Victoza vs. Qsymia
See how Victoza and Qsymia compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Victoza is an injectable GLP-1 approved for type 2 diabetes and cardiovascular risk reduction, while Qsymia is an oral capsule approved specifically for chronic weight management.
Any weight-loss benefit from Victoza is off-label, since Saxenda is the liraglutide product actually approved for that use, whereas Qsymia is FDA-approved for weight loss from the start.
Qsymia is a controlled substance requiring REMS pharmacy dispensing and monthly pregnancy testing, while Victoza carries a boxed warning for thyroid tumor risk seen in animal studies.
Victoza vs. Qsymia Drug Summary
Victoza
Victoza (liraglutide) is a GLP-1 receptor agonist approved to improve blood sugar control in type 2 diabetes and to lower cardiovascular risk in adults with type 2 diabetes and heart disease. It is given as a once-daily subcutaneous injection, with the dose increased gradually over the first few weeks. It is not FDA-approved for weight loss, though it is sometimes used off-label for that purpose.
Qsymia
Qsymia combines phentermine, a stimulant appetite suppressant, with topiramate, an anticonvulsant, and is approved for chronic weight management. It is taken as a once-daily oral capsule, with the dose increased in stages over about 12 to 16 weeks. It is dispensed only through certified pharmacies because of a REMS program tied to pregnancy risk.
Victoza vs. Qsymia Side Effects
Victoza
Qsymia
Victoza vs. Qsymia Dosage
Victoza
Qsymia
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 3.75 mg/23 mg daily | Days 1-14 |
| Maximum dose | 15 mg/92 mg daily | Week 17 onward |
| Dose changes | 3 increases | As tolerated |
Victoza
| 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 |
Qsymia
| STAGE | DOSE | WHEN |
| Starting dose | 3.75 mg/23 mg daily | Days 1-14 |
| Maximum dose | 15 mg/92 mg daily | Week 17 onward |
| Dose changes | 3 increases | As tolerated |
Victoza vs. Qsymia Indications
Victoza
Victoza is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, and to reduce cardiovascular risk in adults with type 2 diabetes and heart disease. It is not approved for weight loss on its own, though some clinicians prescribe it off-label for that purpose, and Saxenda, a higher-dose version of the same drug, is approved specifically for weight management.
Adjunct to diet and exercise for glycemic control in type 2 diabetes
Approved for children as young as 10 with type 2 diabetes
Reduces risk of major cardiovascular events in adults with heart disease
Not approved for type 1 diabetes
Off-label weight-loss use exists, but Saxenda is the approved version for that
Qsymia
Qsymia is FDA-approved for chronic weight management in adults with obesity, in adults who are overweight with a weight-related condition, and in adolescents 12 and older with obesity. It does not treat diabetes and is not a substitute for insulin or other glucose-lowering medication. Because of teratogenicity risk, it is dispensed only through certified REMS pharmacies.
Chronic weight management in adults with obesity
Chronic weight management in adults who are overweight with a related condition
Chronic weight management in adolescents 12 and older with obesity
Not approved for use during pregnancy
Requires REMS enrollment and dispensing through certified pharmacies
Victoza vs. Qsymia Pros and Cons
Victoza
Victoza carries a boxed warning for thyroid C-cell tumors and requires a daily injection, but it is the only option here proven to lower cardiovascular risk in type 2 diabetes. It is not a controlled substance, and insurance often covers it because it treats an FDA-approved condition rather than an off-label use.
Pros
FDA-approved to lower cardiovascular risk in type 2 diabetes, not just control blood sugar
Approved for children as young as 10 with type 2 diabetes
Not a controlled substance, so no abuse-potential scheduling
Insurance often covers it since it treats an FDA-approved condition
Cons
Boxed warning for thyroid C-cell tumor risk seen in animal studies
Requires a daily injection rather than a pill
Carries a risk of acute pancreatitis
Costs more out of pocket, roughly $935 to $1,470 a month without insurance
Not FDA-approved for weight loss, so that use is off-label
Qsymia
Qsymia combines a stimulant and an anticonvulsant specifically for weight management, taken as a once-daily pill rather than an injection. As a Schedule IV controlled substance dispensed only through certified REMS pharmacies, it carries added monitoring requirements around mood, pregnancy, and heart rate.
Pros
Lower list price, roughly $200 to $350 a month without insurance
Oral capsule, no injections needed
FDA-approved specifically for chronic weight management, not off-label
Combines two mechanisms that can produce substantial weight loss for some patients
Cons
Schedule IV controlled substance with potential for abuse and dependence
Not approved for use during pregnancy and requires monthly pregnancy testing
Available only through certified REMS pharmacies, limiting where it can be filled
Risk of increased heart rate, mood changes, and word-finding difficulty
Contraindicated with glaucoma, hyperthyroidism, and MAOIs
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