Comparison · Medication Choice

Semaglutide vs
Tirzepatide Calculator

Enter your details to see a personalised side-by-side comparison of Ozempic/Wegovy vs Mounjaro/Zepbound — weight loss projections, costs, dosing, and side effect profiles.

Semaglutide
Ozempic / Wegovy
Generic · Compounded
Avg. weight loss (trial)—
Projected loss (your weight)—
Compounded from$146/mo
Branded (Wegovy)~$1,349/mo
Weekly injectionOnce weekly
Titration to maintenance~16 weeks
Tirzepatide
Mounjaro / Zepbound
Generic · Compounded
Avg. weight loss (trial)—
Projected loss (your weight)—
Compounded from$258/mo
Branded (Zepbound)~$1,059/mo
Weekly injectionOnce weekly
Titration to maintenance~8–12 weeks
Side effectSemaglutide frequencyTirzepatide frequency
NauseaModerate (44%)Higher (31–45%)
VomitingLow (24%)Moderate (25%)
ConstipationModerate (24%)Moderate (29%)
DiarrhoeaModerate (30%)Similar (23%)
FatigueLow (11%)Similar (9%)
Hair lossPossibleSimilar
Pancreatitis riskVery lowVery low
Our recommendation based on your inputs
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Projections based on STEP 1 and SURMOUNT-1 trial averages. Individual results vary. Not medical advice — consult your healthcare provider before starting any GLP-1 medication.
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Both medications are available through licensed telehealth providers. No in-person visit required — prescription issued online and delivered to your door.
Both sema & tirz available
Yucca Health
Sema from $146/mo · Tirz from $258/mo
Oral or injectable options
Strut Health
Sema & tirz · From $199/mo
Compare all 7 providers and pricing →
Sponsored · Compounded GLP-1 not FDA-approved as finished drug · Prices confirmed at intake
Semaglutide vs tirzepatide — what the evidence says

The key clinical difference

Semaglutide (Ozempic, Wegovy) is a GLP-1 receptor agonist. Tirzepatide (Mounjaro, Zepbound) is a dual GLP-1 and GIP receptor agonist. The addition of GIP stimulation in tirzepatide provides enhanced insulin secretion, reduced glucagon levels, and potentially stronger appetite suppression — explaining the greater weight loss in trials.

The SURMOUNT-5 trial, the first direct head-to-head comparison between Zepbound and Wegovy in non-diabetic patients, showed Zepbound produced approximately 47% more weight loss over 72 weeks (20.2% vs 13.7% of body weight).

Important context: Both medications are effective. The average difference of 5 to 7 percentage points in weight loss is clinically meaningful for some patients and not decisive for others. Cost, tolerability, and access matter too.

When to choose semaglutide

  • First-time GLP-1 patient — proven track record, more clinical experience
  • Cost-sensitive — $146/month vs $258/month compounded
  • Nausea-sensitive — semaglutide generally produces milder GI side effects
  • Available through your insurance — more formulary coverage than tirzepatide
  • Oral option preferred — Rybelsus (oral semaglutide) and Ro's pill form are available

When to choose tirzepatide

  • Maximum weight loss is the priority
  • Type 2 diabetes — dual mechanism provides added HbA1c benefit
  • Previous semaglutide plateau — tirzepatide often restores progress
  • Higher starting BMI — greater absolute weight loss at higher body weights
  • Budget for $100–150/month more

The cost difference

At current compounded pricing through licensed telehealth providers, semaglutide starts at $146/month and tirzepatide at $258/month — a difference of $112/month or $1,344/year. For patients on long-term treatment, this is a meaningful financial consideration. For patients who need maximum results, the superior weight loss outcomes of tirzepatide may justify the difference.

Frequently asked questions
Clinical trial data consistently shows tirzepatide produces greater weight loss than semaglutide. The SURMOUNT-1 trial demonstrated an average 20.9% body weight loss on tirzepatide 15mg versus 15.3% on semaglutide 2.4mg in STEP 1. In the SURMOUNT-5 head-to-head trial comparing Zepbound and Wegovy directly, tirzepatide produced approximately 47% more weight loss. However, tirzepatide costs more and may cause more GI side effects initially. For most first-time GLP-1 patients, semaglutide is still the right starting point.
Ozempic (semaglutide) and Mounjaro (tirzepatide) differ in mechanism and approved indication. Ozempic is approved for type 2 diabetes and works by activating GLP-1 receptors. Mounjaro is approved for type 2 diabetes and works by activating both GLP-1 and GIP receptors — a dual agonist. The dual mechanism is why tirzepatide produces greater weight loss. For weight loss specifically, Wegovy (semaglutide 2.4mg) and Zepbound (tirzepatide) are the FDA-approved versions.
For most first-time GLP-1 patients, semaglutide (Ozempic or Wegovy) is the recommended starting point. It has a longer safety track record, costs less ($146 vs $258 per month compounded), and is effective for the majority of patients. Tirzepatide is worth considering if you need maximum weight loss results, have previously tried semaglutide without adequate response, or have type 2 diabetes where tirzepatide's dual mechanism provides added benefit.
Zepbound (tirzepatide) is more effective than Wegovy (semaglutide) for weight loss in clinical trials. The SURMOUNT-5 trial directly compared the two in people without diabetes and found Zepbound produced approximately 47% greater weight loss over 72 weeks — 20.2% vs 13.7% of body weight. However, Wegovy is generally better tolerated initially and has a longer post-market safety record.
Both sema & tirz from $146/mo
Yucca Health · Licensed telehealth
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