Evidence-anchoredFact-table drivenHead-to-head

Semaglutide vs tirzepatide, side by side.

Both are weekly injections in the same therapeutic family, but they are not the same drug. Semaglutide activates one gut-hormone receptor (GLP-1); tirzepatide activates two (GIP and GLP-1) — a difference that shows up in the trial weight-loss numbers, the side-effect profile, and the price.

Semaglutide

Single GLP-1 receptor agonist

Sold as Ozempic (type 2 diabetes) and Wegovy (chronic weight management). The molecule behind the largest body of long-term GLP-1 weight-loss data.

Tirzepatide

Dual GIP + GLP-1 receptor agonist

Sold as Mounjaro (type 2 diabetes) and Zepbound (chronic weight management). The added GIP activity is associated with larger average weight loss in head-to-head trial data.

§ 01Semaglutide vs Tirzepatide

cited · DailyMed + ClinicalTrials.gov

Attribute

Semaglutide

semaglutide

HIGHLIGHTED

Tirzepatide

tirzepatide

Generic name

semaglutide

tirzepatide

Manufacturer

Novo Nordisk

Eli Lilly

Drug class

GLP-1 receptor agonist

Dual GIP / GLP-1 receptor agonist

FDA approved

December 2017 (Ozempic) · June 2021 (Wegovy)

May 2022 (Mounjaro) · November 2023 (Zepbound)

Indication

T2D (Ozempic/Rybelsus); chronic weight management (Wegovy)

T2D (Mounjaro); chronic weight management (Zepbound)

Dose schedule

Subcutaneous injection (weekly) · oral tablet (Rybelsus, daily) · Once weekly (injectable)

Subcutaneous injection · Once weekly

Available doses

0.25 mg · 0.5 mg · 1 mg · 1.7 mg · 2.4 mg

2.5 mg · 5 mg · 7.5 mg · 10 mg · 12.5 mg · 15 mg

Mechanism

Semaglutide is a GLP-1 analog with 94% homology to native human GLP-1. It binds the GLP-1 receptor, augmenting glucose-dependent insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite via central nervous system pathways.

Tirzepatide is a first-in-class single molecule that activates both the GIP and GLP-1 receptors. The dual incretin action augments glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and reduces appetite — producing larger average weight and HbA1c reductions than GLP-1 agonism alone in head-to-head trials.

Common side effects

Nausea, diarrhea, vomiting, constipation — mostly mild, ease after titration

Cost range

$0 – $1,400 / month depending on brand and coverage

$25 – $1,300 / month depending on brand and coverage

Semaglutide deep dive →Tirzepatide deep dive →All GLP-1 medications →

This comparison is for education only and is not medical advice. Semaglutide and tirzepatide are prescription medicines with distinct FDA-approved indications. Whether either is appropriate for you — and at what dose — is a decision for a licensed clinician.