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Product comparison · approved uses side by side

Wegovy vs Zepbound

Wegovy and Zepbound are two different medicines, not two names for the same one. One trial has compared them directly, SURMOUNT-5: over 72 weeks, average weight change was -13.7% on semaglutide and -20.2% on tirzepatide. But the bigger difference is what each one treats. Only Wegovy is approved to cut heart risk, for patients from age 12, and for a liver condition called MASH, while only Zepbound is approved for sleep apnea.

FDA label Human trial

What matters first

Direct trial
SURMOUNT-5
Wegovy only
3 approved uses
Zepbound only
1 approved uses
Shared
1 approved uses

What each product is approved to treat

This is where the two stop being interchangeable, before anyone gets to which works better. Each row is one approved use. Each cell says who the label covers and when that approval was signed. An empty cell means no approval for that use — which is a fact about the label, not proof the drug was never studied for it.

Approved uses for Wegovy and Zepbound. One row per use; each cell gives the people the label covers, the approval date and application number, and the ongoing label dose. It also says when a use is not approved for that product.
Approved useWegovy (semaglutide)Zepbound (tirzepatide)
Weight reduction in adults

Adults with obesity, or adults with overweight and at least one weight-related comorbid condition, alongside a reduced-calorie diet and increased physical activity.

Approved 2021-06-04 · NDA 215256

Label maintenance dosage: 1.7 mg or 2.4 mg once weekly, 2.4 mg recommended

Adults with obesity, or adults with overweight and at least one weight-related comorbid condition, alongside a reduced-calorie diet and increased physical activity.

Approved 2023-11-08 · NDA 217806

Label maintenance dosage: 5 mg, 10 mg or 15 mg once weekly

Weight reduction from age 12

Pediatric patients aged 12 years and older with obesity, defined on the label as an initial BMI at the 95th percentile or greater standardized for age and sex.

Approved 2022-12-23 · NDA 215256/S-005

Label maintenance dosage: 2.4 mg recommended, or 1.7 mg once weekly

Not an approved use of Zepbound
Cardiovascular risk reduction

Adults with established cardiovascular disease and either obesity or overweight, to reduce the risk of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke.

Approved 2024-03-08 · NDA 215256/S-011

Label maintenance dosage: 2.4 mg recommended, or 1.7 mg once weekly

Not an approved use of Zepbound
Obstructive sleep apneaNot an approved use of Wegovy

Adults with obesity who have moderate to severe obstructive sleep apnea. This was the first drug treatment the FDA approved for obstructive sleep apnea.

Approved 2024-12-20 · NDA 217806/S-013

Label maintenance dosage: 10 mg or 15 mg once weekly

Noncirrhotic MASH with liver fibrosis

Adults with noncirrhotic metabolic dysfunction-associated steatohepatitis and moderate to advanced liver fibrosis, consistent with stages F2 to F3.

Approved 2025-08-15 · NDA 215256/S-024 · accelerated approval

Label maintenance dosage: 2.4 mg once weekly, reducible to 1.7 mg if not tolerated

Not an approved use of Zepbound
Every use and date above is read from the signed FDA approval letter named in the cell, listed in Sources. Reference information—not a recommendation, and not a statement that anyone is eligible for any of these uses.
Both labels carry (1)
  • Weight reduction in adults
Wegovy only
  • Weight reduction from age 12
  • Cardiovascular risk reduction
  • Noncirrhotic MASH with liver fibrosis
Zepbound only
  • Obstructive sleep apnea

Zepbound vs Wegovy in the one head-to-head trial

SURMOUNT-5 was a phase 3b open-label randomized trial in adults with obesity, without type 2 diabetes, and it is the only trial that put these two ingredients against each other. One thing to hold onto: it tested weight loss in adults, on the same weekly step-ups the Wegovy and Zepbound labels use. So it answers one of the five uses in the table above and none of the others.

