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Semaglutide vs. tirzepatide: which is right for you?
Quick answer
Semaglutide acts on one appetite hormone (GLP-1). Tirzepatide acts on two (GLP-1 and GIP).
In a 2025 head-to-head trial of the FDA-approved versions, people taking tirzepatide lost more weight on average after 72 weeks: 20.2% of body weight versus 13.7% with semaglutide.
At Surna, compounded semaglutide starts at $109/mo and compounded tirzepatide at $139/mo. A licensed provider helps you choose.
Updated · Sources below
Side by side
| Feature | Semaglutide | Tirzepatide |
|---|---|---|
| What it acts on | GLP-1 | GLP-1 and GIP |
| FDA-approved brand versions | Wegovy®, Ozempic® | Zepbound®, Mounjaro® |
| How it’s taken at Surna | Weekly injection or daily dissolving tablet | Weekly injection or daily dissolving tablet |
| Average weight loss, head-to-head trial* | 13.7% at 72 weeks | 20.2% at 72 weeks |
| Most common side effects | Nausea, diarrhea, constipation, vomiting | Nausea, diarrhea, constipation, vomiting |
| Surna starting price | $109/mo | $139/mo |
*SURMOUNT-5 studied FDA-approved Wegovy® and Zepbound® at maximum tolerated doses. Compounded versions were not studied.
Which is right for you?
Your provider makes the final call based on your health history.
Choose Semaglutide if
- You want the lower price
- You’ve done well on semaglutide before
- You want a dissolving tablet at the lowest cost
Choose Tirzepatide if
- You want the option that showed more weight loss on average in a head-to-head trial
- Your progress stalled on semaglutide
- The higher price fits your budget
How they work
Both medications mimic hormones your gut releases after eating. They signal fullness to your brain, slow how quickly your stomach empties, and help regulate blood sugar.
Semaglutide activates the GLP-1 receptor. Tirzepatide activates both the GLP-1 and GIP receptors, which is why it’s sometimes called a dual agonist. Both start at a low dose that increases gradually.
What the research shows
In SURMOUNT-5, 751 adults with obesity and without diabetes took the maximum tolerated dose of either tirzepatide or semaglutide for 72 weeks. Average weight loss was 20.2% with tirzepatide and 13.7% with semaglutide.
In their own placebo-controlled trials, semaglutide 2.4 mg produced an average 14.9% weight loss at 68 weeks (STEP 1), and tirzepatide produced up to 20.9% at its highest dose at 72 weeks (SURMOUNT-1).
These trials studied FDA-approved medications. Compounded semaglutide and tirzepatide are not FDA-approved and were not part of these studies. Individual results vary.
Side effects
Side effects are similar for both. The most common are digestive: nausea, diarrhea, constipation, and vomiting, usually strongest when starting or increasing a dose. Both carry the same warnings, including a boxed warning about thyroid C-cell tumors seen in rodent studies.
Cost at Surna
Compounded semaglutide starts at $109/mo and compounded tirzepatide at $139/mo. Quarterly and monthly plans are available, and prices are locked for 12 months.
Questions, answered
Which works better, semaglutide or tirzepatide?
In a 2025 head-to-head trial of the FDA-approved versions, tirzepatide led to more weight loss on average (20.2% vs. 13.7% at 72 weeks). Individual results vary, and the right choice depends on your health history, budget, and how you respond.
Can I switch from semaglutide to tirzepatide?
Often, yes. Your provider sets a starting tirzepatide dose based on your current semaglutide dose and how you tolerated it.
Are compounded versions the same as Wegovy® or Zepbound®?
No. Compounded semaglutide and tirzepatide are prepared by state-licensed pharmacies and are not FDA-approved. They are not the same products as Wegovy® or Zepbound®.
Which has fewer side effects?
Their side effects are similar, mostly digestive. In the head-to-head trial, both groups most often reported gastrointestinal effects.
Sources
- Aronne LJ, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med. 2025;393:26-36. Source
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. 2021;384:989-1002. Source
- Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med. 2022;387:205-216. Source
- U.S. Food and Drug Administration. FDA’s concerns with unapproved GLP-1 drugs used for weight loss. Source
This page is general information, not medical advice. A licensed provider will determine whether treatment is appropriate for you. Individual results vary. Wegovy®, Ozempic®, and Rybelsus® are registered trademarks of Novo Nordisk; Zepbound® and Mounjaro® of Eli Lilly and Company; Viagra® of Viatris; Cialis® of Eli Lilly and Company. Surna Health is not affiliated with these companies.
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