Victoza vs Ozempic

In 2024, Ozempic accounted for over 34% of the GLP-1 drug market, overtaking Victoza in popularity among people with type 2 diabetes. It’s a surprising shift, especially since Victoza was once the leading GLP-1 option after its launch in 2010, seven years before Ozempic became available.

Both Ozempic and Victoza are injectable medications developed by Novo Nordisk. They help manage blood sugar and promote weight loss. But with more patients and doctors now choosing Ozempic, the question is: what’s driving this change?

This article compares Victoza vs. Ozempic in terms of effectiveness, safety, and practical use so you can better understand how they differ and which one might suit your treatment plan.

Effectiveness

Below is a comparison based on current clinical evidence:

Victoza vs. Ozempic for Type 2 Diabetes

In the SUSTAIN 10 study, researchers directly compared Ozempic 1 mg and Victoza 1.8 mg in people with type 2 diabetes already taking one to three oral antidiabetic medications. The results showed that Ozempic was more effective at lowering blood sugar. On average, Ozempic reduced A1C by 1.7%, while Victoza lowered it by 1.0%.

A separate network meta-analysis examined how the two drugs performed over the long term. The analysis found that Ozempic consistently delivered better blood sugar control than Victoza.

At the 1 mg weekly dose, Ozempic lowered A1C more than both Victoza 1.2 mg and 1.8 mg taken daily. The difference in A1C reduction was 0.47% greater compared to Victoza 1.2 mg, and 0.3% greater compared to Victoza 1.8 mg. Even at a lower dose of 0.5 mg, Ozempic outperformed Victoza 1.2 mg, with an additional 0.17% drop in A1C.

The REALISE-DM study looked at real-world results from people who switched from Victoza or Trulicity to Ozempic. Unlike clinical trials, this study analyzed outcomes in routine medical practice.

After six months on Ozempic:

• • HbA1c dropped by 0.65%, from an average of 7.9% to around 7.25%
  • Participants lost an average of 1.7 kg (3.7 lbs)
  • BMI decreased by about 0.6 points
  • 11.6% experienced stomach-related side effects
  • Most people tolerated the switch well and continued treatment

These findings suggest that Ozempic is more effective than Victoza for blood sugar control.

Victoza vs. Ozempic for Weight Loss

Both medications support weight loss, but Ozempic leads to greater reductions. In the SUSTAIN 10 trial, people using Ozempic lost an average of 5.8 kg (12.8 lbs), while those using Victoza lost about 1.9 kg (4.2 lbs).

In the network meta-analysis, Ozempic at both 0.5 mg and 1 mg doses led to more weight loss than Victoza at 0.6 mg, by 2.42 kg (5.3 lbs) and 3.06 kg (6.7 lbs), respectively. However, the difference in weight loss was smaller when compared with higher doses of Victoza (1.2 mg and 1.8 mg).

A more recent real-world study looked at how much weight people actually lost when using semaglutide (Ozempic, Wegovy) or liraglutide (Victoza, Saxenda) in routine clinical practice.

Researchers found that people on semaglutide lost more weight overall:

• • Semaglutide: average 5.1% reduction in body weight after one year
  • Liraglutide: average 2.2% reduction in body weight after one year

Those using the medication for obesity lost more weight than those using it for type 2 diabetes:

• • Obesity treatment: average 5.9% weight loss
  • Type 2 diabetes treatment: average 3.2% weight loss

People who stayed on the medication for the full year also saw better outcomes:

• • Full-year users: average 5.5% weight loss
  • Less than 90 days of use: as low as 1.8% loss

The study found that the chance of losing at least 10% of body weight was higher if:

• • You were on semaglutide instead of liraglutide
  • You used it to treat obesity rather than diabetes
  • You stayed on the medication for most of the year
  • You were on a higher dose
  • You were female

These findings support Ozempic as the more effective option for long-term weight loss, especially when used consistently and for obesity management.

Victoza vs. Ozempic in Reducing the Risk of MACE

Both Victoza and Ozempic were shown to significantly lower the risk of major heart problems in people with type 2 diabetes and high or very high cardiovascular (CV) risk, based on results from two large studies–LEADER and SUSTAIN 6.

