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Comparison · sourced side by side
Tirzepatide vs Semaglutide
One trial has compared tirzepatide and semaglutide directly: SURMOUNT-5. It ran 72 weeks in 751 adults. Average weight change was -20.2% on tirzepatide and -13.7% on semaglutide. Both groups went up to the highest dose they could tolerate.
FDA label FDA label
What matters first
- Head-to-head evidence
- SURMOUNT-5, 751 adults
- Tirzepatide record
- FDA label; 2 sourced dose rows
- Semaglutide record
- FDA label; 2 sourced dose rows
Is there a head-to-head trial?
Yes. SURMOUNT-5 was a phase 3b open-label randomized trial in adults with obesity, without diabetes. It compared both drugs in the same study. Everyone went up to the highest dose they could handle. The result therefore reflects how the drugs were used, not a matched dose on paper.
| Trial arm | Mean weight change |
|---|---|
| Tirzepatide (highest dose reached) | −20.2% |
| Semaglutide (highest dose reached) | −13.7% |
Source: Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med 2025;393:26-36 · retrieved 2026-08-12. Randomized head-to-head; 751 participants over 72 weeks. These are group averages. They do not predict how much weight one person will lose.
- Mean waist-circumference change: −18.4 cm with tirzepatide vs −13.0 cm with semaglutide.
- More people on tirzepatide reached each weight-loss mark: 10%, 15%, 20% and 25%.
- Both drugs were raised step by step to the highest dose each person could handle, using their own label schedules.
Side by side
Compare approved uses, studied doses and reported effects. Missing information is labeled, and the sources for the clinical figures appear below.
| Property | Tirzepatide | Semaglutide |
|---|---|---|
| Drug class | GIP/GLP-1 dual receptor agonist | GLP-1 receptor agonist |
| Brand names | Zepbound, Mounjaro | Wegovy, Ozempic, Rybelsus |
| FDA approval | Approved | Approved |
| Strongest source | FDA label | FDA label |
| Dosing | 5–15 mg | 1.7–2.4 mg |
| Half-life | ≈ 5 days | ≈ 7 days |
| Boxed warning | Risk of thyroid C-cell tumors | Risk of thyroid C-cell tumors |
| Reactions on record | 15 | 15 |
| Typical vial sizes | 5 mg · 10 mg · 15 mg · 30 mg · 60 mg | 2 mg · 5 mg · 10 mg |
4Comparison details
How they work differently
Tirzepatide is a gip/glp-1 dual receptor agonist. Semaglutide is a glp-1 receptor agonist. They switch on different signals in the body. That can change both benefits and side effects. Even with a shared target, one drug cannot simply take the place of the other.
More targets do not guarantee a better result. They change both the effect and the side-effect pattern. A clinician weighs those tradeoffs for each person.
Side effects compared
Side effects below come from each compound’s own page, grouped by whether both records list them. A side effect on one list only means the other record does not carry it — not that it never happens.
Regulatory status compared
Tirzepatide
FDA-approved as branded pens.
Compounded tirzepatide now faces tight limits. FDA declared the shortage over in late 2024. It has proposed dropping tirzepatide from the 503B bulks list.
That leaves one narrow lane: 503A compounding for a named patient with a documented clinical need.
Semaglutide
FDA has approved the branded pens, and the oral tablet Rybelsus.
FDA declared the semaglutide shortage resolved in February 2025. Mass compounding has wound down since. FDA has also proposed dropping it from the 503B bulks list.
Keep reading
Open the individual drug guides for full dose schedules, study details and related tools.
Tirzepatide on its own page, outside Tirzepatide vs semaglutide
Wegovy vs zepbound, the counterpart to Tirzepatide vs semaglutide
The semaglutide page behind Tirzepatide vs semaglutide
Work out a tirzepatide draw, one side of Tirzepatide vs semaglutide
The semaglutide calculator behind Tirzepatide vs semaglutide
Tirzepatide dosing in full, beyond Tirzepatide vs semaglutide
Every semaglutide step, outside Tirzepatide vs semaglutide
Mixing math for any peptide, with Tirzepatide vs semaglutide as one example
More options to compare after Tirzepatide vs semaglutide
The dated regulatory page behind Tirzepatide vs semaglutide
Common questions
Which is more effective, tirzepatide or semaglutide?
In SURMOUNT-5, tirzepatide came out ahead on average weight change — -20.2% against -13.7% over 72 weeks. That is an average across a study group. It cannot predict your result. A prescriber also considers the approved uses, risks and your health.
Can these two be compared using their separate trial results?
Not reliably. The people, time span and goals can differ from trial to trial. A head-to-head trial tests both drugs in the same study.
Are the side-effect profiles the same?
Both records list 14 of the same side effects, mostly gut symptoms. Their full lists and study groups differ, so matching names do not mean matching rates.
Is either one approved by the FDA?
Both have FDA-approved products. Their labels state the approved uses, doses and side effects.
Does a newer compound mean a better one?
No. A newer drug often has less evidence, a shorter safety record, and no approved label. The strength of the evidence above is more useful than age alone.
Can someone switch between them?
A prescriber needs to consider the reason for treatment, current dose and response before planning a change.
Questions readers ask
How long does it take to lose 20 lbs on tirzepatide?
How long does it take to lose 20 lbs on tirzepatide?
SURMOUNT-5 reports weight change after 72 weeks, not a deadline for losing 20 pounds. Average loss was 20.2% of starting weight with tirzepatide and 13.7% with semaglutide.
A group average cannot predict when one person will reach a target. The trial studied adults with obesity who did not have type 2 diabetes.
Why would a doctor prescribe semaglutide instead of tirzepatide?
Why would a doctor prescribe semaglutide instead of tirzepatide?
Their approved uses differ by product. Both Ozempic and Mounjaro now have a heart-risk use for certain adults with type 2 diabetes.
Ozempic also has a kidney-risk use for adults with type 2 diabetes and chronic kidney disease. These label differences do not make one drug the best choice for everyone.
What makes you less sick, semaglutide or tirzepatide?
What makes you less sick, semaglutide or tirzepatide?
In SURPASS-2, nausea affected 17–22% of people on tirzepatide and 18% on semaglutide. Vomiting affected 6–10% and 8%, respectively.
The study compared tirzepatide 5, 10 and 15 mg with semaglutide 1 mg in adults with type 2 diabetes. These rates do not tell us which weight-loss dose is easier to tolerate.
Do you lose more muscle on semaglutide or tirzepatide?
Do you lose more muscle on semaglutide or tirzepatide?
The weight-loss figures on this page do not separate fat loss from muscle loss. SURMOUNT-5’s main result is total body weight, with waist size also measured.
That result cannot establish which drug preserves more muscle. A body-composition study would need to measure those changes directly.
- Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med 2025;393:26-36retrieved 2026-08-12Human trial
- Zepbound (tirzepatide) — FDA-approved Prescribing Informationretrieved 2026-09-19FDA label
- Wegovy (semaglutide) — FDA-approved Prescribing Information (DailyMed)retrieved 2026-08-20FDA label