Before Ozempic took over the weight loss conversation, Saxenda was the go-to injectable for weight management in Canada. Both are made by Novo Nordisk and both are GLP-1 receptor agonists. But they use different molecules, different dosing schedules, and produce different results. If you're trying to decide between the two, here's what you need to know.
Quick Comparison
| Feature | Saxenda | Ozempic |
| --- | --- | --- |
| Active ingredient | Liraglutide | Semaglutide |
| Injection frequency | Once daily | Once weekly |
| Approved for | Chronic weight management | Type 2 diabetes |
| Avg weight loss | 5-8% body weight | 10-15% body weight |
| Monthly cost | $300-$400 | $250-$340 |
| Manufacturer | Novo Nordisk | Novo Nordisk |
How Saxenda Works
Saxenda contains liraglutide, a GLP-1 receptor agonist that was one of the first in its class. Liraglutide has a shorter half-life than semaglutide, which is why it needs to be injected every day rather than once a week. The maintenance dose is 3 mg daily.
Health Canada approved Saxenda for chronic weight management in adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related condition. It was also the first GLP-1 approved for adolescent obesity in Canada (ages 12-17).
The dosing schedule starts at 0.6 mg daily and increases by 0.6 mg each week until reaching 3 mg. Patients typically reach the full dose in about five weeks.
How Ozempic Works
Ozempic uses semaglutide, a newer GLP-1 receptor agonist with a modified molecular structure that extends its half-life to about seven days. This is what allows weekly dosing. It works through the same GLP-1 pathway as Saxenda but with greater potency and longer duration of action.
Ozempic is approved in Canada for type 2 diabetes, not weight management. However, off-label prescribing for weight loss is extremely common. For the full breakdown, see our guide to getting Ozempic in Canada.
Weight Loss Results
The numbers here are not close. Ozempic produces significantly more weight loss than Saxenda in clinical studies.
Saxenda (SCALE trials): Average weight loss of 5.4% to 8% of body weight over 56 weeks. About one-third of participants lost more than 10%.
Ozempic (SUSTAIN/STEP trials): Average weight loss of 10-15% of body weight over 68 weeks with semaglutide. In the STEP 8 trial, which directly compared the two, semaglutide 2.4 mg produced 15.8% weight loss vs. 6.4% with liraglutide 3 mg.
The head-to-head STEP 8 data is about as clear as it gets. Semaglutide roughly doubled the weight loss of liraglutide.
Cost in Canada
| Cost Factor | Saxenda | Ozempic |
| --- | --- | --- |
| Monthly retail | $300-$400 | $250-$340 |
| Annual cost | $3,600-$4,800 | $3,000-$4,080 |
| Coverage for weight loss | Some private plans | Rarely covered for weight loss |
| Coverage for diabetes | N/A (not approved for T2D) | Most provincial formularies |
Cost per month is similar, but Ozempic tends to be slightly cheaper. The real difference is in what your insurance will cover and what indication you need the medication for.
One more cost factor: generic semaglutide. Since May 2026, the Apotex and Dr. Reddy's generics sell for roughly $88 to $99 per month at Costco Pharmacy, below brand Ozempic at $250 to $340. Saxenda (liraglutide) has no comparable low-cost generic on Canadian shelves, so the gap favours the Ozempic side. See our generic semaglutide guide.
Side Effects Comparison
Both medications cause similar GI side effects since they work on the same receptor:
- Nausea (very common with both, especially early on)
- Diarrhea and constipation
- Headache
- Injection site reactions
One practical difference: with Saxenda, you experience mild daily fluctuations in GLP-1 levels. With Ozempic, the weekly injection creates a more sustained and stable drug level. Some patients find Saxenda's daily peaks and troughs cause more inconsistent nausea, while Ozempic users tend to feel it most in the first two days after injection.
Insurance and Coverage
Here's where Saxenda has one advantage. Because it's approved specifically for weight management, some private insurance plans cover it for that purpose. Ozempic, approved only for diabetes, typically requires a diabetes diagnosis for coverage.
That said, many private plans still exclude weight management drugs entirely. Provincial formularies generally do not cover Saxenda. If you have type 2 diabetes, Ozempic's coverage will be far superior through public drug plans.
Which Should You Choose?
Choose Saxenda if: Your insurance covers it for weight management, you prefer the flexibility of adjusting a daily dose, or you've tried semaglutide and didn't tolerate it well.
Choose Ozempic if: You want better weight loss results, prefer once-weekly dosing, or have type 2 diabetes. For most patients, Ozempic is the stronger option on nearly every measure.
The daily injection burden is a real factor. I've talked to patients who switched from Saxenda to Ozempic and said the convenience of weekly dosing made a huge difference in adherence. Sticking with any medication long term is where the real results come from.
Frequently Asked Questions
Can I switch from Saxenda to Ozempic?
Yes. They are different molecules so your doctor will start you at the beginning of the Ozempic dose escalation (0.25 mg). You won't be able to jump to a higher Ozempic dose based on your Saxenda experience. Most patients find the transition smooth.
Is Saxenda still worth taking in 2026?
It can be. Saxenda remains a valid option for patients who can't tolerate semaglutide, whose insurance covers it specifically, or who prefer the ability to fine-tune a daily dose. It also has the longest safety track record among GLP-1 weight loss medications in Canada.
Do Saxenda and Ozempic use the same pen?
No. Saxenda uses a multi-dose pen with adjustable daily doses. Ozempic uses a pre-filled pen designed for weekly injection at a fixed dose. Both are injected subcutaneously, typically in the abdomen, thigh, or upper arm.