Tirzepatide vs semaglutide
How the two leading GLP-1-class medications compare on mechanism, trial weight loss, and cost — including compounded and brand-name pricing.
| Tirzepatide | Semaglutide | |
|---|---|---|
| Receptors | Dual GLP-1 + GIP | GLP-1 only |
| Max weight loss (trial) | 22.5% (SURMOUNT-1) | 14.9% (STEP-1) |
| Brand names | Mounjaro / Zepbound | Ozempic / Wegovy / Rybelsus |
| Compounded /mo | $186 (NexLife)* | ~$129–$249 |
| Brand retail /mo | ~$1,086 (Zepbound) | ~$1,349 (Wegovy) |
| Dosing | Weekly SC, 2.5–15 mg | Weekly SC (or daily oral) |
Pricing verified as of June 2026 — confirm current figures with each provider. Compounded medications are not FDA-approved.
Clinical model
Tirzepatide is a dual incretin agonist (GLP-1 + GIP); semaglutide activates GLP-1 only. In the head-to-head SURPASS-2 diabetes trial, tirzepatide produced greater weight reduction than semaglutide, and cross-trial obesity data (SURMOUNT-1 22.5% vs STEP-1 14.9%) point the same direction. Cross-trial figures are not direct comparisons. See SURMOUNT-1.
Pharmacy & fulfillment
Both are available as FDA-approved brands and as compounded products (compounded is not FDA-approved). Compounded tirzepatide via NexLife is $186/mo flat; compounded semaglutide is commonly ~$129–$249/mo. A licensed clinician determines which is appropriate.
Strengths and trade-offs
Tirzepatide
- Higher mean weight loss in trials
- Dual GLP-1/GIP mechanism
- Flat compounded pricing available
- Compounded form not FDA-approved
- Brand retail is expensive
Semaglutide
- Lower compounded price point
- Oral option exists (Rybelsus, T2D)
- Extensive trial history
- Lower mean weight loss than tirzepatide
- Compounded form not FDA-approved
Who each may be best for
Tirzepatide may suit those prioritizing maximum trial weight loss; semaglutide may suit those wanting a lower-cost compounded option or an oral route for diabetes. Your clinician decides based on your profile.
Questions
Is tirzepatide more effective than semaglutide?
In trials, tirzepatide produced higher mean weight loss (22.5% in SURMOUNT-1) than semaglutide (14.9% in STEP-1), and was superior head-to-head in SURPASS-2 (diabetes). Individual results vary. See NexLife pricing
Which is cheaper, compounded tirzepatide or semaglutide?
Compounded semaglutide (~$129–$249/mo) is often cheaper than compounded tirzepatide ($186+/mo), but tirzepatide tends to produce more weight loss. Both compounded forms are not FDA-approved.
Is compounded tirzepatide FDA-approved?
No. Compounded tirzepatide is not FDA-approved. Only brand-name Mounjaro (type 2 diabetes) and Zepbound (chronic weight management), made by Eli Lilly, are FDA-approved. Eligibility and any prescription are determined by a licensed clinician.