Ozempic and Victoza are both glucagon-like peptide 1 (GLP-1) agonists that are used in the treatment of type 2 diabetes. 

They help people better manage their blood sugar levels, lower HbA1c levels, improve insulin sensitivity, and fight insulin resistance. 

While remarkably similar, the two have several key differences that may affect your choice. So: Ozempic versus Victoza: which one should you choose? 

This article will explain the similarities and differences between these two drugs so you can make the best choice for yourself. 

Ozempic vs. Victoza: Which One Should You Choose?

What are the active ingredients in Ozempic versus Victoza?

The active ingredient in Ozempic is semaglutide and the active ingredient in Victoza is liraglutide, both of which fall under the same drug class, glucagon-like peptide 1 (GLP-1) agonist. 

This means that although their active ingredients are slightly different, their mechanism of action is the same and they can usually be used interchangeably (under the supervision of a doctor) unless you are allergic to one or the other active ingredients. 

Why do people take Ozempic or Victoza?

Ozempic and Victoza are both used in the treatment of type 2 diabetes. They are liquid, injectable pens that help lower blood sugars and A1C levels that are taken subcutaneously (just under the skin). 

They aid with improving insulin sensitivity, fighting insulin resistance, slowing digestion, and suppressing appetite. As a result, many people who take these medications experience weight loss

Ozempic and Victoza lower all-cause mortality, and help lower the risk of heart attack and stroke in people with type 2 diabetes and heart disease. 

People who have prediabetes or type 1 diabetes may be prescribed Ozempic or Victoza “off-label”, which means it is not approved by the FDA, to improve insulin resistance and blood sugar levels. 

People are never prescribed both medications; you take one or the other. You can never mix the two medications. 

How are Ozempic and Victoza similar? 

Ozempic and Victoza can be used alone or in conjunction with other diabetes medications. However, they can never fully replace the use of insulin if you’re insulin-dependent. 

The following are additional similarities between the two medications:

Lower blood sugar and A1C levels

Ozempic and Victoza both increase insulin secretion, thus increasing sugar metabolism and improving insulin sensitivity. 

They also inhibit the liver’s production of glucagon, helping people with type 2 diabetes better manage their blood sugars and lower their A1Cs. 

May cause weight loss 

While neither medication is FDA-approved as a weight loss drug, the medications suppress appetite and slow digestion, which cause many people to lose weight while taking either one. 

Since they aren’t approved for weight loss by the Food and Drug Administration, there is no recommended dose to achieve this. Talk with your doctor if you’re interested in losing weight and living with type 2 diabetes, as there are weight loss medications approved by the FDA for people living with diabetes. 

Lower cardiovascular risks 

Both Ozempic and Victoza lower cardiovascular risks for people currently living with both type 2 diabetes and heart disease. 

A meta-analysis from The Lancet found this to be true: Ozempic and Victoza lowered cardiovascular risk and even decreased the risk of death in people with diabetes and heart disease. 

The American Diabetes Association even recommends GLP-1 agonists (a drug class of which both Ozempic and Victoza are a part) for people who have type 2 diabetes and heart disease to lower cardiovascular risk. 

May cause adverse side effects

Both Ozempic and Victoza may cause adverse side effects. 

These include:

  • Nausea
  • Vomiting
  • Diarrhea 
  • Constipation
  • Low blood sugar, especially when used in conjunction with insulin 

They also may cause serious side effects, including:

  • Pancreatitis 
  • Kidney problems 
  • Increased risk of thyroid cancer 
  • Allergic reaction 

To learn more about the potential side effects, read our guides to Ozempic side effects and Victoza side effects.

They are name-brand and expensive 

Unfortunately, there are no generic versions of Ozempic or Victoza. They are both name brands and quite expensive. Some health insurance plans may not cover either. 

Check with your health plan to see if it is included on the formulary, and what your cost-sharing would be before starting the medication, as they can become quite cost prohibitive over time. 

They do not replace insulin 

Ozempic nor Victoza replaces insulin. If you are insulin-dependent and decide to begin treatment with one of these medications, you will still need to continue taking your other diabetes medications as prescribed unless your doctor tells you otherwise. 

They can be taken with or without food 

Unlike insulin and many other medications, GLP-1 agonists can be taken with or without a meal, and they can be taken any time of day. Even though they’re proven to lower blood sugars in a general sense, they do not cause acute low blood sugars after administration. 

If you take your injection of either in the morning and then go exercise, it will not have an immediate effect on your blood sugar levels, causing you to drop low. 

However, if you tend to experience nausea after your injection, eating something bland (like toast, a banana, rice, or crackers) may help alleviate it. 

How are Ozempic and Victoza different? 

Ozempic and Victoza are also different in several ways that might sway you towards one or the other. The major differences between these two medications are: 

The frequency of administration and dosing differ 

Ozempic is taken once weekly and Victoza needs to be taken once daily. This is the major difference between these two medications. 

Ozempic is stronger and longer lasting; however, if you take too much Ozempic and experience side effects such as nausea or vomiting, be warned that those effects will last an entire week. If you’re calibrating your Victoza dose and take too much, the effects wear off after 24 hours. 

However, if you don’t want to take a daily injection, or tend to forget to take a daily medication, the convenience of Ozempic may fit your lifestyle better. 

Also of note is that their dosing is completely different. You will need to work with your doctor to determine the correct dose for you and your health goals. 

Ozempic may cause diabetic retinopathy 

This is a severe side effect of Ozempic that is not associated with Victoza. Studies show that semaglutide (the active ingredient in Ozempic) is associated with the early worsening of diabetic retinopathy

Although this does not happen in all or even many patients who take Ozempic, taking this medication does come with an increased risk. 

Talk with your doctor if you have early-stage diabetic retinopathy or are worried that taking Ozempic may threaten your eye health. 

Frequently asked questions

Can I switch between the two drugs? 

Yes. You can switch between the two, especially if you’re experiencing adverse side effects on one drug or the other. However, if you’ve been taking Ozempic, you will need to wait a full week from your last dose before beginning your first dose of Victoza. 

If you’re currently on Victoza, you will need to wait 24 hours before taking your first dose of Ozempic. 

Only switch medications under the guidance of your doctor, as the dosing is completely different between the two medications and it does not translate between them. 

Even if you’re on the highest dose of Victoza, your doctor will probably start you on a small dose of Ozempic (and vice versa) until your body gets used to the new active ingredient. 

If I lose enough weight taking Ozempic or Victoza, can I get off my other diabetes medications?

This is possible, but not always likely. Losing weight can help improve both insulin resistance and blood sugar levels, sometimes making insulin or other diabetes medications unnecessary.

However, these changes can take a lot of time, and they should only ever be done under the guidance of a doctor. 

Ozempic and Victoza cannot cure diabetes, but if you’ve lost a significant amount of weight and your blood sugars are in great control with less insulin (and you’re managing well with healthy eating and exercise), you may be able to lower your insulin needs or stop taking insulin completely. 

This will only apply to people who have type 2 diabetes, as people with type 1 diabetes must never stop taking their insulin. 

Talk with your doctor if you have questions or concerns or are experiencing severe bouts of low blood sugar levels while taking Ozempic or Victoza. 

Takeaway 

Ultimately, the choice between taking Ozempic or Victoza is completely up to you and will vary based on your health history, lifestyle, health goals, and health insurance coverage. 

Talk with your doctor about any questions or concerns you have, and if you start one medication but dislike it, you can always switch and try the alternative.