Wegovy vs Zepbound (semaglutide vs tirzepatide)

Quick answer

On weight loss alone, tirzepatide came out ahead in a direct comparison: 20.2% versus 13.7% at 72 weeks, and 18.4 cm versus 13.0 cm off the waist, with people on tirzepatide more likely to reach 25% weight loss ^[3]. Wegovy has a broader label: it is approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and excess weight, for teens 12 and older, and for a liver condition called MASH ^[1]. Zepbound is the only one approved for obstructive sleep apnea ^[2]. Neither is "better" for every person; a prescriber weighs your history, other conditions and coverage.

Side-by-side

Wegovy vs Zepbound, label and price facts as of Oct 17, 2026

	Wegovy	Zepbound
Active ingredient	Semaglutide [1]	Tirzepatide [2]
Maker	Novo Nordisk	Eli Lilly
Approved for	Weight reduction (adults; injection also 12+), heart-risk reduction with CVD, MASH with F2 to F3 fibrosis (injection) [1]	Weight reduction in adults; moderate to severe sleep apnea with obesity [2]
Key approval dates	Heart-risk indication March 8, 2024 [6]; pill Dec 22, 2025 [7]	Weight Nov 8, 2023 [8]; sleep apnea Dec 20, 2024 [9]
Forms	Weekly pen; daily tablet [1]	Weekly single-dose pen or vial; 4-dose KwikPen [2] [10]
Start and step-up	0.25 mg weekly for 4 weeks, then 0.5, 1, 1.7 mg at 4-week steps [1]	2.5 mg weekly for 4 weeks, then 5 mg, then 2.5 mg steps every 4+ weeks [2]
Maintenance and max	1.7 or 2.4 mg; up to 7.2 mg for adults [1]	5, 10 or 15 mg; max 15 mg [2]
Pivotal weight trial	STEP 1: 14.9% vs 2.4% placebo at 68 weeks [11]	SURMOUNT-1: 20.9% at 15 mg vs 3.1% placebo at 72 weeks [12]
Nausea in trials	44% vs 16% placebo at 2.4 mg [1]	25% to 29% vs 8% placebo [13]
Self-pay price	$349 a month; $199 for first 2 low-dose fills; 7.2 mg $399 [5]	$299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) [4]
List price	$1,349 a month; cut to $675 on Jan 1, 2027 [14] [15]	$1,087 a month per TrumpRx [14]
Medicare GLP-1 Bridge ($50)	Covered (pen and tablets) [16]	KwikPen only [16]

Where they differ

How much weight people lost

SURMOUNT-5 is the cleanest comparison because both drugs were tested in one trial ^[3]. Separately, in SURMOUNT-1 people on Zepbound 15 mg lost an average of 20.9% at 72 weeks ^[12], and in STEP 1 people on Wegovy 2.4 mg lost 14.9% at 68 weeks ^[11]. Wegovy's label now allows 7.2 mg for adults who tolerate 2.4 mg and need more weight loss ^[1]. See tirzepatide results and Wegovy results.

Side effects and safety

Both labels carry the same boxed warning for thyroid C-cell tumors in rodents and list pancreatitis, gallbladder disease, kidney injury from dehydration, serious allergic reactions and aspiration during anesthesia ^{[13] [1]}. Wegovy's label also lists a heart rate increase ^[1]. In the trials, 4.8% to 6.7% of people on Zepbound stopped because of side effects versus 3.4% on placebo ^[13]; on Wegovy 2.4 mg it was 6.8% versus 3.2% ^[1]. No trial has shown one to be safer overall. Details on GLP-1 side effects.

Missed doses and daily life

If you miss Zepbound, take it within 4 days; after that, skip it ^[2]. For a Wegovy injection, take it if the next dose is more than 2 days away; miss 2 or more doses in a row and your provider may restart at a lower dose ^[1]. Tirzepatide, the drug in Zepbound, may make birth control pills less effective, so its labels advise a non-oral or backup method for 4 weeks after starting and after each dose increase ^[17]. More on Zepbound interactions.

