Medication Comparison

Semaglutide vs Tirzepatide

Tirzepatide shows greater weight loss in head-to-head trials (~22% vs ~15%), but semaglutide has a longer track record and more availability. Cost is similar for compounded versions.

Category Semaglutide Tirzepatide
Brands Ozempic / Wegovy Mounjaro / Zepbound
Class GLP-1 RA GLP-1/GIP dual agonist
Administration Weekly injection Weekly injection
Average weight loss ~15% ~22%
Compounded cost $150-400/mo (compounded) $150-450/mo (compounded)
Brand cost $1,000-1,400/mo $1,000-1,200/mo
Half-life ~7 days ~5 days
Dosing frequency Once weekly Once weekly
Key trial STEP (16.9% weight loss) SURMOUNT-1 (22.5% weight loss)

Best for Semaglutide

Patients who want a well-studied medication with oral option

Best for Tirzepatide

Patients seeking maximum weight loss with dual-action mechanism

Semaglutide tradeoffs

Pros

  • More data available
  • Oral option exists
  • Widely available

Cons

  • Less weight loss than tirzepatide
  • GI side effects common

Tirzepatide tradeoffs

Pros

  • Greater average weight loss
  • Dual mechanism (GLP-1 + GIP)
  • May improve insulin sensitivity more

Cons

  • Less long-term data
  • No oral option yet
  • Supply constraints

Common questions

Is tirzepatide better than semaglutide?

Clinical trials suggest tirzepatide produces more weight loss on average (~22% vs ~15%), but individual results vary. Both are effective GLP-1 medications.

Can you switch from semaglutide to tirzepatide?

Yes, with your doctor's guidance. Typically you'd start tirzepatide at the lowest dose even if you were on a high dose of semaglutide.

Which has fewer side effects?

Both have similar GI side effect profiles. Some studies suggest tirzepatide may cause slightly less nausea at equivalent efficacy doses.

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