Wegovy vs. Zepbound

See how Wegovy and Zepbound compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Wegovy contains semaglutide and targets one receptor, while Zepbound contains tirzepatide and targets two receptors, though both are once-weekly injections for weight management.

  • Wegovy is the only one of the two FDA-approved to reduce major cardiovascular events, while Zepbound is the only one FDA-approved for moderate-to-severe obstructive sleep apnea.

  • Both drugs cause nausea, diarrhea, vomiting, and constipation as their most common side effects, though the exact rates differ by drug and dose.

Wegovy vs. Zepbound Drug Summary

Wegovy

Wegovy (semaglutide) is a GLP-1 receptor agonist approved for chronic weight management in adults and adolescents 12 and older with obesity or overweight plus a weight-related condition. It is also approved to lower the risk of heart attack, stroke, and cardiovascular death in adults with established heart disease and obesity or overweight. It is given as a once-weekly subcutaneous injection.

Zepbound

Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist approved for chronic weight management in adults with obesity or overweight plus a weight-related condition. It is also approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity. It is given as a once-weekly subcutaneous injection.

Wegovy vs. Zepbound Side Effects

Wegovy

Most common
Nausea (up to 44%)
Diarrhea (up to 30%)
Constipation (up to 24%)
Vomiting (up to 24%)

Zepbound

Most common
Nausea (up to 29%)
Diarrhea (up to 23%)
Constipation (up to 17%)
Vomiting (up to 13%)

Wegovy vs. Zepbound Dosage

Wegovy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.25 mg once weekly Weeks 1-4
Maximum dose 2.4 mg once weekly Week 17 onward
Dose changes 4 increases Every 4 weeks

Zepbound

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mg once weekly Weeks 1-4
Maximum dose 15 mg once weekly Week 21 onward
Dose changes 5 increases Every 4 weeks

Wegovy vs. Zepbound Indications

Wegovy

Wegovy treats obesity and overweight with a related health condition, in both adults and adolescents 12 and older. It also carries a separate approval to lower cardiovascular risk in adults with heart disease and excess weight. It is meant to be used along with a reduced-calorie diet and more physical activity.

  • Adults and adolescents (12+) with obesity

  • Adults with overweight plus a weight-related condition

  • Reducing cardiovascular risk in adults with heart disease

  • Used alongside diet and exercise

Zepbound

Zepbound treats obesity and overweight with a related health condition in adults only. It also carries a separate approval for moderate-to-severe obstructive sleep apnea in adults with obesity. It is meant to be used along with a reduced-calorie diet and more physical activity.

  • Adults with obesity

  • Adults with overweight plus a weight-related condition

  • Moderate-to-severe sleep apnea in adults with obesity

  • Used alongside diet and exercise

Wegovy vs. Zepbound Pros and Cons

Wegovy

Wegovy has the longest track record of the two, with FDA approval since 2021 and outcomes data on heart disease. It is not approved for sleep apnea, and some patients find its single-receptor mechanism produces somewhat less weight loss than dual-mechanism options.

Pros

  • Approved for adolescents 12 and older

  • Only one of the two with a cardiovascular risk-reduction approval

  • Longer real-world safety track record since 2021

Cons

  • Not approved for obstructive sleep apnea

  • Single-receptor mechanism may produce less weight loss on average

  • Higher list price than Zepbound — roughly $1,300 to $1,350 per month without insurance, before savings programs

Zepbound

Zepbound's dual GIP/GLP-1 mechanism is linked to greater average weight loss in trials than single-receptor drugs. It is not approved for adolescents or for cardiovascular risk reduction, so patients needing those uses have to look elsewhere.

Pros

  • Dual mechanism linked to greater average weight loss in trials

  • Only one of the two approved for obstructive sleep apnea

  • Lower list price than Wegovy — roughly $1,050 to $1,100 per month without insurance, before savings programs

Cons

  • Not approved for adolescents

  • No cardiovascular risk-reduction approval

  • Shorter real-world track record since its 2023 approval

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