{"@context": "https://schema.org", "@graph": [{"@type": "MedicalWebPage", "@id": "https://www.eden.health/learn/tirzepatide-vs-semaglutide", "url": "https://www.eden.health/learn/tirzepatide-vs-semaglutide", "name": "Tirzepatide vs. semaglutide: how the two GLP-1 medicines differ", "description": "Semaglutide (Wegovy) and tirzepatide (Zepbound) are FDA-approved prescription medicines for weight management that work on gut hormone receptors. This guide compares how they work, what the head-to-head SURMOUNT-5 trial found, what each is approved for, and the warnings they share, as of November 7, 2026.", "inLanguage": "en-US", "dateModified": "2026-11-07T12:00:00.000Z", "publisher": {"@type": "Organization", "name": "Eden", "url": "https://www.eden.health/"}, "citation": ["https://investor.lilly.com/news-releases/news-release-details/zepbound-tirzepatide-showed-superior-weight-loss-over-wegovy", "https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management", "https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea", "https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or", "https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-serious-liver-disease-known-mash", "https://www.fda.gov/news-events/press-announcements/fda-approves-fourth-product-under-national-priority-voucher-program-higher-dose-semaglutide", "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b", "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b"]}, {"@type": "FAQPage", "mainEntity": [{"@type": "Question", "name": "Is tirzepatide better than semaglutide?", "acceptedAnswer": {"@type": "Answer", "text": "In the SURMOUNT-5 trial, tirzepatide produced more average weight loss. Which medicine fits a person also depends on their other health conditions, how they tolerate side effects, and which uses each medicine is approved for. A prescriber can help weigh these."}}, {"@type": "Question", "name": "Are Zepbound and Mounjaro the same medicine?", "acceptedAnswer": {"@type": "Answer", "text": "Both contain tirzepatide. Zepbound is approved for weight management, and Mounjaro is approved to improve blood sugar in adults with type 2 diabetes. They shouldn't be used together."}}, {"@type": "Question", "name": "Can semaglutide and tirzepatide be taken together?", "acceptedAnswer": {"@type": "Answer", "text": "No. Both labels say not to combine them with other GLP-1 receptor agonists."}}, {"@type": "Question", "name": "Is there a pill version?", "acceptedAnswer": {"@type": "Answer", "text": "Semaglutide is available as Wegovy tablets for adults. The Zepbound label lists only injections."}}, {"@type": "Question", "name": "Which one is approved for sleep apnea or heart risk?", "acceptedAnswer": {"@type": "Answer", "text": "Tirzepatide (Zepbound) is approved for moderate to severe obstructive sleep apnea in adults with obesity. Semaglutide (Wegovy) is approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight."}}, {"@type": "Question", "name": "Do both have the same thyroid warning?", "acceptedAnswer": {"@type": "Answer", "text": "Yes. Both caused thyroid C-cell tumors in rodents, and neither should be used by people with a personal or family history of medullary thyroid carcinoma or with MEN 2."}}]}, {"@type": "BreadcrumbList", "itemListElement": [{"@type": "ListItem", "position": 1, "name": "Learn", "item": "https://www.eden.health/learn"}, {"@type": "ListItem", "position": 2, "name": "Medications", "item": "https://www.eden.health/learn-topics/medications"}, {"@type": "ListItem", "position": 3, "name": "Tirzepatide vs. semaglutide", "item": "https://www.eden.health/learn/tirzepatide-vs-semaglutide"}]}]}
Tirzepatide vs. semaglutide: how the two GLP-1 medicines differ
Semaglutide (Wegovy) and tirzepatide (Zepbound) are FDA-approved prescription medicines for weight management that work on gut hormone receptors. This guide compares how they work, what the head-to-head SURMOUNT-5 trial found, what each is approved for, and the warnings they share, as of November 7, 2026.
Tirzepatide produced more weight loss in a head-to-head trial. Each has approved uses the other doesn't.
Semaglutide activates the GLP-1 receptor. Tirzepatide activates both the GIP and GLP-1 receptors [2][4]. In the SURMOUNT-5 trial, adults without diabetes lost an average of 20.2% of their body weight on tirzepatide and 13.7% on semaglutide over 72 weeks [1]. Semaglutide (Wegovy) is also approved to lower cardiovascular risk and to treat a form of fatty liver disease. Tirzepatide (Zepbound) is also approved for obstructive sleep apnea [3][4][5]. Both carry the same boxed warning about thyroid tumors seen in rodents [7][8].
Get AI summary
The basics
Two medicines, two mechanisms
Both medicines act on receptors for hormones the gut releases after eating, which reduce appetite and food intake. [2] Semaglutide is a GLP-1 receptor agonist. [4] Tirzepatide is a single molecule that activates two receptors, GIP and GLP-1. [2] Both are given as once-weekly injections, and semaglutide is also available as a daily tablet. [7][8]
Checked against FDA labels and announcements as of November 7, 2026
Question
Answer
Primary support
How does each work?
Semaglutide activates GLP-1 receptors. Tirzepatide activates GIP and GLP-1 receptors.
