Zepbound vs. Victoza

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

Key Takeaways

  • Zepbound is FDA-approved for chronic weight management and obstructive sleep apnea, while Victoza is approved for type 2 diabetes and cardiovascular risk reduction, not weight loss.

  • Zepbound is injected once a week and takes 20 weeks to reach its top dose, while Victoza is a daily injection that reaches its full maintenance dose in about three weeks.

  • Both drugs carry a boxed warning for thyroid C-cell tumors and should be avoided by anyone with a personal or family history of medullary thyroid cancer.

Zepbound vs. Victoza Drug Summary

Zepbound

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

Victoza

Victoza (liraglutide) is a GLP-1 receptor agonist given as a once-daily injection. It is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, and to lower cardiovascular risk in adults with type 2 diabetes and heart disease.

Zepbound vs. Victoza Side Effects

Zepbound

Most common
nausea (up to 29%)
diarrhea (up to 23%)
vomiting (up to 13%)
constipation (up to 17%)

Victoza

Most common
nausea (≥5%)
diarrhea (up to 11.7%)
vomiting (≥5%)
decreased appetite (≥5%)

Zepbound vs. Victoza Dosage

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

Victoza

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.6 mg once daily Week 1
Maximum dose 1.8 mg once daily Week 3 onward
Dose changes 2 increases Every week

Zepbound vs. Victoza Indications

Zepbound

Zepbound is FDA-approved for chronic weight management in adults with obesity, or overweight plus a related health condition. It is also approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity, used alongside diet and exercise changes.

  • Weight loss in adults with obesity or overweight plus a weight-related condition

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

  • Used together with a reduced-calorie diet and more physical activity

  • Not approved for type 1 or type 2 diabetes management

Victoza

Victoza is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, alongside diet and exercise. It is also approved to lower the risk of major cardiovascular events in adults with type 2 diabetes and existing heart disease.

  • Glycemic control adjunct to diet and exercise in type 2 diabetes

  • Reduces risk of major cardiovascular events in adults with type 2 diabetes and heart disease

  • Approved for children age 10 and older with type 2 diabetes

  • Not FDA-approved for weight loss; Saxenda is the higher-dose version cleared for that use

Zepbound vs. Victoza Pros and Cons

Zepbound

Zepbound is a newer dual GIP/GLP-1 agonist with FDA approval for both weight management and obstructive sleep apnea, and it produced substantial weight loss in clinical trials. It carries the same thyroid boxed warning as older GLP-1 drugs and is not an option for treating diabetes.

Pros

  • FDA-approved for weight loss and for obstructive sleep apnea, not just glycemic control

  • Only needs to be injected once a week

  • Dual GIP/GLP-1 action linked to greater average weight loss in trials

  • Adults lost an average of up to 48 pounds at the highest dose in SURMOUNT-1

Cons

  • Titration takes 20 weeks to reach the full maintenance dose

  • Not approved for treating type 2 diabetes

  • On the market since late 2023, so less long-term real-world safety data

  • Higher reported rates of nausea and diarrhea than seen with Victoza in trials

Victoza

Victoza is a well-established GLP-1 agonist with FDA approval for type 2 diabetes and cardiovascular risk reduction, not weight loss. Its daily dosing and long track record are its main strengths, though its weight effects are modest compared with newer options.

Pros

  • FDA-approved for type 2 diabetes glycemic control and cardiovascular risk reduction

  • Reaches its full maintenance dose in about 3 weeks

  • On the market since 2010, with 15 years of real-world safety experience

  • Approved for children age 10 and older with type 2 diabetes

Cons

  • Not FDA-approved for weight loss; using it for that purpose is off-label

  • Requires a daily injection instead of a once-weekly shot

  • Produces less weight loss than Zepbound, since weight loss is only a secondary effect

  • Single GLP-1 mechanism, linked to more modest appetite and weight effects

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