◆ SURMOUNT-5 — mean weight change at week 72Mean weight change
2Exact values — 2 rows in the data table
SURMOUNT-5 — mean weight change at week 72
Trial armMean weight change
Semaglutide, titrated to 1.7 mg or 2.4 mg once weekly (Wegovy)−13.7%
Tirzepatide, titrated to 10 mg or 15 mg once weekly (Zepbound)−20.2%

Source: Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med 2025;393(1):26-36 — PubMed 40353578 · retrieved 2026-08-12. Open-label randomized trial; 751 adults with obesity and without type 2 diabetes, over 72 weeks. Trial results describe averages across a study population, not an individual outcome.

  • Each group moved up step by step to the highest dose each person could handle. That meant semaglutide 1.7 mg or 2.4 mg once weekly, and tirzepatide 10 mg or 15 mg once weekly. Those are the same ongoing doses the Wegovy and Zepbound labels give for weight reduction in adults.
  • Mean waist-circumference change was −13.0 cm with semaglutide and −18.4 cm with tirzepatide.
  • The trial was registered under the two molecule names, not the brand names. It measured weight and waist size, but not sleep apnea, heart, or liver outcomes.
4Comparison detailsTitration ladders, devices, practical differences, and source records

The two titration schedules

Both start low and step up slowly to keep stomach side effects down, but the two ladders do not line up and the doses do not match. Wegovy prints a fixed 16-week table ending at 2.4 mg, plus one higher step allowed only for weight loss in adults. Zepbound gives a rule instead of a table — go up 2.5 mg after at least 4 weeks — and treats three of its 6 levels as places you can stay. Stepping up is the prescriber’s call; neither table below is instructions.

Wegovy weekly schedule

6 dose levels · 3 maintenance dosages · maximum 7.2 mg weekly

Wegovy label titration schedule, weekly subcutaneous dosage
PeriodWeekly doseRole on the label
Weeks 1 through 40.25 mgStarting dosage
Weeks 5 through 80.5 mgEscalation step only
Weeks 9 through 121 mgEscalation step only
Weeks 13 through 161.7 mgLower maintenance option
Week 17 and onward2.4 mgRecommended maintenance dosage, and the end of the label’s printed table
Week 21 at the earliest7.2 mgWeight reduction in adults only, after at least 4 weeks tolerating 2.4 mg

Week numbers through the recommended maintenance dose are printed in the label’s own escalation table; any later step is dated from the condition the label attaches to it. Only weight reduction in adults can reach 7.2 mg. The label asks for at least 4 weeks at 2.4 mg first, and for a clinical reason to go further. The FDA added this dose on 2026-03-19. Source: Wegovy (semaglutide) injection and tablets — FDA-approved Prescribing Information (DailyMed), revision 06/2026.

Zepbound weekly schedule

6 dose levels · 3 maintenance dosages · maximum 15 mg weekly

Zepbound label titration schedule, weekly subcutaneous dosage
PeriodWeekly doseRole on the label
Weeks 1 through 42.5 mgStarting dosage — not approved as a maintenance dosage
Weeks 5 through 85 mgLowest maintenance option
Weeks 9 through 127.5 mgEscalation step only
Weeks 13 through 1610 mgMaintenance option, and the lower of the two sleep apnea dosages
Weeks 17 through 2012.5 mgEscalation step only
Week 21 and onward15 mgMaximum for every approved use

The label sets 2.5 mg increments after at least 4 weeks on the current dose rather than printing week numbers; the weeks above are the earliest that rule allows. 15 mg once weekly is the maximum for every approved use of Zepbound. The label sets no higher dose. Source: Zepbound (tirzepatide) injection — FDA-approved Prescribing Information (DailyMed), revision 02/2026.

Devices, presentations and injection frequency

Both are once-weekly injections under the skin, so how often you take them is the same. What they come in differs. Zepbound comes as single-dose pens, single-dose vials, multi-dose vials or a four-dose KwikPen. Wegovy comes as single-dose pens, prefilled syringes or a four-dose FlexTouch pen — and it is the only one of the two that also comes as a tablet.

