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Saxenda® (liraglutide) and constipation

Constipation on Saxenda®: 19.4% of adults vs 8.5% on placebo, 4.8% of teens. Why it happens, other causes, what helps and signs of a blocked bowel.

Published · Updated · Saxenda®: side effects by symptom · Written by the PepLabo editorial team

When to get help
Context and scope

Constipation is one of four stomach and bowel effects that the EU product information calls very common with Saxenda®, alongside nausea, vomiting and diarrhea. It rarely made people stop treatment in the trials, but it can be uncomfortable, and the product information also records a rare, serious end: a blocked bowel. This page covers the figures from three regulators, what newer analyses add about liraglutide, the reasons stools can slow down, the self-care steps health agencies describe and the warning signs that should not wait.

Key takeaways 4
  • The US and Canadian adult tables give the same figures: 658 of 3,384 people on Saxenda® (19.4%) against 165 of 1,941 on placebo (8.5%). [1][3]
  • In both the adult pool and the teen trial, constipation was roughly twice as common on liraglutide as on placebo. [1]
  • A 2025 network meta-analysis of 39 studies in adults without diabetes linked liraglutide with a higher risk of constipation than placebo. [4]
  • Bowel obstruction is listed by all three regulators from post-approval reports; in a 2025 meta-analysis, the liraglutide subgroup showed a raised risk. [1][2][3][6]

Constipation across the three product documents

All three sets of Saxenda® product information list constipation for adults. [1][2][3] The US and Canadian figures come from the same five placebo-controlled adult trials of 32 to 56 weeks, and every participant was also counselled on diet and activity. [1][3]

Constipation in Saxenda® product information (checked 20-10-2026)
Document and groupSaxenda®PlaceboNote
US label, Table 2, adults [1]19.4%8.5%Third most common adult reaction
Canadian monograph, Table 3, adults [3]658 of 3,384 (19.4%)165 of 1,941 (8.5%)Same adult pool
US label, Table 3, ages 12–17 [1]4.8%2.4%About six of 125 teens
EU SmPC, Table 4 [2]Very common (≥1 in 10)—Leaflet: usually goes away in days or weeks
Post-approval reports [1][2][3]Severe constipation, impaction, ileus, obstruction—No frequency; cause not established

Reading the adult and teen numbers

The teen figure is about a quarter of the adult one, but it comes from a single trial of 125 young people, so it describes that trial rather than a rule about age. [1] What the two tables share is the ratio: in each, constipation was about twice as frequent on liraglutide as on placebo. [1]

Constipation was not among the leading reasons people stopped the medicine. In adults those were nausea, vomiting and diarrhea; in teenagers, vomiting and nausea. [1] Across all stomach and bowel complaints, 67.9% of adults on Saxenda® reported at least one, against 39.3% on placebo. [3]

What studies add for liraglutide

A 2025 systematic review and network meta-analysis pooled 39 studies with 33,354 adults who had overweight or obesity but no diabetes. Nausea, vomiting, diarrhea and constipation were the most common digestive effects, and liraglutide and semaglutide were the medicines associated with a higher constipation risk than placebo. [4]

In a 12-week Danish trial of 52 adults that stepped liraglutide up to 3 mg, nausea and constipation were the most frequently reported adverse events. [5]

For the rare serious end, a 2025 meta-analysis combined trials, cohort and case-control studies. Overall, GLP-1 medicines were not linked with a clearly higher risk of bowel obstruction or ileus, and results varied widely between studies. In the liraglutide subgroup, however, the odds were about three times higher than in comparison groups. [6] Observational data like these can show an association but not prove cause, and the events remain uncommon.

How liraglutide may slow things down

Label level: liraglutide delays gastric emptying, and it lowers weight by reducing how much people eat rather than by burning more energy. [1] The label lists constipation but does not explain its mechanism.

Study level: the liraglutide 3 mg studies cited on this site measured how quickly the stomach empties, not how fast stool moves through the colon, so a direct effect on the large bowel is not shown in these sources. [5]

General level: the NIH digestive diseases institute lists eating less or differently, too little fibre, too little fluid or dehydration, and less physical activity among causes of constipation. [7] Eating smaller portions on Saxenda®, or losing fluid through vomiting or diarrhea, could therefore play a part.

Other reasons stools may slow

  • Medicines and supplements the NIH lists: iron, antacids containing aluminium or calcium, opioid pain medicines, some antidepressants, calcium channel blockers, diuretics and seizure medicines. [7]
  • Routine changes: travel, pregnancy, getting older, putting off going to the toilet, or changing medicines or diet. [7]
  • Health conditions: irritable bowel syndrome, an underactive thyroid, diabetes, coeliac disease and pelvic floor problems. [7]
  • Severe stomach slowing: the US label does not recommend Saxenda® for people with severe gastroparesis, and the EU summary advises against it in inflammatory bowel disease. [1][2]

What the health agencies suggest

MedlinePlus self-care guidance centres on habits: add fibre-rich foods gradually, because a sudden increase can cause bloating and gas; drink more water, especially alongside extra fibre; keep active through the week; do not skip meals; avoid heavily processed and fast foods; and go when you feel the urge rather than holding it. Some people find a regular time each day, often after a meal, helps. [8] Getting to know your usual pattern makes changes easier to spot. [8]