In the LEADER trial, Victoza reduced the risk of major adverse cardiovascular events (cardiovascular death, nonfatal heart attack, or nonfatal stroke) by 13%. In the SUSTAIN 6 trial, Ozempic reduced the risk of major cardiovascular events by 26%.

A separate analysis focused on those who have peripheral artery disease (PAD), which is a condition that narrows the blood vessels in the legs and increases the risk of heart attacks and strokes. People with PAD had about 35% higher risk of having a major heart event than those without PAD.

Researchers found that Ozempic showed a slightly stronger benefit. Still, because the data isn’t statistically strong enough to prove superiority, we can’t say with certainty that it’s better.

Side Effects

The side effects of Victoza and Ozempic were closely examined in their clinical trials. Since both drugs belong to the same class (GLP-1 receptor agonists), they tend to cause similar adverse effects. These include:

• • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Constipation
  • Loss of appetite
  • Indigestion

In the SUSTAIN 10 trial, the overall safety profiles of both drugs were similar. However, Ozempic was associated with a higher number of stomach-related side effects, such as nausea and diarrhea. It also led to a greater number of early treatment discontinuations due to side effects.

A meta-analysis supported this trend. People taking semaglutide (Ozempic) experienced gastrointestinal issues more often than those on liraglutide (Victoza), though the difference was not statistically significant.

Serious side effects that could require hospitalization or cause patients to stop treatment were also slightly more frequent with semaglutide, but again, the evidence was too limited to draw firm conclusions.

Another study, conducted in a veteran population with type 2 diabetes, also found that side effects were more common with Ozempic, leading to a higher number of patients discontinuing the drug.

In addition to these common side effects, both medications carry similar warnings and risks, including:

• • Thyroid C-cell tumors
  • Pancreatitis
  • Worsening diabetic retinopathy
  • Low blood sugar (especially when used with insulin or sulfonylureas)
  • Acute kidney injury
  • Allergic reactions
  • Gallbladder problems
  • Risk of pulmonary aspiration during anesthesia or deep sedation

Regularly communicate with your healthcare provider to manage these risks and adjust treatment if needed.

How Victoza and Ozempic Work in Your Body

Ozempic (semaglutide) and Victoza (liraglutide) belong to a class of medications called GLP-1 receptor agonists. They mimic a hormone called glucagon-like peptide-1 (GLP-1), which helps regulate blood sugar in people with type 2 diabetes.

For Blood Sugar Control

GLP-1 is naturally released by your body after you eat. It attaches to a receptor known as GLP-1R, triggering a series of reactions that support blood sugar control:

• • It boosts levels of a signaling molecule called cAMP.
  • cAMP activates PKA, an enzyme that helps release insulin from the pancreas.
  • It also tells the body to stop releasing glucagon, a hormone that raises blood sugar.
  • It also allows more calcium into the cells, which boosts insulin release even more.

These effects help your body respond more efficiently to glucose. GLP-1 also promotes the growth of insulin-producing cells in the pancreas and helps protect them from damage.

Ozempic and Victoza are both engineered to last longer in the body than natural GLP-1:

• • Ozempic is about 94% similar to natural GLP-1 and is more resistant to breakdown, allowing it to remain active longer.
  • Victoza is about 97% similar but is cleared from the body more quickly, requiring daily dosing instead of weekly.

For Weight Loss

In addition to lowering blood sugar, both medications affect brain and fat tissue in ways that promote weight loss.

First, they influence appetite and digestion:

• • They send signals to the brain that increase feelings of fullness.
  • They slow down how quickly food leaves your stomach, helping you feel full longer.
  • They may reduce inflammation in the brain, which can be elevated in people with obesity.

GLP-1 receptors are present in brain regions that regulate hunger and metabolism, making these effects possible.

Next, they affect how your body handles fat:

• • They block fat-making genes and reduce how much fat your body stores.
  • They help your body use stored fat for energy, especially in white fat tissue (where excess fat is stored).
  • They lower levels of specific proteins involved in storing fat.
  • They increase thermogenesis, which is your body’s process of burning calories to produce heat.
  • They stimulate brown fat, a type of fat that burns calories instead of storing them.

