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
Victoza
Zepbound vs. Victoza Dosage
Zepbound
Victoza
| 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 |
| 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
| 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
| 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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