What the product information shows
Frequent urination, urgency or night-time urination does not appear among Victoza® reactions in the US label, the European summary or the Canadian monograph. [1][2][3] The Canadian tables, which list every event above 1% in each trial, include urinary tract infections and cystitis, so those are the closest measured rows. [3]
The kidney warnings point the other way. The US label warns of acute kidney injury after dehydration from nausea, vomiting or diarrhoea, and MedlinePlus lists decreased urination among liraglutide symptoms that need a call to the doctor right away. [1][10] So for Victoza®, passing less urine is the more worrying change.
| Trial and term | Victoza® | Comparison |
|---|---|---|
| LEAD-2, 26 weeks, with metformin: urinary tract infection [3] | 0.6 mg 1.2%; 1.2 mg 2.1%; 1.8 mg 1.2% | Placebo 2.5%; glimepiride 1.2% |
| LEAD-5, 26 weeks, with metformin and glimepiride [3] | 1.8 mg 1.3% | Placebo 1.8%; insulin glargine 1.3% |
| Trial 1860, 26 weeks, with metformin [3] | 1.2 mg 1.8%; 1.8 mg 0.5% | Sitagliptin 0.9% |
| Trial 1842, 52 weeks, 1.8 mg with metformin [3] | 1.3%; 2.5% with insulin detemir added | No placebo arm |
| Trial 1842: cystitis [3] | 0.6%; 0.0% with insulin detemir added | No placebo arm |
| LEAD-3, 52 weeks, Victoza® alone [3] | 1.2 mg 8.0%; 1.8 mg 4.1% | Glimepiride 4.0% |
| Saxenda® 3 mg, US Table 2 (higher dose) [4] | 4.3% | Placebo 3.1% |
Does liraglutide make the kidneys pass more salt and water?
Several small studies have measured this. In a 3-week crossover trial in people with type 2 diabetes and high blood pressure, liraglutide titrated to 1.8 mg increased sodium excretion over 24 hours and at night compared with placebo. [5] A single 1.2 mg dose in 11 men with type 2 diabetes did not change kidney filtration or blood flow but reduced sodium reabsorption in the first part of the kidney tubule. [6] In people with chronic kidney disease, a single 1.2 mg dose raised 24-hour urinary sodium excretion, most in those with better kidney function. [7]
These studies measured salt, not how often people went to the toilet, and none reported a rise in urination as a symptom. [5][6][7] They suggest a mechanism, not a side effect, and the effect sits alongside the blood pressure and kidney changes these teams were actually studying.
High blood sugar and other diabetes medicines
MedlinePlus lists needing to urinate a lot, or getting up more often at night to urinate, among the symptoms of high blood sugar, together with thirst, dry mouth, blurry vision and tiredness. [9] Victoza® starts at 0.6 mg for a week, a dose the US label says is for reducing digestive reactions and is not effective for blood sugar, so readings may still be high early in treatment. [1] As blood sugar comes down, this cause of frequent urination should ease.
Many people take Victoza® with other diabetes medicines. MedlinePlus explains that SGLT-2 inhibitors such as empagliflozin lower blood sugar by making the kidneys pass more glucose in the urine, and lists urinating a lot, including at night, and increased thirst among their side effects. [11] Water pills (diuretics), often used for blood pressure, are another common cause. [8]
Other causes
MedlinePlus lists urinary tract infection, an enlarged prostate in middle-aged and older men, inflammation of the urethra, vaginitis, nerve problems and caffeine as common causes of frequent or urgent urination. [8] Less common causes include alcohol, anxiety, poorly controlled diabetes, pregnancy, overactive bladder and some neurological conditions. [8]
NIDDK explains that diabetes can damage the nerves of the urinary tract, which can cause frequency, urgency or the opposite problem, a bladder that does not empty fully, and that people with diabetes are more likely to have bladder infections. [12] Drinking more water because of thirst or advice to avoid dehydration also adds trips to the toilet. [1]
What the sources describe
- Keep a voiding diary of when you urinate and roughly how much, and bring it to your appointment. [8]
- For night-time urination, avoid drinking a lot just before bed and cut down on alcohol and caffeine. [8]
- Do not cut back on fluids during vomiting or diarrhoea; the Medication Guide says drinking fluids reduces the chance of dehydration. [1]
- Check your blood sugar if frequent urination comes with thirst or tiredness. [9]
- Keep blood sugar, blood pressure and cholesterol near target and stay active, which NIDDK says helps prevent bladder problems. [12]
Victoza® and Saxenda® are registered trademarks of Novo Nordisk A/S. PepLabo is not affiliated with or endorsed by Novo Nordisk A/S.
When to get help
| Sign | Who to contact | How fast | Source |
|---|---|---|---|
| Frequent urination with fever, back or side pain, vomiting or shaking chills | Contact your provider right away | Today | MedlinePlus [8] |
| Frequent, urgent urination that is painful or burning | See a doctor right away | Today | NIDDK [12] |
| Passing much less urine, or swelling of the legs, ankles or feet | Call your doctor immediately | Today | MedlinePlus liraglutide [10] |
| Frequent urination with increased thirst or appetite, tiredness or sudden weight loss | Contact your provider right away | Today | MedlinePlus [8] |
| Bloody or cloudy urine, or discharge from the penis or vagina | Contact your provider | Today | MedlinePlus [8] |
| Urgency or leaking that has changed your daily routine | Raise it at your next visit | At your next appointment | MedlinePlus [8]; NIDDK [12] |
