⚡
Semaglutide vs Tirzepatide
Comparing Ozempic/Wegovy vs Mounjaro/Zepbound — weight loss, dosing, side effects, cost
Semaglutide
Ozempic / Wegovy
VS
Tirzepatide
Mounjaro / Zepbound
| Factor | Semaglutide | Tirzepatide |
|---|
| Mechanism |
GLP-1 receptor agonist (single) |
Dual GLP-1 + GIP receptor agonist |
| Avg Weight Loss (trials) |
14.9% body weight (STEP trials) |
20.9% body weight (SURMOUNT trials) |
| Max Dose |
2.4 mg/week |
15 mg/week |
| Starting Dose |
0.25 mg/week |
2.5 mg/week |
| Titration Steps |
5 steps over ~16 weeks |
6 steps over ~20 weeks |
| Injection Frequency |
Once weekly |
Once weekly |
| Half-Life |
~7 days |
~5 days |
| FDA-Approved For |
Type 2 diabetes (Ozempic) + Obesity (Wegovy) |
Type 2 diabetes (Mounjaro) + Obesity (Zepbound) |
| GI Side Effects |
Common — nausea 44%, diarrhea 30% |
Similar — slightly better GI tolerability reported |
| Cardiovascular |
20% reduction in MACE (SELECT trial) |
SURPASS-CVOT trial ongoing as of 2025 |
| Compounded Available |
Yes — acetate form only, verify compounder |
Yes — acetate/free base form, verify compounder |
| Brand Cost (approx) |
$900–$1,400/month without insurance |
$900–$1,400/month without insurance |
| Winner |
More clinical long-term data |
Greater average weight loss |
⚖️ The Verdict
Tirzepatide produces approximately 47% more weight loss than semaglutide in head-to-head data (SURMOUNT-5 trial, 2024). For most people seeking maximum weight loss, tirzepatide is the stronger option. Semaglutide has more long-term cardiovascular data (SELECT trial showed 20% reduction in major cardiac events) and more years of real-world experience. If cardiovascular protection is the primary goal or you've already started semaglutide with good results, it remains an excellent choice.
⚠️ Research purposes only. Not medical advice. Consult a licensed healthcare provider.