 18 years and older, and Victoza can be used in adults and pediatric patients 10 years and older. 

Ozempic or Victoza can also be used to lower the risk of major cardiovascular events, such as cardiovascular death, heart attack, or stroke, in adults with Type 2 diabetes who also have cardiovascular disease (heart disease).

Ozempic or Victoza are also sometimes prescribed for off-label use, which means for non-FDA-approved use, for weight reduction.

Ozempic and Victoza are not indicated for the treatment of Type 1 diabetes.

Is Ozempic or Victoza more effective?

A study comparing Ozempic and Victoza concluded that Ozempic was better than Victoza in terms of lowering HbA1C and weight; however, people who took Ozempic had more stomach-related side effects than people who took Victoza.

A 2022 review of studies compared Ozempic and Victoza in adults with obesity or overweight, but without diabetes. The researchers found that both drugs led to significant weight loss, with Ozempic showing higher success rates than Victoza. The medications were generally well-tolerated, with most side effects being mild to moderate, making them effective options for weight management in this population.

A 2019 review of studies was published in The Lancet. This study looked at Ozempic, Victoza, and other drugs in the GLP-1 agonist class. The study found that all of the drugs lowered the risk of heart problems, kidney problems, and death.

A consensus report by the American Diabetes Association and the European Association for the Study of Diabetes recommends a GLP-1 agonist as an option for people with Type 2 diabetes who have heart disease. This recommendation is based on evidence that GLP-1 agonists (or another drug class called SGLT2 inhibitors) improve cardiovascular outcomes as well as other outcomes such as kidney disease, in patients who have established heart or kidney disease.

The best drug for the patient, however, can only be determined by the health care provider, who can take into account the patient’s complete medical history.

Coverage and cost comparison of Ozempic vs. Victoza

Ozempic and Victoza may be covered by health insurance or Medicare prescription plans, but the coverage and copay will vary based on the plan. Contact your insurance provider for up-to-date coverage information. Some insurance plans require prior authorization, meaning the healthcare provider must submit additional information to the insurance company to determine if the medication will be covered.

A typical prescription of an Ozempic pen can cost around $1,317, but you can use a free SingleCare card to lower the price to about $788.

A typical prescription of a Victoza pen can cost about $1,447, but a free SingleCare coupon can lower the price to approximately $258 for generic liraglutide.

Common side effects of Ozempic vs. Victoza

The most common side effects of Ozempic are gastrointestinal (stomach) problems such as stomach pain, nausea, vomiting, diarrhea, or constipation. 

Similarly, the most common potential side effects of Victoza are also stomach-related and include nausea, vomiting, indigestion, and diarrhea or constipation, among others. 

With either drug, injection site reactions can occur. Serious side effects, such as hypoglycemia (low blood sugar), can also occur. Hypoglycemia is more likely to occur when Ozempic or Victoza is used along with insulin or certain diabetes medications (such as glimepiride) for Type 2 diabetes. Allergic reactions are rare, but are considered a medical emergency. Symptoms of hives, difficulty breathing, or swelling around the face, lips, tongue, or throat, require emergency medical attention.

A summary of common side effects is listed in the table below. This is not a full list of side effects. Contact your doctor for a full list of side effects. 

* depending on dosage

Source: Ozempic (DailyMed), Victoza (DailyMed)

Ozempic and Victoza drug interactions

Using Ozempic or Victoza with insulin or certain oral diabetes medications can increase the risk of low blood sugar. If you take this combination of medications, your prescriber may adjust the dosing of your insulin or oral medication. Also, because Ozempic and Victoza delay stomach emptying, the absorption of other medications (that are taken by mouth) may be affected if taken at the same time. When the drugs were studied, these drug interactions did not occur to a clinically relevant degree. However, it is a good idea to consult your healthcare provider about the timing of your medications. Narrow therapeutic index drugs should especially be monitored. These include drugs with a small window between therapeutic effect and toxicity such as Coumadin (warfarin), Lanoxin (digoxin), and seizure medications. 

Before taking Ozempic or Victoza, review your medication list with a healthcare provider. Be sure to tell your provider about all the medications you take, including prescription and over-the-counter medicines, vitamins, and natural products or dietary supplements.

This is not a full list of drug interactions. Consult your healthcare provider for a full list of drug interactions. 

Warnings of Ozempic and Victoza

Because both medications are in the same drug class, warnings and precautions are mostly the same. You will receive a medication guide any time you fill a prescription for Ozempic or Victoza, which goes over side effects and warnings. 

