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Semaglutide vs Tirzepatide

Semaglutide is FDA-approved and rated 5/5 for evidence; Tirzepatide is FDA-approved and rated 5/5. They have a similar amount of human evidence. Both are used for metabolic & weight goals.

CompareSemaglutide

The GLP-1 drug that started the modern weight-loss era: Ozempic and Wegovy.

Tirzepatide

The dual GIP/GLP-1 agonist behind Mounjaro and Zepbound.

CategoryMetabolic & WeightMetabolic & Weight
Evidence 5/5FDA-approved with large RCT programs (SUSTAIN, STEP, SELECT). SELECT showed a 20% reduction in major cardiovascular events in people with heart disease and overweight. 5/5FDA-approved on the basis of large phase 3 programs (SURPASS for diabetes, SURMOUNT for obesity, SURMOUNT-OSA for sleep apnea).
FDA statusFDA-approved (Ozempic 2017, Wegovy 2021)FDA-approved (Mounjaro 2022, Zepbound 2023)
WADA (sport)Not prohibitedNot prohibited
Also known asOzempic, Wegovy, Rybelsus, NN9535, AMP-1 (SM)Mounjaro, Zepbound, LY3298176, AMP-2 (TR)
How it worksA modified version of the natural hormone GLP-1 with a fatty-acid side chain that binds albumin, stretching its half-life to about a week. It lowers appetite through the brain, slows stomach emptying, and increases insulin release when blood sugar is high.A 39-amino-acid peptide with a C20 fatty diacid at lysine-20 that binds albumin, so it lasts about 5 days. GLP-1 and GIP receptor activation lowers appetite, slows stomach emptying, and boosts insulin release when blood sugar is high.
Half-lifeAbout 7 days (once-weekly dosing)About 5 days (once-weekly dosing)
Commonly reported doses
  • Wegovy label start: 250 mcg, once weekly
  • Ozempic step 2: 500 mcg, once weekly
  • Wegovy maintenance: 2.4 mg, once weekly
  • Label start: 2.5 mg, once weekly
  • Label maintenance (low): 5 mg, once weekly
  • Label maximum: 15 mg, once weekly
RouteSubcutaneous (abdomen, thigh, upper arm)Subcutaneous (abdomen, thigh, upper arm)
Good once mixed~28 days in the fridge~28 days in the fridge
Top side effects
  • Nausea, vomiting, diarrhea, constipation (most common, worst during dose increases)
  • Belly pain, bloating, burping
  • Fatigue, headache
  • Nausea, diarrhea, vomiting, constipation (most common, worst during dose increases)
  • Reduced appetite, indigestion, belly pain
  • Injection-site reactions
Lowest price per mg$3.00 (10 mg vial, 40% off)$1.10 (60 mg vial, 40% off)
Latest lab purity99.17% (lot SEM0001)99.76% (lot TRZ0001)
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