Saxenda and alcohol: can you drink, and what should you watch out for?

What does alcohol do in combination with liraglutide?

Alcohol and liraglutide both act on your stomach and your blood sugar, and those effects add up. Liraglutide is a GLP-1 receptor agonist: it slows gastric emptying, suppresses appetite and lowers blood sugar. Alcohol irritates the stomach lining, inhibits glucose production by the liver and disrupts the feeling of fullness. Read more about how to buy Saxenda.

As a result, three things happen at the same time:

• Alcohol stays in your stomach longer. Because of the slower gastric emptying, you feel the effect more slowly and sometimes more strongly than you are used to.
• Your blood sugar can drop, especially if you drink without eating. Liraglutide lowers blood sugar and alcohol blocks the backup supply from the liver.
• Your stomach protests sooner. The nausea that many users already have in the build-up phase is made worse by alcohol.

There is no chemical interaction between alcohol and liraglutide; the medication does not become less effective. What changes is how your body responds to the combination.

Side effects that alcohol can worsen

Alcohol mainly worsens the side effects that are already the most common with Saxenda: nausea, vomiting, diarrhoea and stomach pain. According to Apotheek.nl, stomach and bowel complaints occur in more than 30 in every 100 users, especially in the first weeks and after each dose increase.

The Farmacotherapeutisch Kompas (the Dutch national drug formulary) of Zorginstituut Nederland (the Dutch National Health Care Institute) points to the risk of dehydration from stomach and bowel complaints, especially at the start of treatment, and to the rare but serious inflammation of the pancreas. Alcohol increases both risks. The full overview is in our article on Saxenda side effects.

Does alcohol affect your weight loss result?

Yes, in three ways: calories, appetite and motivation. According to the Voedingscentrum (the Netherlands Nutrition Centre), alcohol provides 7 kilocalories per gram; a 250 ml glass of beer contains about 88 kcal, a 100 ml glass of wine about 96 kcal. Two glasses in an evening equal a small meal, without making you feel full.

In addition, alcohol breaks through exactly the effect for which you use Saxenda. The medication suppresses your appetite; alcohol lowers your inhibitions and increases cravings for salty and fatty food. People who drink often eat more and make poorer choices, the same evening and the next day.

The Voedingscentrum and the Gezondheidsraad (the Health Council of the Netherlands) advise not to drink alcohol; there is no safe amount. For people losing weight, that is also the best advice in practical terms. What you can eat and drink during treatment is in our Saxenda diet example.

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In practice: alcohol in the build-up weeks, at a party and on holiday

In practice, the advice depends on the moment in your treatment. The build-up weeks of the Saxenda dosing schedule, in which you go up by 0.6 mg every week to 3 mg per day, are the phase with the most side effects. During this phase it is best to avoid alcohol altogether. Later, on a stable dosage, a single glass is usually well tolerated.

Do not skip your daily injection because you have been drinking. If you have vomited heavily, discuss the dosage with your doctor.

Which choices are wiser if you do drink?

If you drink, choose little, slowly and with food. Specifically:

• Never drink on an empty stomach. Food slows the absorption of alcohol and protects your blood sugar.
• Choose low-calorie and sugar-free: a dry wine or a small glass of beer instead of cocktails, liqueurs and mixed drinks with soft drinks.
• Alternate with water. This limits the amount and the fluid loss.
• Stick to 1 glass and plan alcohol-free days.
• Watch for signs of low blood sugar: trembling, sweating, palpitations, hunger. Then eat something and stop drinking.

What you had better not do: use alcohol to "chase away" nausea, drink in the week after a dose increase, and drink several days in a row.

When should you consult your doctor?

Consult your doctor if alcohol does more to you than cause mild nausea, or if you notice that you drink more often or more than you want to. Get in touch in case of:

• Severe, persistent abdominal pain, possibly radiating to the back.
• Vomiting or diarrhoea that lasts longer than a day, especially with little urination or dizziness when standing up.
• Repeated signs of low blood sugar after alcohol.
• Existing liver or pancreas problems, or a history of alcohol addiction: the advice is then often to avoid alcohol completely.

With us, you discuss this with your own doctor, who follows you throughout the programme medical weight loss with injections. Also simply mention that you drink now and then: the doctor can take it into account in your support.

Would you like support from your own doctor at every step? The doctor assesses whether medical weight loss suits you and is available if you have side effects. Medical weight loss with injections →

Frequently asked questions about Saxenda, alcohol and other medications

Can you drink alcohol if you use Saxenda?

It is not forbidden, but Apotheek.nl advises preferably no alcohol, or at most 1 glass per day. Alcohol increases the chance of nausea and low blood sugar and works against weight loss. In the build-up weeks, it is best to avoid alcohol.

Which alcohol can you drink when losing weight?

If you drink, choose a dry wine or a small glass of beer, without sugary mixers, and drink it with a meal. Each glass provides about 90 to 100 kilocalories without satiety. No alcohol is the best choice for weight loss.

What are the downsides of Saxenda?

The main downsides are the daily injection, the stomach and bowel complaints in the build-up phase (in more than 30 in 100 users) and the cost, because Saxenda is only reimbursed for weight loss under strict conditions. Rare serious side effects are pancreatitis and gallstones. Read more about Saxenda insurance coverage.

How much weight can you lose in 3 months with Saxenda?

That varies from person to person. The European Medicines Agency (EMA) uses as a benchmark that treatment is stopped if you have not lost at least 5% of your starting weight after 12 weeks on the full dosage of 3 mg. You can read more about the pace in our article how fast does Saxenda work.

Can you drink alcohol if you use Ozempic?

The same principle applies to Ozempic and Mounjaro: no ban, but caution because of nausea, blood sugar and calories. The details per medication are in our articles on Ozempic and alcohol and Mounjaro and alcohol.

What else should you not do while using Saxenda?

Do not skip injections, never increase the dosage yourself, do not use the medication during pregnancy or if you want to have children, and do not combine it with other blood sugar-lowering medication without consultation. Very fatty or large meals and alcohol worsen the stomach complaints.

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