There is a boxed warning for Ozempic and Victoza, which is the most serious warning required by the FDA. In animal studies, Ozempic and Victoza have caused thyroid cancer (thyroid C-cell tumors, including medullary thyroid carcinoma (MTC)). It is unknown whether there is an increased risk of thyroid cancer in humans who take Ozempic or Victoza. Patients with a history or family history of thyroid cancer, or with multiple endocrine neoplasia syndrome Type 2 (MEN 2) should not take Ozempic or Victoza. Additionally, anyone who takes Ozempic or Victoza should call their healthcare professional right away if they have signs or symptoms of thyroid cancer such as difficulty breathing or swallowing, hoarseness, or a lump in the neck.

Other warnings include:

• Acute pancreatitis may occur. Patients should be carefully monitored for signs and symptoms of pancreatitis, which may include severe, persistent abdominal pain (which may radiate to the back), and may be accompanied by vomiting. If pancreatitis is suspected, Ozempic or Victoza should be stopped and the patient should seek medical care. If pancreatitis is confirmed, the drug should not be started again.
• Ozempic or Victoza pens should never be shared between patients, even if the needle is changed. This is due to an increased risk for transmission of blood-borne pathogens.
• Low blood sugar (hypoglycemia) may occur, and is more likely when Ozempic or Victoza is taken with insulin or certain other diabetes medication. A dose adjustment may be required. Patients should talk to their physician about low blood sugar treatment, blood sugar monitoring, and a prescription for glucagon. Glucagon can be used in an emergency low blood sugar situation. 
• Acute kidney injury or worsening of kidney failure may occur, which may require dialysis. Symptoms of kidney problems can include nausea, vomiting, diarrhea, and/or dehydration. Monitor kidney function while taking Ozempic or Victoza. 
• Call your healthcare provider right away if you have symptoms of a gallbladder problem, such as upper stomach pain, fever, clay-colored stools, or yellowing of the skin or whites of the eyes.
• Because of the potential risk to the unborn baby, Ozempic or Victoza generally should not be used in pregnancy, unless your doctor determines that the potential benefits outweigh risks. 

Frequently asked questions about Ozempic vs. Victoza

Are Ozempic and Victoza the same?

Ozempic and Victoza work the same way, but they have some differences. For example, Ozempic is injected weekly, while Victoza is injected daily. The information above outlines the similarities and differences between Ozempic and Victoza. 

Is Ozempic or Victoza better?

For managing Type 2 diabetes, many people require combination treatment, meaning they need more than one medication to control their blood sugar. Often, a GLP-1 agonist like Ozempic or Victoza is included in this combination. Both medications are considered effective in managing blood sugar levels and reducing cardiovascular risk.

In terms of weight loss, as discussed above, Ozempic may offer more significant results compared to Victoza, but it may also come with more possible side effects. Therefore, the best choice between Ozempic and Victoza will depend on individual factors. Insurance coverage and medical conditions may also play a role in this decision, so it is important to work with your healthcare provider to determine the best option for you.

Is it safe to take Ozempic and Victoza together?

Combining Ozempic with Victoza is not recommended. Because both drugs work in similar ways, using them together could increase the risk of side effects, such as low blood sugar, and nausea or other gastrointestinal side effects, without offering additional benefits.

If additional glucose control is needed, healthcare providers typically consider other classes of medications or combination therapies that work in different ways rather than using two GLP-1 receptor agonists. Consult with a healthcare provider for medical advice.

How much weight can you lose in a month on Ozempic and Victoza?

It is difficult to pinpoint an exact number, because everyone is different. The number of pounds lost each month does not always correlate with the percentage of body weight lost (for example, two people could each lose 10% of their body weight, but that would translate to different amounts of pounds). 

On average, participants in an Ozempic study lost about 5 pounds per month, which translated to a 5.9% weight loss over three months and a 10.9% loss over six months.

A small study on Victoza found that people experienced significant weight loss at 1, 3, and 6 months. About 27% of people lost 5% or more of their weight after one month, and 57% achieved this by 6 months. Those who lost weight after one month were more likely to have overall success with the treatment.

What drugs are comparable to Ozempic?

Drugs in the GLP-1 agonist class that, like Ozempic, contain semaglutide include:

• Wegovy, which is a weekly semaglutide injectable medication indicated for weight management. It is also FDA-approved to lower the risk of heart attack, stroke, and cardiovascular death in adults with heart disease and obesity or overweight.
• Rybelsus, which is a daily oral medication indicated to improve blood sugar control, along with diet and increased physical activity, in adults with Type 2 diabetes.

Other GLP-1 agonist drugs besides Ozempic and Victoza include:

• Adlyxin (lixisenatide)
• Bydureon BCise (exenatide)
• Byetta (exenatide)
• Saxenda (liraglutide) – indicated for treatment of obesity/weight loss (contains the same ingredient as Victoza)
• Trulicity (dulaglutide)