Greater Glasgow and Clyde Medicines

Liraglutide (Saxenda®) for Weight Loss

Key Messages

• Liraglutide (Saxenda®) has been added to the NHSGGC Adult Medicines Formulary for weight management as per Scottish Medicines Consortium (SMC) restrictions.

• An NHSGGC short life working group have developed a patient pathway for assessment, initiation, monitoring and discontinuation of Liraglutide (Saxenda®).

• The Specialist Weight Management Service (SWMS) will identify eligible patients and will send a request to prescribe Liraglutide (Saxenda®) to their GP following a 3 month diet and lifestyle intervention.

• SWMS will provide the diet and lifestyle intervention specified by the SMC. In addition SWMS will undertake the assessment, initiation information and monitoring of patient weight for Liraglutide (Saxenda®).

Who is eligible?

• Meets triage criteria for the Specialist Weight Management Service
• Referred to NHSGGC Weight Management Service Referral - NHSGGC
• Meets the SMC restricted use criteria
• Has no contraindications
• Aged between 18 and 74 years old

Patient Pathway 

Initial Assessment

• Patients with prediabetes and high risk of CVD are identified at the initial assessment with SWMS. Lipid management and antihypertensive medications will be taken into account by SWMS.

• If HbA1c, cholesterol, and BP in the patients identified have not been completed within the last year, SWMS will request that these are completed by primary care as per good clinical practice to ensure:

  • Patient meets the SMC criteria

• SWMS will highlight to primary care, severe liver disease and severe renal disease as specific contraindications for Liraglutide (Saxenda®). A link to the EMC will be provided to primary care by SWMS for further information when identifying patients who are potential candidates for Liraglutide (Saxenda®) to ensure:

  • Medication is safe for patient

Initiation

• Patients that meet the SMC restricted use criteria for Liraglutide (Saxenda®) will complete a 3 month active weight loss phase. After successful completion of the 3 month diet and lifestyle intervention, a prescription request will be sent from the SWMS to the GP for Liraglutide (Saxenda®) and a one off request for needle clippers. The needle clippers will negate the need for a sharps bin.

• All initiation information and literature will be provided by SWMS.

Monitoring

• SWMS will monitor the weight of the patient monthly during the SWMS intervention.

• GPs will have no additional monitoring requirements for this medication, although in line with the NHSGGC Weight Management Service referral criteria, referrers have continued responsibility to monitor conditions such as prediabetes/CVD risk factors as per good clinical practice.

• After completing the 2 year SWMS intervention the patient will be discharged from SWMS. Some patients may wish to continue to take Liraglutide (Saxenda®). This will be discussed on a case by case basis with the GP as the patient’s weight will no longer be monitored by SWMS.

Discontinuation

• SWMS will send the GP a request to discontinue Liraglutide (Saxenda®) if:

  • After 4 months a patient has not lost 5% of their body weight.

  • The patient is unable to tolerate Liraglutide (Saxenda®).

  • The patient experiences significant weight gain over 3 consecutive months despite increased input from the SWMS.

  • The patient disengages with the SWMS.

  • The patient wishes to discontinue Liraglutide (Saxenda®).

  • The patient is non compliant with Liraglutide (Saxenda®).

Published 28/06/2023. Medicines Update blogs are correct at the time of publication.

If you would like to subscribe to Medicines Update or provide feedback on the blogs, email medicines.update@ggc.scot.nhs.uk.
Follow Medicines Update on Twitter @NHSGGCMeds