Quick take
Both Zepbound (tirzepatide) and Wegovy (semaglutide 2.4 mg) are FDA‑approved for chronic weight management. Head‑to‑head pricing and access can differ by dose, supply, and your insurance formulary. If cost and tolerability are your main concerns, request two scripts (preferred + backup) and price them at 3 pharmacies.
How they work
Wegovy is a GLP‑1 receptor agonist (semaglutide). Zepbound is a dual GIP/GLP‑1 agonist (tirzepatide). Both slow gastric emptying, reduce appetite, and improve glycemic control. The dual mechanism of tirzepatide may drive larger average weight‑loss in trials but individual responses vary.
Dosing schedules
Both are once‑weekly injections with step‑up titration. Titrate slowly to improve tolerability. Do not skip medical supervision; dose escalations are individualized.
Efficacy (trial snapshots)
Large randomized trials showed clinically meaningful weight loss for both. Many participants achieved ≥15% weight reduction on full doses. Remember: your result depends on adherence, dose, time, and lifestyle.
Side effects & safety
Common: nausea, vomiting, diarrhea/constipation, headache, fatigue. Boxed warning about thyroid C‑cell tumors in rodents (contraindicated with personal/family history of MTC or MEN2). Discuss pancreatitis and gallbladder risks, pregnancy planning, and drug‑interaction timing (e.g., oral contraceptives, levothyroxine).
Access & price tips (U.S.)
- Ask for manufacturer savings if commercially insured. • Compare cash‑pay prices by dose. • Telehealth bundles can include visits + medication. • Re‑quote every 1–2 months due to supply dynamics.
Which one should I choose?
Decide with your clinician: health history, side‑effect tolerance, access, and price. Some people prefer the medication they can reliably obtain at a sustainable cost.
Frequently Asked Questions
Is one drug clearly better?
Trials suggest tirzepatide can yield larger average weight loss, but personal response and tolerability vary. Access and cost often decide.
Can I switch between them?
Switching requires clinical oversight to avoid side effects; dosing is not 1:1.
Do I need a special diet?
You do not need keto. A protein‑forward, fiber‑rich pattern with resistance training preserves lean mass.
Are compounded versions OK?
Use FDA‑approved products when available; compounded products are not FDA‑approved and may vary in potency or purity.
Sources
- FDA Prescribing Information: Wegovy (semaglutide 2.4 mg).
- FDA Prescribing Information: Zepbound (tirzepatide).
- NEJM / JAMA trial publications on semaglutide and tirzepatide for chronic weight management.
- Cleveland Clinic — GLP‑1 & GIP/GLP‑1 overview for patients.
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