Semaglutide vs tirzepatide: how they compare
How two GLP-1 weight-loss medicines differ in how they work, side effects, research and cost, and how your provider decides.
See plans & start my assessment →Exact price is shown before you pay. No hidden fees.Semaglutide vs tirzepatide: the short answer
Both are once-weekly injectable medicines used, with diet and activity changes, for chronic weight management. Semaglutide acts on one hormone receptor (GLP-1). Tirzepatide acts on two (GIP and GLP-1). Which one is right for you depends on your health history, other medicines, side effects and preference, and the decision is your provider's.
| Semaglutide | Tirzepatide | |
|---|---|---|
| How it works | GLP-1 receptor agonist | GIP and GLP-1 receptor agonist |
| How often | Once a week (an oral daily option also exists) | Once a week |
| Common side effects | Nausea, diarrhea, vomiting, constipation, stomach pain | Nausea, diarrhea, vomiting, constipation, stomach pain, decreased appetite |
| Boxed warning (FDA-approved versions) | Thyroid C-cell tumors in rodents; not for people with a personal or family history of MTC or with MEN 2 | |
| Living+ price (compounded) | $197 a month | $247 a month |
What the research says
Both medicines have been studied in large clinical trials in their FDA-approved forms. In separate placebo-controlled trials, adults taking either medicine alongside lifestyle changes lost more weight on average than adults on a placebo. In a head-to-head trial published in 2025, adults with obesity who took tirzepatide lost more weight on average than those who took semaglutide over 72 weeks.
Those trials studied FDA-approved products, not compounded preparations, and an average is not a prediction for any one person. Side effects, cost and how a medicine fits your life matter too.
How your provider decides
- Your health history, including thyroid, pancreas, gallbladder and kidney history
- Other medicines you take, including insulin, sulfonylureas and birth control pills
- How you have tolerated GLP-1 medicines before, if you have taken one
- Whether you would prefer a daily oral option to an injection
- Your preference, which you can share in your assessment
About compounded medication. Some medications prescribed through Living+ are compounded. Compounded drugs are not FDA-approved. The FDA does not review them for safety, effectiveness or quality before they are sold. They are prepared by a licensed pharmacy for one patient, on a prescription. They are not generic versions of any brand-name medicine. A compounded preparation is prescribed only when your provider decides an FDA-approved product is not clinically suitable for you, and your provider records the reason in your chart.
GLP-1 treatment through Living+ is available in every state except Louisiana.
Start with a short online assessment. A licensed provider reviews it and decides whether treatment is right for you.
See plans & start my assessment →Learn more on our semaglutide, tirzepatide and GLP-1 cost pages.
Side effects and safety
The most common side effects of GLP-1 medicines are stomach-related: nausea, diarrhea, vomiting, constipation and stomach pain. They are usually worst when you start or when the dose goes up. Tell your provider about any side effect, and get medical help right away for severe stomach pain that does not go away, signs of an allergic reaction, or very little urine.
Important: FDA-approved semaglutide and tirzepatide carry a boxed warning about thyroid C-cell tumors seen in rodent studies. Do not use these medicines if you or anyone in your family has had medullary thyroid carcinoma (MTC), or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2). Other serious risks include pancreatitis, gallbladder problems, low blood sugar (especially with insulin or a sulfonylurea), kidney problems from dehydration, and allergic reactions. These medicines are not for use during pregnancy. See our Important Safety Information.
Frequently asked questions
Is tirzepatide stronger than semaglutide?
Tirzepatide acts on two receptors (GIP and GLP-1) and semaglutide on one. In a 2025 head-to-head trial of the FDA-approved versions, the tirzepatide group lost more weight on average. That does not predict your own result, and those trials did not study compounded preparations.
Which has fewer side effects?
Both share the same common stomach-related side effects, such as nausea, diarrhea and constipation. How you tolerate either one is individual; your provider adjusts your dose and plan.
Can I switch from semaglutide to tirzepatide?
Your provider can review a switch with you. Never change or combine GLP-1 medicines on your own.
How much do they cost at Living+?
Compounded semaglutide is $197 a month and compounded tirzepatide is $247 a month, flat, including provider care, unlimited visits, labs when ordered, coaching and 24/7 care-team support.
Sources
- MedlinePlus (U.S. National Library of Medicine). Semaglutide injection. medlineplus.gov
- MedlinePlus (U.S. National Library of Medicine). Tirzepatide injection. medlineplus.gov
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989-1002. pubmed.ncbi.nlm.nih.gov
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387:205-216. pubmed.ncbi.nlm.nih.gov
- Aronne LJ, et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025. pubmed.ncbi.nlm.nih.gov
- U.S. Food and Drug Administration. FDA's concerns with unapproved GLP-1 drugs used for weight loss. www.fda.gov
Living+ Rx connects patients with licensed providers who determine whether a prescription is appropriate. Treatment is not guaranteed. Some medications offered may be compounded; compounded drugs are not FDA-approved and are prepared by a licensed pharmacy for an individual patient. Discuss risks and benefits with your provider.
Care coaching is educational, non-clinical support and is not a substitute for medical care, registered-dietitian services, or mental-health therapy.
This page is general information, not medical advice. Prices were accurate at the time this was published; the exact price is always shown before you pay.