Victoza (liraglutide) alternatives: What can I take instead of Victoza?

In this article:

• What can I take in place of Victoza?
• Compare Victoza alternatives
• Top 5 Victoza alternatives
• Natural alternatives to Victoza
• How to switch to a Victoza alternative

In this article

• What can I take in place of Victoza?
• Compare Victoza alternatives
• Top 5 Victoza alternatives
• Natural alternatives to Victoza
• How to switch to a Victoza alternative

Victoza (liraglutide) is a glucagon-like peptide-1 (GLP-1) agonist medication approved by the U.S. Food and Drug Administration (FDA) to help manage Type 2 diabetes by mimicking a natural hormone for blood sugar control. Victoza use comes with a black box warning due to potential risks that include acute pancreatitis and an increased risk of thyroid cancer. Gastrointestinal side effects, such as diarrhea, nausea, vomiting, and possible limitations in insurance coverage, may lead some patients to consider alternative treatment options.

What can I take in place of Victoza?

Approximately 10% of the American population has diabetes mellitus, with the vast majority living with Type 2 diabetes. While both Type 1 and Type 2 diabetes result in blood sugar level issues, the main difference is that Type 2 diabetes develops over years and most commonly affects adults 45 years of age or older. New and effective options are continually emerging for managing blood sugar in Type 2 diabetes. Victoza is available only as an injectable drug and is a first-line prescription for those with additional medical conditions like heart disease, increased risk of heart attack, or kidney function problems. 

A benefit of the GLP-1 receptor agonist class of medication is its low likelihood of causing low blood sugar as a side effect when used as monotherapy. However, many more medication options are available for those who are unable or do not want to self-inject or tolerate the common side effect profile of Victoza. The alternative treatments include other types of GLP-1 agonists, plus other medication classes like biguanides, sulfonylureas, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors. Insulin also remains an option. 

Other alternatives to Victoza

• Alpha-glucosidase inhibitors 
  • Precose (acarbose) 
  • Glyset (miglitol) 
• Amylin analog
  • Symlin (pramlintide) 
• DPP-4 inhibitors
  • Nesina (alogliptin) 
  • Onglyza (saxagliptin) 
  • Januvia (sitagliptin) 
• GLP-1 agonists 
  • Trulicity (dulaglutide) 
  • Adlyxin (lixisenatide)
  • Bydureon Bcise (exenatide) 
• SGLTs inhibitors 
  • Farxiga (dapagliflozin) 
  • Jardiance (empagliflozin) 
  • Steglatro (ertugliflozin) 
• Sulfonylureas 
  • Amaryl (glimepiride) 
  • Glynase (glyburide) 
  • Glucotrol (glipizide) 
• Thiazolidinedione 
  • Actos (pioglitazone) 

Top 5 Victoza alternatives

The following are some of the most common alternatives to Victoza.

1. Ozempic (semaglutide)

Ozempic is another glucagon-like peptide-1 receptor agonist that exerts its mechanism of action in different ways, including increasing insulin secretion in response to elevated blood glucose, decreasing glucagon secretion, and slowing gastric emptying. Ozempic may have a greater reduction in A1c versus Victoza and may be a better option in those individuals most overweight and with more severe disease. Ozempic may be more desirable for some individuals since it requires only weekly subcutaneous injections, whereas Victoza requires daily injections. 

2. Glumetza (metformin ER)

Metformin is the only member of the biguanide drug class available in a few different formulations, such as immediate-release, extended-release, and oral solution. Metformin works by inhibiting glucose production and absorption, increasing insulin sensitivity in muscle and fat. Metformin remains a strong contender in initial oral Type 2 diabetes management for most individuals, given its extensive history of use and safety. However, it must be used with a healthy diet and exercise for glucose control. Metformin does not directly reduce cardiovascular or kidney disease risk but may reduce cardiovascular events and mortality. 

Metformin is co-formulated with members of other medication classes, including SGLT2 inhibitors, DPP-4 inhibitors, and sulfonylureas. It may also be given in conjunction with insulin, lessening the weight gain associated with it. Access to GLP-1 agonists, including Victoza and Ozempic, may also be an issue for some individuals. Shortages or costs (whether insurance co-pays or cash) have been ongoing issues for GLP-1 agonists. At the same time, metformin and its formulations are often available as generic oral medicine with a more favorable cost profile. Metformin does come with its possible side effects and should be avoided in those with renal impairment and excessive alcohol intake.