Cost over a year

On self-pay, a year of Wegovy pens (13 boxes) on the label schedule is 2 x $199 + 11 x $349 = $4,237 ^[5]. A year of Zepbound stepping to 10 mg is $299 + $399 + 11 x $449 = $5,637, if every refill lands within 45 days ^[4]. Visit fees are extra. See Zepbound cost and Wegovy cost.

Who each may fit

• Wegovy is the one labeled to lower heart attack and stroke risk in adults with heart disease and excess weight, and the only one with a pill form and a teen approval ^[1].
• Zepbound produced more average weight loss head to head ^[3] and is the one labeled for obstructive sleep apnea ^[2].
• Coverage often decides it. Medicare's Bridge covers Wegovy pens and tablets but only the Zepbound KwikPen ^[16].

These are general differences from the labels and trials, not a prediction of how either drug will work for you.

Ozempic, Mounjaro and how they fit in

Ozempic is also semaglutide, approved for type 2 diabetes, not weight loss ^[18]. Mounjaro is also tirzepatide, approved for type 2 diabetes ^[17]. So Zepbound is not the same as Ozempic, and Wegovy is not the same as Mounjaro: each pair contains different drugs. Read Ozempic vs Wegovy, Mounjaro vs Zepbound and Ozempic vs Mounjaro.

Switching between them

Both labels say not to use the drug with any other GLP-1 receptor agonist ^{[2] [1]}, so people switch rather than combine. Neither label gives a dose conversion from the other drug. Each label's own starting dose is 2.5 mg for Zepbound and 0.25 mg for Wegovy ^{[2] [1]}; the dose you start at after switching is set by your prescriber. More in switching GLP-1s.

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Where to get either online (clean, provisional)

1. RRo (Ro Body Program)

   Clean

   Price

   Zepbound KwikPen $299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) a month; Wegovy pill $149 to $299; Wegovy pen $199 for the first 2 months at 0.25 to 0.5 mg, then $349, or $399 for 7.2 mg. Membership $39 the first month, then $74 to $149 a month. Checked Oct 17, 2026 ^[19].

   What you get

   FDA-approved brand drugs only (Zepbound, Wegovy pen and pill, Foundayo, Ozempic). Helps with insurance prior authorizations.

   FDA record

   No FDA warning letter found as of Oct 17, 2026.

   BBB

   BBB profile not checked as of Oct 17, 2026.

   Note

   Membership is billed on top of the drug. The $74 rate needs a 12-month prepay. Verdict: clean (provisional). Ro review

   Visit Ro (Ro Body Program)

2. LLifeMD

   Clean

   Price

   Wegovy pill from $149, Wegovy pen from $199, Zepbound vial from $299 a month, plus a program fee of $39 the first month and $149 a month after. Checked Oct 17, 2026 ^[20].

   What you get

   Brand GLP-1s with insurance help. Says compounded drugs "may" be prescribed through a compounding partner, with no products or prices shown.

   FDA record

   No FDA warning letter found as of Oct 17, 2026.

   BBB

   BBB profile not checked as of Oct 17, 2026.

   Note

   Its own pages list two different program fees ($149 and $75). Medicare patients are not eligible for the program. Verdict: clean (provisional). LifeMD review

   Visit LifeMD

3. FForm Health

   Clean

   Price

   Self-pay program $299 a month with clinician and dietitian video visits; medication and labs extra. HSA/FSA eligible. Checked Oct 17, 2026 ^[21].

   What you get

   FDA-approved drugs only (Zepbound, Wegovy, Saxenda, Contrave). Takes insurance, including Medicare.

   FDA record

   No FDA warning letter found as of Oct 17, 2026.

   BBB

   BBB profile not checked as of Oct 17, 2026.

   Note

   The $299 is before the cost of the drug. Refund terms are not published. Verdict: clean (provisional). Form Health review

   Visit Form Health

See Ro prices