In some cases, they may enhance thyroid hormone activity, which can raise your metabolic rate and energy use. These combined effects help support gradual and sustained weight loss.

Further Reading

If you’re interested in exploring more about how Victoza and Ozempic contribute to weight loss, consider reading the following topics:

• • Victoza for Weight Loss – Understand how Victoza, though primarily prescribed for type 2 diabetes, may assist in weight management.

• • Ozempic for Weight Loss in Non-Diabetics – Learn about the use of Ozempic for weight loss in individuals without diabetes.

• • Can Type 1 Diabetics Take Ozempic for Weight Loss? – Understand the considerations and potential implications of using Ozempic for weight loss in people with type 1 diabetes.

Approved Indications

Both Ozempic and Victoza are medications used to manage type 2 diabetes. However, there are some differences:

Dosing Schedule of Victoza vs. Ozempic

Here is a comparison of the dosing schedules for Ozempic and Victoza:

When Ozempic is used to reduce the risk of kidney decline, kidney failure, or cardiovascular death in people with T2D and CKD, treatment usually starts at 0.5 mg once a week. After you’ve been on that dose for at least 4 weeks, your doctor may increase it to 1 mg once a week. This higher dose is the recommended long-term (maintenance) dose for this use.

Both drugs are injected subcutaneously in the abdomen, thigh, or upper arm. You can take them at any time of day, with or without food.

Recommendations Regarding Missed Dose

If you forget a dose of Victoza, just take the next one as usual. Don’t double up. But if it’s been more than 3 days since your last dose, you may need to start over with the lowest dose (0.6 mg) to reduce stomach-related side effects.

If you miss a dose of Ozempic, take the missed dose as soon as possible within 5 days. If it’s been more than 5 days, skip the missed dose. Resume your regular weekly schedule with the next planned dose. You don’t need to restart at a lower dose.

Switching Between Victoza and Ozempic

When switching between Victoza and Ozempic, you generally:

• • Stop the medication you’re currently taking, and
  • Start the new one at its usual starting dose, as guided by your doctor.

There’s no need for a taper or overlap between the two. However, both drugs can cause gastrointestinal side effects when starting, so your doctor will usually begin you on the lowest starting dose of the new medication (0.25 mg for Ozempic, 0.6 mg for Victoza) to help your body adjust.

Just be sure the switch is supervised so dosing and timing are done safely.

Ozempic vs. Victoza’s Cost

In the US, the cost of Ozempic and Victoza can be high, especially without insurance. According to the manufacturer’s wholesale acquisition cost (WAC), a one-month supply of Ozempic is about $998. Victoza is listed at $543.51 for a two-pen package and $815.27 for a three-pen package.

Retail prices may vary depending on the pharmacy, with some listings showing Ozempic costs exceeding $1,200.

For a more affordable option, Pharma Giant, a Canadian online pharmacy network, offers these same medications at significantly lower prices:

• • Ozempic: $419 per month
  • Victoza: $255 per month

Prices can drop even further with bulk orders, and discount coupons are available for both Ozempic and Victoza. These are the same FDA-approved medications, manufactured by the same companies, but offered at reduced prices due to Canada’s fair drug pricing system.

Summary

Based on current studies, Ozempic appears to be more effective than Victoza for managing type 2 diabetes. Clinical trials and real-world data show that Ozempic leads to greater A1C reductions and more weight loss. It also has broader approved uses, including reducing cardiovascular and kidney risks in people with chronic kidney disease.

The two medications share similar safety concerns, including risks of pancreatitis, thyroid tumors, and kidney issues. Both are injected under the skin and can be taken with or without food. However, Ozempic is administered weekly, while Victoza requires daily dosing.

In the US, out-of-pocket costs can be high for either option, but lower prices are available through Canadian pharmacy networks like Pharma Giant.

What to Read Next:

If you’re curious about how other GLP-1 drugs compare or want to explore your options, check out these related topics:

• • Trulicity vs. Ozempic

• • Mounjaro vs. Ozempic

These articles break down the differences in how these medications work, their benefits, and what you should consider before switching or starting treatment.

Frequently Asked Questions