Converting from Wegovy to Saxenda: Dosage, Cost and Weight Loss Differences

Switching from Wegovy to Saxenda: What to Know

Wegovy and Saxenda are two injectable medications used for chronic weight management. Both contain the active ingredient semaglutide and work by suppressing appetite. However, Wegovy is a higher dose approved specifically for weight loss, while Saxenda is a lower dose approved for both diabetes and weight loss.

If you have been taking Wegovy but need to switch to Saxenda, either due to side effects, insurance coverage, or cost issues, here is what you need to know about converting between the two drugs.

Uses of Wegovy vs. Saxenda

Wegovy and Saxenda share the same active ingredient, semaglutide, but are approved for slightly different uses:

• Wegovy - Approved in 2021 specifically for chronic weight management as an adjunct to diet and exercise in adults with obesity or overweight with at least one weight-related condition. Dosed at 2.4mg once weekly.
• Saxenda - Approved in 2014 for treatment of obesity along with diet and exercise. Also approved for glycemic control in adults with type 2 diabetes. Dosed at 3mg daily.

While the two medications contain the same semaglutide compound, Saxenda is an older, lower dose drug also able to treat diabetes, not just obesity.

Reasons for Switching from Wegovy to Saxenda

There are several reasons your doctor may recommend changing from Wegovy to Saxenda treatment:

• Insurance coverage - Saxenda is more widely covered by insurance plans than the newer Wegovy.
• High cost of Wegovy - Saxenda is significantly cheaper without insurance discounts.
• Side effects - The lower Saxenda dose may result in fewer side effects.
• Need diabetes treatment - Saxenda can treat both weight issues and diabetes.

Talk to your doctor to determine if switching to Saxenda makes sense given your weight loss progress, side effect profile, and insurance coverage status.

How to Switch from Wegovy to Saxenda

When transitioning from Wegovy to Saxenda, your doctor will create a conversion dosage plan and schedule. Here are some general guidelines for switching:

Timing

There are a couple options for when to initiate the medication switch:

• Switch immediately at the time your next Wegovy dose was due.
• Delay starting Saxenda for several days or weeks to allow the effects of the last Wegovy dose to taper off.

Discuss the timing with your doctor based on your previous dosage, response, and preference.

Starting Saxenda Dose

Saxenda is dosed daily rather than weekly. Your doctor will determine an appropriate daily Saxenda dose to convert to based on your previous Wegovy dosage. For example:

• If you were on 1.7mg Wegovy, may start Saxenda at 1.2mg or 1.8mg daily.
• If you were on 2.4mg Wegovy, may start Saxenda at 1.8mg or the max dose of 3mg daily.

In most cases, the starting Saxenda dose will be lower than the equivalent weekly Wegovy dose.

Titration Schedule

Like when initially starting Wegovy, your doctor will have you gradually increase the Saxenda dosage over several weeks or months. This titration schedule minimizes side effects.

A typical escalation may go:

• Weeks 1-4: 0.6mg daily
• Weeks 5-8: 1.2mg daily
• Weeks 9-12: 1.8mg daily
• Week 13 onward: 3mg daily (max dose)

However, your specific titration plan will depend on your previous Wegovy dosage and how well you tolerated it.

Comparing Wegovy vs. Saxenda

While Wegovy and Saxenda share the semaglutide compound, there are some key differences between the two obesity medications:

	Wegovy	Saxenda
Dosing	2.4mg once weekly	Titrated up to 3mg daily
Primary Use	Weight management	Weight loss and diabetes
Administration	Subcutaneous injection	Subcutaneous injection
Cost	Around $1500/month without insurance	Around $1000-1200/month without insurance
Side effects	GI issues, nausea, vomiting, constipation	GI issues, nausea, vomiting, constipation

The most significant differences are the higher dose and once weekly dosing regimen of Wegovy compared to the lower daily Saxenda dose. Wegovy also leads to slightly more weight loss on average.

Weight Loss Differences

Clinical trials found greater average weight loss with Wegovy compared to Saxenda:

• In trials, Wegovy patients lost between 5.7% and 15.3% of body weight over 6 months.
• In trials, Saxenda patients lost between 5.6% and 8% of body weight over 6 months.

However, weight loss results can vary significantly based on the individual. Some may lose more weight on Saxenda, especially if they experience side effects with Wegovy's higher dosing.

Sustained Weight Loss

In addition to enhanced weight loss, Wegovy appears to help sustain weight loss longer term better than Saxenda.

In a 56 week study, Wegovy patients maintained over 10% weight loss compared to only 3% for Saxenda users after 56 weeks.

The weekly 2.4mg Wegovy dose may provide longer-lasting appetite suppression between doses compared to daily Saxenda.

Side Effect Differences

Wegovy and Saxenda share a very similar side effect profile since they contain the same semaglutide ingredient. However, some differences in frequency exist:

• Gastrointestinal - The most common side effects are GI including nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia. These tend to be more frequent and severe with Wegovy, especially when first starting treatment.
• Hypoglycemia - Saxenda poses a greater risk of low blood sugar since it is used to treat diabetes.
• Injection site reactions - Local irritation, swelling, reddening may occur with either. Usually mild.
• Gallbladder problems - Both drugs may rarely cause gallstones, obstruction, or acute pancreatitis. Risk is low.

In general, side effects are dose-dependent, so the higher 2.4mg dose of Wegovy often produces more adverse effects. The Saxenda dose can be lowered if side effects become intolerable.

Cost and Insurance Coverage

One of the main reasons doctors switch patients from Wegovy to Saxenda is due to the significant cost differences between the two weight loss medications.

The typical monthly retail cost without insurance is:

• Wegovy - $1,300 to $1,500 per month
• Saxenda - $1,000 to $1,200 per month

However, with insurance coverage the patient responsibility drops substantially for both. Saxenda tends to have higher coverage rates since it is an older drug.

Factors Affecting Medication Costs

Your out-of-pocket costs for Wegovy or Saxenda will depend on:

• Your insurance plan - Deductibles, formulary coverage, prior authorization requirements
• Pharmacy - Retail vs. mail order, use of coupons or savings cards
• Dosage prescribed - Higher doses mean greater monthly costs
• Duration of treatment - Costs continue for duration on medication

Talk to your insurance and doctor about ways to reduce your out-of-pocket expense if cost is an issue.

Lifestyle Changes

While drugs like Wegovy and Saxenda can aid weight loss through appetite suppression, lifestyle modification is still crucial for success. Important lifestyle changes include:

• Following a calorie-controlled, low-carb diet focusing on lean proteins, high-fiber foods, fruits and vegetables.
• Limiting processed foods, sugars, refined carbohydrates and unhealthy fats.
• Engaging in regular exercise - Ideally 150-300 minutes per week of moderate activity like brisk walking.
• Making behavioral changes like mindful eating, self-monitoring, stress reduction techniques.
• Joining weight loss support programs, counseling, or accountability groups.

Medication works best paired with dietary, exercise, and behavioral strategies to promote weight loss and maintenance long term.

The Bottom Line

Wegovy and Saxenda are both effective prescription medications for weight management. In some cases, it makes sense to switch from Wegovy to Saxenda due to insurance restrictions, high Wegovy costs, or persistent side effects.

When converting between the two semaglutide drugs, work closely with your provider to establish the right timing, starting dosage, titration schedule, and ongoing lifestyle modifications.

Know that weight loss results may be more modest on Saxenda compared to Wegovy's higher dosing. However, Saxenda can still produce clinically meaningful weight reduction when combined with healthy lifestyle changes.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.