Dr. Ahmed How to switch from Victoza to Ozempic? Although both are GLP-1 analogs, there are differences in their doses, dosage frequency, efficacy in lowering A1C, and weight loss effects.
When switching from Victoza to Ozempic, one needs to consider two important things in mind:
- The dosing frequency,
- The comparable doses of Victoza and Ozempic
How frequently should you administer Ozempic?
Unlike Victoza, which is administered daily, Ozempic is administered weekly. If you have been injecting Victoza daily subcutaneously, you should now be administering it once every week.
When to start Ozempic when switching from Victoza?
Start Ozempic injection on the next day after the last dose of Victoza. Suppose, you have administered a Victoza injection on Friday and you are planning to switch to Ozempic, you can get your first dose of Ozempic on Saturday.
Your second dose of Ozempic will automatically be scheduled for the next Saturday. You should not be injecting Ozempic in between.
What dose should you use when switching from Victoza to Ozempic?
The dose of Ozempic depends on a few factors. Before you switch from Victoza to Ozempic, ask yourself a few questions:
- Are you switching from Victoza to Ozempic because of intolerant gastrointestinal side effects?
- Do you want improved glycemic control?
- Are you switching from Victoza to Ozempic to avoid needles?
- Are you switching from Victoza to Ozempic because you want to lose more weight?
Switching from Victoza to Ozempic because of side effects:
Both Victoza and Ozempic are GLP-1 agonists. They have the same side effects profile. So, if you are switching from Victoza to Ozempic, you may still experience the same GI side effects.
However, Ozempic is administered weekly and some patients may tolerate it better than Victoza. If you have severe side effects, it is better to withhold treatment for a few days until the gastrointestinal side effects improve.
You may start with a lower dose of Ozempic after the gastrointestinal side effects improve and gradually increase the dose [Ref]
Switching from Victoza to Ozempic because of severe GI Side effects | ||
| Dose of Victoza before switching to Ozempic | To | Dose of Ozempic |
| 0.6 mg, 1.2 mg, or 1.8 mg | ⇒⇒⇒⇒ | Stop Victoza for a few days until your symptoms improve. Start Ozempic in a dose of 0.25 mg the next day. Administer four doses at weekly intervals. Increase the dose to 0.5 mg if required. |
Switching from Victoza to Ozempic because of mild GI Side effects | ||
| Victoza 0.6 mg or 1.2 mg | ⇒⇒ | Start Ozempic the next day in a dose of 0.25 mg weekly for four weeks. Increase the dose to 0.5 mg if required. |
| Victoza 1.8 mg | ⇒⇒⇒⇒ | Start Ozempic the next day in a dose of 0.5 mg weekly for four weeks. Alternatively, start with a low dose of 0.25 mg weekly for four weeks and then increase the dose to 0.5 mg. However, expect an increase in blood glucose. You may need to temporarily increase the dose of the other antidiabetic medications or add another antidiabetic medication for at least four weeks. |
When switching from Victoza to Ozempic for better glycemic control & Weight loss:
The comparable doses of Victoza and Ozempic are given here in the table below:
| Victoza | Ozempic |
|---|---|
| 0.6 mg | – |
| 1.2 mg | 0.25 mg |
| 1.8 mg | 0.5 mg |
| – | 1 mg |
Although Ozempic is initially recommended in a dose of 0.25 mg weekly for four weeks, a person may initiate it in a dose of 0.5 mg directly if he/ she is already using a high dose of Victoza or any GLP-1 analog.
Higher doses of Ozempic such as 0.5 mg are only recommended if the person is tolerating Victoza without gastrointestinal side effects.
Furthermore, initiating a lower dose of 0.25 mg weekly in a person who is already tolerating a higher dose of Victoza may observe a sudden deterioration in blood glucose.
Switching from Victoza to Ozempic to improve glycemic control, lose weight, and avoid needles | ||
| Dose of Victoza before switching to Ozempic | To | Dose of Ozempic |
| 0.6 mg or 1.2 mg | ⇒⇒⇒ | Start Ozempic in a dose of 0.25 mg the next day. Administer four doses at weekly intervals. Increase the dose to 0.5 mg if required. |
| Victoza 1.2 mg or 1.8 mg | ⇒⇒ | Start Ozempic the next day in a dose of 0.5 mg weekly for four weeks. Increase the dose to 1 mg if required. |
| You may temporarily notice a rise in blood glucose when switching from Victoza to Ozempic. | ||
Suppose you are switching from Victoza to Ozempic because of a lack of efficacy. In that case, it is advisable to titrate the dose of Victoza to the maximum tolerated dose and wait for two to three months.
If, after two to three months, blood glucose is still out of range, Ozempic treatment may be considered.
What are the similarities and differences between Victoza and Ozempic?
Both Victoza and Ozempic are GLP-1 analogs approved for the treatment of diabetes. Both drugs are administered via subcutaneous injections.
However, Ozempic is administered weekly, while Victoza is administered daily.
Both Victoza and Ozempic have proven cardiovascular safety profiles.
| Victoza | Ozempic | |
|---|---|---|
| Drug | Liraglutide | Semaglutide |
| Class | GLP-1 analog | GLP-1 analog |
| Administration | Subcutaneous Injection | Subcutaneous Injection |
| Dosage formulation | 0.6 mg, 1.2 mg, and 1.8 mg | 0.25 mg, 0.5 mg, and 1 mg |
| Dosage frequency | Administered daily | Administer weekly |
Victoza has a shorter half-life elimination than Ozempic. All GLP-1 analogs are contraindicated in pregnancy.
It is important to stop Ozempic (Semaglutide) and Victoza (Liraglutide) at least two months before a planned pregnancy.
All patients who have a personal or a family history of MEN-2 syndrome or medullary thyroid cancer should avoid GLP-1 analogs.
In addition, all patients who have pancreatitis or a history of pancreatitis should avoid GLP-1 analogs.
| Victoza | Ozempic | |
|---|---|---|
| Bioavailability | 55% | 89% |
| Half-life elimination | 13 hours | 7 days |
| Maximum Plasma concentration | 8 to 12 hours | One to three days |
| Steady-state concentration | 3 days | 4 to 5 weeks |
| Remain in the blood | Three days | Five weeks after the last dose |
Ozempic is considered superior to Victoza in terms of A1C reduction and weight loss effects. In addition, the once-weekly administration of Ozempic makes it easier to administer than Victoza.
In conclusion:
Switching from Victoza to Ozempic can make your life easier since Ozempic is administered once a week. So, you have to prick yourself only once a week.
Secondly, Ozempic has superior glycemic and weight loss effects compared to Victoza.
However, before switching to Ozempic, visit your healthcare provider, who will prescribe you the proper dose and duration of Ozempic.
In addition, he may temporarily adjust or alter your diabetes regimen.
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