Victoza vs. Actos

See how Victoza and Actos compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Victoza is a once-daily injectable GLP-1 that also lowers cardiovascular risk, while Actos is a once-daily pill without that added approval.

  • Actos costs far less out of pocket than Victoza but carries a boxed warning for heart failure that Victoza does not share.

  • Both drugs avoid causing low blood sugar on their own, but they differ sharply in how they are taken and in their most common side effects.

Victoza vs. Actos Drug Summary

Victoza

Victoza (liraglutide) is a GLP-1 receptor agonist used to improve blood sugar control in adults and children 10 and older with type 2 diabetes. It is also approved to lower the risk of heart attack, stroke, and cardiovascular death in adults with heart disease. It comes as a once-daily injection that is titrated up over three weeks.

Actos

Actos (pioglitazone) is a thiazolidinedione taken as a once-daily pill to help control blood sugar in adults with type 2 diabetes, either alone or with other medications. It has been available since 1999 and now comes in an inexpensive generic form. Doctors sometimes prescribe it off-label for nonalcoholic fatty liver disease.

Victoza vs. Actos Side Effects

Victoza

Most common
diarrhea (up to 11.7%)
nausea (≥5%)
vomiting (≥5%)
decreased appetite (≥5%)

Actos

Most common
headache (9.1%)
sinusitis (6.3%)
myalgia (5.4%)
tooth disorder (5.3%)

Victoza vs. Actos Dosage

Victoza

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.6 mg once daily Week 1
Maximum dose 1.8 mg once daily Week 3 onward
Dose changes 2 increases Every week

Actos

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 15 mg once daily At the start
Maximum dose 45 mg once daily If needed
Dose changes 2 increases As tolerated

Victoza vs. Actos Indications

Victoza

Victoza is FDA-approved to improve blood sugar control alongside diet and exercise in adults and children 10 and older with type 2 diabetes. It also carries an approval to reduce the risk of heart attack, stroke, and cardiovascular death in adults with type 2 diabetes and known heart disease. It is not approved for type 1 diabetes.

  • Type 2 diabetes glycemic control in adults and children 10+

  • Reduces risk of heart attack, stroke, and cardiovascular death

  • Used alongside diet and exercise

  • Not approved for type 1 diabetes

Actos

Actos is FDA-approved to control blood sugar in adults with type 2 diabetes, used alone or combined with other diabetes medications. It is not approved for type 1 diabetes or diabetic ketoacidosis. Doctors sometimes prescribe it off-label for nonalcoholic fatty liver disease.

  • Type 2 diabetes glycemic control in adults

  • Can be used as monotherapy or combination therapy

  • Off-label use for nonalcoholic fatty liver disease

  • Not approved for type 1 diabetes or DKA

Victoza vs. Actos Pros and Cons

Victoza

Victoza offers cardiovascular protection that few oral diabetes pills provide, but it requires daily self-injection and carries a thyroid tumor warning. Insurance coverage varies, and the list price is notably higher than many oral options like Actos.

Pros

  • Also lowers cardiovascular event risk in heart disease

  • Approved for children 10 and older with type 2 diabetes

  • Often causes meaningful weight loss as a side benefit

  • No boxed warning for heart failure, unlike Actos

Cons

  • Requires a daily injection rather than a pill

  • Boxed warning for thyroid C-cell tumor risk

  • Carries risk of acute pancreatitis

  • Roughly $935 to $1,470 per month without insurance

Actos

Actos is a low-cost oral pill that has been available as a generic for years, making it accessible for many patients. Its boxed warning for heart failure and long-term bladder cancer risk mean it is not suitable for everyone, and it lacks the cardiovascular benefit data Victoza has.

Pros

  • Taken as a once-daily oral tablet, no injections

  • Available as an inexpensive generic

  • No boxed warning for thyroid tumors or pancreatitis

  • Roughly $588 to $700 per month without insurance

Cons

  • Boxed warning for causing or worsening heart failure

  • Increased risk of bladder cancer with long-term use

  • Increased fracture risk in women

  • No proven cardiovascular risk reduction

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