Semaglutide Vs. Tirzepatide: Drug Comparison

Semaglutide is the active ingredient in the brand-name medication Wegovy^®. The information below is about brand name Wegovy.

Wegovy (semaglutide) is an injectable medication approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition, such as hypertension, type 2 diabetes, or high cholesterol. It works by mimicking the hormone glucagon-like peptide-1 (GLP-1), which regulates appetite and food intake, leading to reduced calorie consumption and significant weight loss. Wegovy is administered once weekly and is intended to be used in conjunction with a reduced-calorie diet and increased physical activity. Common side effects include nausea, diarrhea, vomiting, and constipation. It should be used with caution in patients with a history of pancreatitis and is not recommended for use in pregnant or breastfeeding individuals​.

Tirzepatide is the active ingredient in the brand-name medication Zepbound^®. The information below is about brand name Zepbound. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Zepbound (tirzepatide) is an injectable medication approved by the FDA for chronic weight management in adults with obesity or overweight who have at least one weight-related condition. It works by activating both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) hormone receptors, which help reduce appetite and food intake. It is taken once a week as an injection and is gradually increased over time to achieve effective weight loss results. Common side effects include nausea, diarrhea, constipation, and abdominal pain, with more serious risks like thyroid tumors and pancreatitis necessitating careful patient screening. This medication should be used alongside a reduced-calorie diet and increased physical activity for best results.

Glucagon-like peptide-1 (GLP-1) receptor agonist

Glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist

Wegovy (semaglutide) is indicated in combination with a reduced calorie diet and increased physical activity:

• To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight

• To reduce excess body weight and maintain weight reduction long term in:

  • Adults and pediatric patients aged 12 years and older with obesity

  • Adults with overweight in the presence of at least one weight-related comorbid condition

Zepbound (tirzepatide) is indicated:

• As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m² or greater (obesity) or

  • 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea or cardiovascular disease)

• Typically taken as an injection once weekly

• Comes in single-dose pens that deliver 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg per injection

• Typically taken as an injection once weekly

• Comes in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg per 0.5 mL single-dose pens or single-dose vials

Most common adverse reactions (incidence ≥5%) in adults or pediatric patients aged 12 years and older are:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

• Indigestion

• Dizziness

• Abdominal distension

• Belching

• Low blood sugar in patients with type 2 diabetes

• Flatulence

• Inflammation of the digestive system

• Gastroesophageal reflux disease (heartburn)

• Inflammation of the nasal cavities and back of the throat

The most common adverse reactions, reported in ≥5% of patients treated with Zepbound are:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Indigestion

• Injection site reactions

• Fatigue

• Hypersensitivity reactions

• Belching

• Hair loss

• Gastroesophageal reflux disease (heartburn)

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Known hypersensitivity to semaglutide or any of the excipients in Wegovy

• Drug interactions: Wegovy delays gastric emptying. May impact absorption of concomitantly administered oral medications

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Known serious hypersensitivity to tirzepatide or any of the excipients in Zepbound

• Drug interactions: Zepbound delays gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications

• Acute pancreatitis

• Acute gallbladder disease

• Low blood sugar: Concomitant use with insulin or an insulin secretagogue may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Diabetic retinopathy complications in patients with type 2 diabetes

• Heart rate increase

• Suicidal behavior and ideation

• Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue Wegovy

• Females and males of reproductive potential: Discontinue Wegovy at least 2 months before a planned pregnancy because of the long half-life of semaglutide

• Severe gastrointestinal disease

• Acute kidney injury

• Acute gallbladder disease

• Acute pancreatitis

• Hypersensitivity reactions

• Low blood sugar: Concomitant use with an insulin secretagogue or insulin may increase the risk of low blood sugar, including severe low blood sugar

• Diabetic retinopathy complications in patients with type 2 diabetes mellitus

• Suicidal behavior and ideation

• Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue Zepbound

• Females of reproductive potential: Females using oral contraceptives should consider switching to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Wegovy causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Wegovy is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

WARNING: RISK OF THYROID C-CELL TUMORS

In rats, tirzepatide causes thyroid C-cell tumors. It is unknown whether Zepbound causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of tirzepatide-induced rodent thyroid C-cell tumors has not been determined.

Zepbound is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Wegovy^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Wegovy, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.

*This information is from the label for brand name Zepbound^®. See the Full Prescribing Information for more complete information. Tirzepatide, the active ingredient in Zepbound, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient tirzepatide.