Devices and presentations for Wegovy and Zepbound: active ingredient, drug class, injection frequency and route, injection presentations, other dosage form, application number, sponsor, first approval date and the label revision read
PropertyWegovyZepbound
Active ingredientSemaglutideTirzepatide
Drug classGLP-1 receptor agonistGIP and GLP-1 dual receptor agonist
Injection frequencyOnce weekly, on the same day each week, at any time of dayOnce weekly, at any time of day
Injection routeSubcutaneous injection in the abdomen, thigh or upper armSubcutaneous injection in the abdomen, thigh or upper arm
Injection presentations
  • Single-dose pen0.25, 0.5, 1, 1.7, 2.4 and 7.2 mg (7.2 mg as Wegovy HD) · 1 dose
  • Single-dose syringe0.25, 0.5, 1, 1.7 and 2.4 mg · 1 dose
  • Single-patient-use pen (Wegovy FlexTouch)9.6 mg/3 mL, delivering 2.4 mg per dose · 4 doses
  • Single-dose pen2.5, 5, 7.5, 10, 12.5 and 15 mg per 0.5 mL · 1 dose
  • Single-dose vial2.5, 5, 7.5, 10, 12.5 and 15 mg per 0.5 mL · 1 dose
  • Multi-dose vial10 to 60 mg per 2.4 mL, delivering 2.5 to 15 mg per 0.6 mL dose · 4 doses
  • Single-patient-use KwikPen10 to 60 mg per 2.4 mL, delivering 2.5 to 15 mg per dose · 4 doses
Other dosage formThe Wegovy tablet comes in 1.5, 4, 9 and 25 mg. It is taken once a day, on an empty stomach, with water. Each strength runs for 30 days before the next one, and 25 mg is where it settles. The tablet covers only two of the four approved uses: heart risk reduction, and weight reduction in adults.None — injection only
ApplicationNDA 215256NDA 217806
SponsorNovo NordiskEli Lilly and Company
First approved2021-06-042023-11-08
Label revision read06/202602/2026

Presentations and strengths are read from section 3 of each FDA-approved label, revision date shown in the last row.

What actually differs when choosing between them

Five things, and only one of them is the weight number. Which of them matters is a call for the prescriber, who is also the only person who can say whether either is right at all.

  • Why you are being treated decides which. Sleep apnea with obesity is a use only Zepbound holds. Heart disease, being 12 to 17 years old, or MASH with moderate liver scarring are uses only Wegovy holds.
  • The ladders are different shapes. Wegovy reaches its usual 2.4 mg dose at week 17 on a table the label prints in full. Zepbound makes its lowest steady dose available from week 5, but its top 15 mg dose is five steps up — week 21 at the fastest the label allows.
  • One offers more places to stop. Zepbound has three doses a prescriber can settle on (5, 10, 15 mg). Wegovy has two for most uses (1.7 mg and 2.4 mg), plus a 7.2 mg dose limited to weight loss in adults who have already handled 2.4 mg for 4 weeks.
  • Only one comes as a tablet. Zepbound is injection only. Wegovy also exists as a tablet — but the tablet carries only two of its four injection uses.
  • Neither label allows taking both. Both say using them alongside each other, or alongside any other GLP-1 medicine, is not recommended.

Where to read more

This comparison covers the two products. The companion comparison covers the two ingredients — how they work, how long they last, and the evidence behind each. None of that changes with the brand on the box, so none of it is repeated here.

The full tirzepatide safety entry wegovy vs zepbound reads from

Information from an approved label behind tirzepatide, apart from wegovy vs zepbound.

What the sources say about tirzepatide, beyond wegovy vs zepbound

15 sourced tirzepatide reactions, on its own page, separate from wegovy vs zepbound.

Tirzepatide vs semaglutide, the counterpart to wegovy vs zepbound

SURMOUNT-5 studied 751 adults for 72 weeks. This sits beyond wegovy vs zepbound.

The semaglutide reaction page behind wegovy vs zepbound

9 common and 6 serious semaglutide reactions, in full past wegovy vs zepbound.

Semaglutide on its own page, outside wegovy vs zepbound

An approved semaglutide label exists — beyond wegovy vs zepbound.

Convert a tirzepatide amount to units, beyond wegovy vs zepbound

U-100, U-50 and U-40 barrels for tirzepatide, computed independently of wegovy vs zepbound.

Semaglutide vial and water to a draw, outside wegovy vs zepbound

Every step of the semaglutide arithmetic printed, past wegovy vs zepbound.

Every tirzepatide step, outside wegovy vs zepbound

2 sourced tirzepatide values, each traceable without going via wegovy vs zepbound.