SURMOUNT-5 compared the two medicines directly for weight management. It enrolled adults with obesity, or with overweight and a weight-related condition such as high blood pressure or sleep apnea. People with diabetes were not included. Each person took the highest weekly dose they could tolerate, alongside counseling on diet and physical activity. [1]
Phase 3b · randomized · open-label
Peer reviewed
SURMOUNT-5: tirzepatide vs. semaglutide
Participants
751 adults without diabetes
Length
72 weeks
Dosing
Highest tolerated dose of each
Average change in body weight at 72 weeks
Assigned group
Mean change
Tirzepatide
−20.2%
Semaglutide
−13.7%
Published in The New England Journal of Medicine in 2025. Sponsored by Eli Lilly, which makes tirzepatide. [1]
Outcome at 72 weeks
Tirzepatide
Semaglutide
Lost at least 10% of body weight
81.6%
60.5%
Lost at least 15%
64.6%
40.1%
Lost at least 20%
48.4%
27.3%
Lost at least 25%
31.6%
16.1%
Average change in waist size
−18.4 cm (7.2 in)
−13.0 cm (5.1 in)
Stopped treatment because of side effects
6.1%
8.0%
All figures from the SURMOUNT-5 results as reported by the sponsor. [1]
Approved uses
What each medicine is FDA-approved for
Both are approved for long-term weight management with a reduced-calorie diet and more physical activity. Their other approved uses differ. [7][8]
Based on the U.S. labels as of November 7, 2026. “Not on the label” means the use isn't approved for that medicine, not that it was tested and failed. Tirzepatide is also sold as Mounjaro for type 2 diabetes. [2]
Safety
Shared warnings and side effects
Both labels carry a boxed warning: each medicine caused thyroid C-cell tumors in rodents, and it isn't known whether that happens in people. Neither should be used by anyone with a personal or family history of medullary thyroid carcinoma or with Multiple Endocrine Neoplasia syndrome type 2. [7][8]
Both labels also warn about severe gastrointestinal reactions, kidney injury from dehydration, gallbladder disease, pancreatitis, serious allergic reactions, low blood sugar when combined with insulin or similar medicines, eye complications in people with type 2 diabetes, and inhaling stomach contents during anesthesia or deep sedation. The Wegovy label adds a warning about increased heart rate. [7][8]
The most common side effects of both are nausea, diarrhea, vomiting, constipation and abdominal pain. Neither should be combined with another GLP-1 medicine. [7][8]
Recent changes
What changed in the last year
Label updated June 2026
Semaglutide
New tablet and a higher-dose injection
Wegovy tablets were added to the label in December 2025 for weight management and cardiovascular risk reduction in adults. [8] On March 19, 2026, the FDA approved a 7.2 mg injection, Wegovy HD, for weight management in adults. The FDA said it is still investigating reports of altered skin sensation, which were more common at the higher dose. [6]
Label updated August 2026
Tirzepatide
Label revised August 2026
Zepbound's label updated its warning on severe gastrointestinal reactions in February 2026 and its warning on eye complications in people with type 2 diabetes in August 2026. [7]
In February 2026, the warning section on suicidal behavior and thinking was removed from both labels. [7][8]
What is settled
In adults without diabetes, tirzepatide produced more average weight loss than semaglutide at the doses tested in SURMOUNT-5 [1]
Both medicines carry the same boxed warning and are not to be combined with other GLP-1 medicines [7][8]
Semaglutide is approved to lower cardiovascular risk and treat MASH; tirzepatide is approved for obstructive sleep apnea [3][4][5]
What is still open
Questions the current evidence leaves open.
How tirzepatide compares with the 7.2 mg semaglutide dose, which SURMOUNT-5 didn't include [1][6]
Whether the difference in weight loss leads to different long-term health outcomes, which the 72-week trial didn't measure [1]
What the FDA concludes about altered skin sensation at the 7.2 mg dose [6]
Common questions
Direct answers
Each answer starts with the conclusion, then gives the limitation or source context you need.
Is tirzepatide better than semaglutide?
In the SURMOUNT-5 trial, tirzepatide produced more average weight loss. Which medicine fits a person also depends on their other health conditions, how they tolerate side effects, and which uses each medicine is approved for. A prescriber can help weigh these. [1]
Are Zepbound and Mounjaro the same medicine?
Both contain tirzepatide. Zepbound is approved for weight management, and Mounjaro is approved to improve blood sugar in adults with type 2 diabetes. They shouldn't be used together. [2]
Can semaglutide and tirzepatide be taken together?
No. Both labels say not to combine them with other GLP-1 receptor agonists. [7][8]
Is there a pill version?
Semaglutide is available as Wegovy tablets for adults. The Zepbound label lists only injections. [7][8]
Which one is approved for sleep apnea or heart risk?
Tirzepatide (Zepbound) is approved for moderate to severe obstructive sleep apnea in adults with obesity. Semaglutide (Wegovy) is approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight. [3][4]
Do both have the same thyroid warning?
Yes. Both caused thyroid C-cell tumors in rodents, and neither should be used by people with a personal or family history of medullary thyroid carcinoma or with MEN 2. [7][8]
Source transparency
Primary sources behind this page
Material statements are tied to regulators, peer-reviewed research, registered trials, or the developer's current status disclosures. Affiliate summaries are never used as clinical or regulatory proof.
