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What's the difference?

Semaglutide is a single GLP-1 receptor agonist. Tirzepatide is a dual GIP/GLP-1 receptor agonist — it activates both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors simultaneously. The dual mechanism produces larger weight-loss effect sizes in head-to-head trials.

DimensionSemaglutideTirzepatide
MechanismGLP-1 receptor agonistDual GIP / GLP-1 receptor agonist
Weight-loss brandWegovy (FDA-approved 2021)Zepbound (FDA-approved 2023)
Diabetes brandOzempic (FDA-approved 2017)Mounjaro (FDA-approved 2022)
Mean weight loss (trial)~14.9% at 68 weeks (STEP-1, 2.4 mg)~22.5% at 72 weeks (SURMOUNT-1, 15 mg)
Max dose2.4 mg weekly15 mg weekly
ScheduleOnce weeklyOnce weekly
Brand list price~$1,349/mo (Wegovy)~$1,086/mo (Zepbound)
Compounded price (telehealth)$199–$449/mo$249–$499/mo
Side-effect profileGI (nausea, constipation), early-titration most commonSimilar GI profile, often slightly higher GI burden at top doses

Which is more effective for weight loss?

Across published Phase 3 trials, tirzepatide produces larger mean weight loss than semaglutide. SURMOUNT-1 (Zepbound 15 mg) reported ~22.5% mean body-weight reduction at 72 weeks. STEP-1 (Wegovy 2.4 mg) reported ~14.9% at 68 weeks. Direct head-to-head SURMOUNT-5 confirmed tirzepatide's edge at the highest doses.

Which is more affordable?

For brand-name list price, Zepbound (~$1,086/mo) is currently slightly cheaper than Wegovy (~$1,349/mo). For compounded versions through telehealth, semaglutide is typically cheaper than tirzepatide ($199 vs $249 entry).

Which has better tolerability?

Both medications share similar GI side-effect profiles (nausea, constipation, vomiting at titration). Tirzepatide is sometimes associated with slightly higher GI-event rates at maximum doses. Most patients tolerate both with appropriate titration over 8–16 weeks.

Which should I choose?

The choice depends on three factors: (1) target weight loss — if you need maximal effect and can tolerate titration, tirzepatide; (2) price sensitivity — if cost is a primary constraint, compounded semaglutide is the cheapest legal pathway; (3) insurance status — if Wegovy or Zepbound is covered, the brand-name pathway becomes cost-equivalent.

Compounded sema and tirz from $199/mo

NexLife offers both compounded semaglutide and tirzepatide under physician-led oversight.

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