3. Invokana (canagliflozin)

Invokana (canagliflozin), an SGLT2 inhibitor, is now a first-line option for Type 2 diabetes patients with cardiovascular disease, high cardiovascular risk, heart failure, or chronic kidney disease (CKD), regardless of baseline A1C, according to the 2022 American Diabetes Association (ADA) Standards of Care in Diabetes. This was the first iteration of these guidelines to offer first-line recommendations based on patient comorbidities.

SGLT2 inhibitors like Invokana are recommended for patients with Type 2 diabetes. The reasoning behind this recommendation is the ability of the medication class to slow CKD progression and reduce the risk of cardiovascular events like heart attacks independent of their blood glucose-lowering effects. The SGLT2 inhibitors block glucose and sodium reabsorption in the kidney, increasing urinary excretion of glucose, sodium, and uric acid. Therefore, this class of medications does come with the possibility of causing genital yeast infections and urinary tract infections. To initiate Invokana, patients must have renal function above a certain threshold, and the dose depends on the renal function range.

4. Tradjenta (linagliptin)

Tradjenta (linagliptin) is a DPP-4 inhibitor medication class member, sometimes called an incretin enhancer. DPP-4 inhibitors increase insulin secretion in response to elevated blood glucose, decrease glucagon secretion, and slow gastric emptying. These medications are well tolerated but are generally not recommended as first-line options. Tradjenta also comes with CYP3A4 drug interactions, so medication lists should be thoroughly reviewed with a healthcare professional before initiation. Unlike the other members of DPP-4 inhibitors and other non-insulin antihyperglycemic medications, Tradjenta’s prescribing information does not recommend dose adjustments based on kidney function. 

5. Mounjaro (tirzepatide)

Mounjaro (tirzepatide) is the sole member of a class known as GLP-1 agonist and glucose-dependent insulinotropic polypeptide (GIP). Its mechanism of action is similar to GLP-1 drugs, but its dual mechanism results in more weight loss and greater A1C reduction than most GLP-1 agonists. Mounjaro can also impact the absorption of other medications. Oral contraceptive absorption can be delayed when on Mounjaro, so doctors should advise their patients to switch to a non-oral contraceptive or add a barrier contraceptive for four weeks after initiation of each dosage increase. 

Natural alternatives to Victoza

Lifestyle modifications remain the cornerstone of a comprehensive healthcare approach to managing Type 2 diabetes. The most important changes to incorporate include losing weight if overweight, healthy eating, and regular physical activity. Similarly, kicking bad habits like smoking cigarettes and keeping stress levels low can also play a role. 

Given the recent hype around GLP-1 agonists like Saxenda and Wegovy inducing weight loss, some have raised the question of whether a dietary supplement known as berberine works for weight loss, which may secondarily assist in managing diabetes control. Berberine is a bitter-tasting chemical found in many plants, and research in animals suggests consumption increased GLP-1 secretion. However, the evidence in humans remains close to null, and the evidence that does exist has many important limitations, including that none were conducted in overweight patients. The existing data also shows an incredibly modest benefit, including consumption of berberine for up to two years resulting in reduced weight by about 4.5 pounds and waist circumference by 1 cm compared with placebo, lifestyle changes, or no intervention. Evidence also demonstrated modest reductions in A1c, fasting glucose, and postprandial (following meal) blood glucose when taken alone or with other diabetes medications. 

How to switch to a Victoza alternative

Switching Type 2 diabetes medications can be a little tricky, especially when dealing with injectables. Changes should only occur with medical help, under the guidance of a healthcare provider, and with close monitoring of blood glucose levels to avoid any potential negative effects. When switching between two GLP-1 agonists, one should be aware of differences in pharmacology, like the drug’s half-life, which allows varying administration schedules, for example, once daily with Victoza to once weekly with Ozempic. In general, many healthcare professionals also suggest adherence to the recommended dose titration within the prescribing information of GLP-1 receptor agonists for each agent to minimize potential risks of side effects. Transitioning from injectables to orals should start with the next injectable dose. For educational purposes, always talk to your healthcare provider or pharmacist to outline a plan with monitoring parameters and familiarize yourself with potential side effects.