On products, MedlinePlus notes that stool softeners are sold in pharmacies and that laxatives should be used as a provider advises, not taken when you have severe belly pain, nausea or vomiting, and not used for more than a week without advice. [8] The MedlinePlus summary adds asking your provider whether any medicine you take may be contributing. [9] Saxenda® slows stomach emptying, so the US label asks for monitoring of medicines taken by mouth at the same time; tell your pharmacist you use it. [1]

The Medication Guide asks you to report stomach problems that are severe or do not go away, and the EU leaflet asks you to drink plenty of fluids to avoid dehydration early in treatment. [1][2]

Saxenda® is a registered trademark of Novo Nordisk A/S. PepLabo is not affiliated with or endorsed by Novo Nordisk.

When to get help

The signs and contact information below come from this article’s sourced guidance.

Emergency

  • Constant belly pain with vomiting, a swollen belly or being unable to pass wind or stool

    Contact: Emergency care now; a possible blocked bowel

    EU leaflet [2]; NIDDK [7]

  • Severe belly pain that does not go away, sometimes reaching the back

    Contact: Stop Saxenda® and seek medical help straight away

    Medication Guide [1]

Today

  • Blood in the stool, bleeding from the rectum, fever or losing weight without trying

    Contact: A doctor the same day

    NIDDK [7]

  • No bowel movement for three days, with bloating, belly pain or nausea

    Contact: Your prescriber or GP

    MedlinePlus [8]

At your next appointment

  • Constipation that is severe, does not ease with self-care or keeps returning

    Contact: Your prescriber

    Medication Guide [1]; NIDDK [7]

Questions

How common is constipation on Saxenda®?

In adults, 19.4% reported it on Saxenda® against 8.5% on placebo, making it the third most common reaction in the adult table. [1] In the teen trial it was 4.8% against 2.4%. [1]

Does Saxenda® constipation go away?

The EU leaflet says the very common stomach effects, constipation included, usually go away after a few days or weeks. [2] The US label gives no timing for constipation, so lasting or severe constipation is worth raising. [1]

Can Saxenda® cause a bowel blockage?

Rarely. Intestinal obstruction and ileus are listed from post-approval reports without a frequency, and a 2025 meta-analysis found a higher risk in its liraglutide subgroup, based largely on observational data. [1][6] Constant belly pain with vomiting or no passing of wind needs urgent care. [7]

Can I take a laxative while using Saxenda®?

Ask your pharmacist or prescriber first. MedlinePlus advises using laxatives as a provider recommends and not with severe belly pain, nausea or vomiting, and the US label asks for monitoring of oral medicines taken with Saxenda®. [1][8]

Can I get constipation and diarrhea on Saxenda®?

Both are very common in the EU table, and the adult US figures are 19.4% for constipation and 20.9% for diarrhea. [1][2] The documents do not say how often the same person has both. A change in bowel habit is worth noting for your provider. [9]

My teenager on Saxenda® is constipated. Is that expected?

It is listed for teens, but less often than in adults: 4.8% against 2.4% on placebo. [1] Vomiting and nausea were far more common in that trial, and the same warning signs apply at any age. [1][7]

Sources

Sources checked on

  1. SAXENDA® (liraglutide) injection Prescribing Information and Medication Guide, Novo Nordisk Revised 02/2026. Sections 5.7, 6.1 (Tables 2–3), 6.2, 7.1, 12.2 and 17; Medication Guide.
  2. Saxenda: EPAR – Product Information (SmPC and package leaflet), European Medicines Agency Sections 4.4, 4.8 (Table 4) and package leaflet sections 2 and 4.
  3. SAXENDA® (liraglutide injection) Product Monograph, Novo Nordisk Canada Inc. (Health Canada Drug Product Database) Date of authorization 10 September 2025. Sections 8.2 (Table 3) and 8.5; Patient Medication Information.
  4. Ismaiel A et al. Gastrointestinal adverse events associated with GLP-1 RA in non-diabetic patients with overweight or obesity: a systematic review and network meta-analysis. Int J Obes 2025 Systematic review and network meta-analysis; PubMed abstract.
  5. Nexøe-Larsen CC et al. Effects of liraglutide on gallbladder emptying: a randomized, placebo-controlled trial in adults with overweight or obesity. Diabetes Obes Metab 2018 Randomised controlled trial, 52 adults; PubMed abstract.
  6. Alfehaid L et al. Evaluating bowel obstruction and ileus events in patients on GLP-1 receptor agonists: a systematic review and meta-analysis. Expert Opin Drug Saf 2025 Meta-analysis of trials and observational studies; PubMed abstract.
  7. Symptoms & Causes of Constipation, National Institute of Diabetes and Digestive and Kidney Diseases (NIH)
  8. Constipation – self-care, MedlinePlus Medical Encyclopedia
  9. Constipation, MedlinePlus (U.S. National Library of Medicine)