Weight loss

Semaglutide vs Tirzepatide

Same family, different math: GLP-1 alone or GLP-1 + GIP. Here is how to choose.

Semaglutide
Semaglutide
Wegovy® / Ozempic®
GLP-1 receptor agonist
vs
Tirzepatide
Tirzepatide
Zepbound® / Mounjaro®
Dual GLP-1 / GIP receptor agonist

Semaglutide and tirzepatide are the two most prescribed GLP-1 weight-loss medications. Both quiet appetite and slow gastric emptying; tirzepatide adds a second receptor (GIP) that drives higher trial outcomes at the cost of titrating up further. Cost, side-effect tolerance, and whether your clinician thinks the GIP arm helps you are the levers that decide.

Side by side.

 
Semaglutide
Tirzepatide
Drug class
GLP-1 receptor agonist
Dual GLP-1 / GIP agonist
Dosing
Weekly subcutaneous, 0.25 → 2.4 mg
Weekly subcutaneous, 2.5 → 15 mg
Average weight loss (peak trial)
~14.9% (STEP 1, 68 wks)
~20.9% (SURMOUNT-1, 72 wks)
FDA-approved brand for weight loss
Wegovy
Zepbound
Cardiovascular outcome data
SELECT: 20% MACE reduction
Trials in progress
GI side effects
Common, dose-dependent
Common; GIP arm may reduce nausea at high doses
Compounded option at Zappy
$199/mo
$349/mo

Who picks which.

Semaglutide
  • Existing cardiovascular disease — SELECT trial data is unique to semaglutide
  • Lower-side-effect ceiling preferred
  • Cost-sensitive, want the longer track record
View Semaglutide
Tirzepatide
  • Greater total weight-loss potential is the priority
  • Tolerated GLP-1 in the past and want a stronger response
  • Insulin-resistant or pre-diabetic — GIP arm may help
View Tirzepatide
Our verdict

If you have established cardiovascular disease or want the lower-priced option with the longest track record, semaglutide. If your goal is maximum total weight loss and you can titrate slowly, tirzepatide. Your clinician should make the call from your labs and history.

See if I qualify

Prescription treatments require an online visit reviewed by a U.S.-licensed provider, who determines if a treatment is clinically appropriate. Compounded medications are prepared by licensed U.S. pharmacies and are not FDA-approved. Individual results vary.

Questions, answered.

Can I switch from one to the other?
Yes, with clinician supervision. Most members re-start at the lowest dose of the new molecule and re-titrate.
Which has more nausea?
Both produce nausea during titration. Tirzepatide's GIP receptor activity appears to reduce nausea at higher doses in trials.
Are compounded versions safe?
Compounded versions are made by LegitScript-verified 503A pharmacies under physician oversight. They are not FDA-approved and are not FDA-approved generics or equivalents of the branded products; your clinician can advise whether a compounded option fits your situation.

Related comparisons

All compares
Wegovy® vs Zepbound®

Two FDA-approved brands, two different molecules. The choice is really semaglutide vs tirzepatide, with branded pricing.

Read the comparison →
Compounded vs Branded

One is FDA-approved; the other is compounded by a 503A pharmacy. Here is what changes between them — and what to weigh.

Read the comparison →
Ozempic® vs Wegovy®

Same active ingredient (semaglutide). Different FDA label. Here is what that actually means.

Read the comparison →