Tirzepatide vs. Semaglutide: What’s the Difference?

If you’ve decided to explore weight loss injections, the next big decision might be: Which one? Two of the most widely known options are semaglutide (Ozempic® and Wegovy®) and tirzepatide (Mounjaro® and Zepbound®).

So how do tirzepatide versus semaglutide compare? What’s the difference between the two?

The active ingredients differ, but they help treat the same conditions: type 2 diabetes, obesity, and overweight.

Below, we’ll explore the many ways these popular medications are similar and go over key differences. The more you understand about tirzepatide and semaglutide, the more confident you’ll be deciding which medication to take — with the help of a healthcare provider, of course.

Semaglutide and tirzepatide are glucagon-like peptide-1 receptor agonists (GLP-1 agonists). Tirzepatide is also a GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, meaning it works on two hormones.

These prescription medications are used to treat type 2 diabetes and obesity — sometimes both. Both drugs are taken as once-weekly subcutaneous (under the skin) injections, usually in the abdomen, thigh, or upper arm.

Each medication was first developed to treat diabetes. In 2017, the U.S. Food and Drug Administration (FDA) approved Ozempic (semaglutide) to help lower blood sugar levels in people with type 2 diabetes. In 2021, Wegovy was FDA-approved to support chronic weight management.

The Food and Drug Administration approved Mounjaro (tirzepatide) in 2022 for blood glucose control in individuals with type 2 diabetes. In 2023, Zepbound was FDA-approved for chronic weight management.

Which is better, semaglutide or tirzepatide? That depends on what you’re trying to treat and what your health goals are, among other factors.

Tirzepatide and semaglutide help lower blood sugar levels by triggering the pancreas to produce more insulin. Insulin is a hormone that helps “unlock” cells to absorb glucose from the food you eat to be used for energy.

If you have insulin resistance, your cells don’t take in as much glucose, causing blood sugar levels to rise and type 2 diabetes to develop. GLP-1 receptor agonists also interfere with the production of glucagon, a hormone involved in raising blood sugar levels.

They’re sometimes prescribed off-label for those with obesity but not necessarily type 2 diabetes. (Off-label use is when a medication is prescribed for something it’s not FDA-approved for — in this case, weight loss.)

GLP-1 receptor agonists can treat obesity and promote weight loss by slowing gastric emptying. This not only helps you feel fuller longer, but it also slows the release of glucose into your bloodstream. The drugs also affect parts of the brain responsible for feelings of hunger and satiety to help you feel less hungry throughout the day.

When it comes to weight loss, both tirzepatide and semaglutide are effective options. But according to a study sponsored by Eli Lily, tirzepatide may lead to greater weight loss.

Research on Tirzapatide vs. Semaglutide for Weight Loss

The 2023 study found that over 72 weeks, participants taking tirzepatide lost an average of 17.8 percent of their body weight, while the group taking semaglutide lost an average of 12.4 percent of their baseline body weight.

A separate 2023 weight loss study comparing the two drugs found that those taking tirzepatide were more likely than people using semaglutide to reach their weight loss goals. The goals were set to five, 10, and 15 percent of baseline body weight lost at three, six, and 12 months, respectively.

Tirzepatide and semaglutide are both effective ways to control blood sugar levels — they were originally diabetes drugs, after all. But in studies comparing the two drugs, tirzepatide has generally produced greater results.

For example, a 2021 study followed nearly 1,900 participants for 40 weeks. It found that tirzepatide was more effective than semaglutide in controlling glycated hemoglobin (A1C) levels.

A1C is a biomarker that shows a person’s average blood sugar levels from the previous three months. Testing A1C levels is one way medical providers diagnose type 2 diabetes.

Semaglutide is also associated with lower risks of cardiovascular events, such as heart attack, as well as cardiovascular risk factors, like high blood pressure (hypertension) and high cholesterol.

If you have obesity or overweight, weight management is one way to help bring your blood pressure, cholesterol, and blood glucose numbers into healthy ranges.

Tirzepatide is not yet FDA-approved to treat cardiovascular issues, though that may be because it was approved later than semaglutide. Clinical trials are underway to study whether tirzepatide can (or should) be prescribed to lower heart disease risks.

Whether for weight loss, blood sugar control, or lowered heart disease risk, tirzepatide and semaglutide are both usually prescribed along with increased physical activity and a healthy eating plan.

Both tirzepatide and semaglutide share similar potential side effects. The most common concerns are gastrointestinal adverse events, such as diarrhea, constipation, nausea, and vomiting.

Other possible side effects include:

• Allergic reactions

• Hypoglycemia (abnormally low blood sugar)

• Kidney failure

• Pancreatitis

• Vision changes

A 2022 study looked at the effectiveness of tirzepatide on weight loss at various doses. It found that most side effects were considered mild to moderate and tended to be worse for brief periods as patients moved up to higher doses.

Side Effects of Switching From Tirzepatide to Semaglutide

Switching from tirzepatide to semaglutide (or vice versa) might trigger a new set of temporary side effects as your body gets used to the new drug.

If unpleasant side effects are what led you to change medications in the first place, keep in mind they could return or continue with the new drug.

As with the side effects associated with any medication, it’s important to keep your healthcare provider informed about new or worsening symptoms. There may be ways to reduce side effects, like changing the timing of your doses or trying a lower dose.

For brand-name Mounjaro and Zepbound, tirzepatide can cost around $1,000 to $1,100 a month.

With brand-name Ozempic, semaglutide ranges from $900 to $1,800 a month. For Wegovy, it’s more like $1,300 to $2,000 per month.

In the 2023 study comparing these drugs, the total cost for 72 weeks of tirzepatide was an estimated $17,527 compared to $22,878 for 68 weeks of semaglutide.

Insurance coverage for prescription drugs often doesn’t include weight loss medications, but plans may cover tirzepatide or semaglutide if they’re prescribed for diabetes.

You can get compounded semaglutide (and potentially compounded tirzepatide in the near future) from Hers for as little as $199 a month if one of our healthcare providers prescribes it.

For folks looking for help managing type 2 diabetes and/or their body weight, simply having the option of tirzepatide or semaglutide is a welcome dilemma. These medications weren’t available several years ago.

Here’s what to keep in mind about tirzepatide versus semaglutide for weight loss:

• Tirzepatide and semaglutide are proven to help with type 2 diabetes and weight loss. But they’re still relatively new medications. As more clinical trials are completed, take note and see which one seems like the best fit.

• Whatever decision you make should be done with the medical advice of a healthcare provider. You may have a preference based on the results a friend or family member experienced. Cost or side effects may be a consideration. In any case, check with your healthcare provider before committing to any treatment.

• Your body may respond differently to the two medications. One might cause extremely unpleasant side effects or not get the results you want. But tirzepatide has been shown to be more effective for weight loss.

• There could be side effects to switching weight loss drugs. A 2020 report suggested that while switching medications might reduce adverse effects or lower certain health risks for some patients, it could also result in more side effects — temporary or not.

• Your healthcare provider should discuss the risks and benefits and tailor a medication plan to your needs. Once you start either of these weight loss medications, you may need to plan for ongoing use for diabetes or chronic weight management.

If you’re interested in exploring affordable GLP-1 medications like compounded semaglutide, start with our quick online weight loss assessment.

You can also check out Ozempic alternatives to see what other options are available.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.