The semaglutide half of the wegovy vs zepbound dosing row

Reference information from the semaglutide source, read directly rather than through wegovy vs zepbound.

Vial and water to a draw, for both drugs in wegovy vs zepbound

U-100, U-50 and U-40 barrels each read differently, including wegovy vs zepbound

Common questions

Are Wegovy and Zepbound the same drug?

No. Different medicines, different makers, separate approvals. Wegovy contains semaglutide; Zepbound contains tirzepatide. They are also approved to treat different things, which matters more for most people than the ingredient names.

Is Zepbound stronger than Wegovy?

For weight loss, in the one trial that compared them, yes: -20.2% against -13.7% over 72 weeks. That is an average across adults with obesity and without type 2 diabetes. It says nothing about sleep apnea, heart risk, teenagers or liver disease — that trial did not measure any of them — and it is not a prediction for any one person.

Can someone switch from one to the other?

That is a decision for the prescriber, and the two ladders do not line up. A dose on one has no matching dose on the other, so a switch starts again at that product’s own starting dose. The labels are summarized here, but a prescriber should advise on starting, stopping or changing treatment.

Why is Zepbound approved for sleep apnea and Wegovy is not?

Because each approval is granted product by product, on that product’s own trials. FDA added sleep apnea in adults with obesity to the Zepbound label on 2024-12-20. Nothing equivalent appears on the Wegovy label — which does not mean it was tested and failed, only that no such approval exists.

Why is Wegovy approved for heart risk and Zepbound is not?

Wegovy was approved for that on 2024-03-08, on the strength of the SELECT trial. It covers adults who already have heart disease and also have obesity or overweight, and it lowers the risk of heart death, heart attack and stroke. That approval belongs to Wegovy alone. The Zepbound label carries no heart-outcome approval.

Do they have the same side effects?

Mostly the same, and mostly stomach-related. Both labels carry the same boxed warning about thyroid tumors seen in rodents. The lists are not identical and the rates differ. The two sourced side-effect records linked below give each label’s own list with a citation for each.

Are the titration schedules the same?

No, and the doses do not match up. Wegovy follows a printed 16-week table ending at 2.4 mg, plus a 7.2 mg step for weight loss in adults only. Zepbound goes up 2.5 mg at a time after at least 4 weeks, through 6 levels to 15 mg. Both are laid out row by row above.

Can a teenager be prescribed either one?

Only one. The Wegovy label covers patients aged 12 and over with obesity, added on 2022-12-23. The Zepbound label says safety and effectiveness in children have not been established.

Which one is covered by insurance?

Coverage is not included because it changes by plan, reason for treatment and over time. Two products approved for different things can be covered differently by the same plan for the same person. Your prescriber’s office and the plan itself are the only reliable answers.

Questions readers ask

Can I lose 20 pounds in 3 months on Wegovy?

There is no three-month number in the published research this site reads. The trial that compared Wegovy’s molecule with Zepbound’s ran 72 weeks.

Both arms were still climbing their dose ladders for the first few months, so the early weeks are not the weeks the result came from.

Is Wegovy more effective than Zepbound?

SURMOUNT-5 is the trial that answers this, and it did not favor Wegovy’s molecule. Over 72 weeks in 751 adults, tirzepatide lost 20.2% of body weight against 13.7% for semaglutide.

Both arms used the doses these two products actually carry, which is what makes this pair the one comparison the evidence genuinely covers.

What has worse side effects, Wegovy or Zepbound?

SURMOUNT-5 published weight and waist size, not a side-by-side symptom table, so there is no clean answer from the head-to-head.

Their labels cannot be lined up either. Both print everything reported by 2 in 100 people or more, but the populations and trial lengths differ.

Why do people switch from Wegovy to Zepbound?

No study tells us why people switch, so any single reason would be a guess. The most relevant trial fact is SURMOUNT-5’s result: 20.2% average weight loss with Zepbound versus 13.7% with Wegovy over 72 weeks.

Coverage moves people too. The two are approved for overlapping weight uses, so a plan change can decide it without anything clinical changing.

14primary sources, each with the day we read it — open the documents used on this page