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

Most common
Diarrhea (up to 11.7%)
Nausea (≥5%)
Vomiting (≥5%)
Decreased appetite (≥5%)

Qsymia

Most common
Paresthesia (up to 21%)
Dry mouth (up to 19%)
Constipation (up to 16%)
Insomnia (up to 11%)

Victoza vs. Qsymia 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

Qsymia

Dosage
Dosage Table
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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