Choosing between Tirzepatide, Semaglutide, and Liraglutide? This comprehensive comparison covers efficacy, side effects, cost, dosing, and clinical evidence to help you make an informed decision.
All three are FDA-approved GLP-1 receptor agonists proven to produce significant weight loss. However, they differ in effectiveness, convenience, cost, and safety profiles.
| Factor | Tirzepatide | Semaglutide | Liraglutide |
|---|---|---|---|
| Brand Names | Mounjaro, Zepbound | Ozempic, Wegovy | Victoza, Saxenda |
| Weight Loss | 20-22% | 15-17% | 8-10% |
| Mechanism | Dual GIP/GLP-1 | GLP-1 only | GLP-1 only |
| Dosing | Weekly injection | Weekly injection | Daily injection |
| Half-Life | 5 days | 7 days | 13 hours |
| FDA Approval | 2022-2023 | 2021 | 2014 |
| Clinical Data | Newer, less long-term data | Extensive, 5+ years | Most established, 10+ years |
| Monthly Cost | $1,000-1,400 | $900-1,400 | $1,300-1,500 |
| Nausea Rate | 25-30% | 30-40% | 35-45% |
| CV Benefits | Under study | Proven (SUSTAIN-6) | Proven (LEADER) |
The newest and most effective option. Tirzepatide is a dual GIP/GLP-1 receptor agonist that produces superior weight loss compared to semaglutide in head-to-head trials.
Patients seeking maximum weight loss who are comfortable with a newer medication. Ideal if you've tried semaglutide with good results but want more efficacy, or if you experienced significant nausea on semaglutide.
The gold standard with extensive research. Semaglutide has the most clinical data, proven cardiovascular benefits, and a well-established safety profile.
Patients who want proven efficacy with extensive long-term data. Ideal if you have cardiovascular disease or risk factors, need established safety data, or want the option of oral administration (Rybelsus).
The most established option with daily dosing. Liraglutide was the first GLP-1 agonist approved for weight loss and has the longest safety track record.
Patients who prioritize established safety data over maximum efficacy. Ideal if you're uncomfortable with newer medications, need the flexibility of a shorter half-life, or want the fastest titration schedule.
The SURMOUNT-2 trial directly compared tirzepatide to semaglutide in patients with obesity and type 2 diabetes.
| Outcome | Tirzepatide 15mg | Semaglutide 1mg | Difference |
|---|---|---|---|
| Weight Loss | -15.7% | -9.3% | +6.4% more |
| ≥15% Weight Loss | 51% | 27% | +24% more patients |
| ≥20% Weight Loss | 35% | 14% | +21% more patients |
| Nausea | 25% | 30% | 5% less |
| Discontinuation | 6.2% | 5.3% | Similar |
Conclusion: Tirzepatide produced 69% more weight loss than semaglutide with similar or better tolerability.
| Peptide | Monthly Cost | Annual Cost | Cost per % Weight Loss |
|---|---|---|---|
| Tirzepatide | $1,000-1,400 | $12,000-16,800 | $600-700 per % |
| Semaglutide | $900-1,400 | $10,800-16,800 | $700-900 per % |
| Liraglutide | $1,300-1,500 | $15,600-18,000 | $1,600-1,800 per % |
Most insurance plans cover these medications for diabetes but NOT for weight loss alone. Coverage for weight loss typically requires:
Copays with insurance: $25-250/month depending on plan.
Due to shortages, compounded versions of semaglutide and tirzepatide became available in 2022-2024 at significantly lower costs ($200-400/month). However:
Most providers recommend starting with semaglutide as the best balance of efficacy, safety data, and cost. If results are insufficient after 6 months, switching to tirzepatide is straightforward.
Liraglutide is typically reserved for patients who specifically need daily dosing flexibility or have concerns about longer-acting medications.
This comparison is for educational purposes only and should not replace consultation with a qualified healthcare provider. The choice between these medications depends on your individual medical history, risk factors, insurance coverage, and personal preferences.
All three medications require prescription and medical supervision. They are not suitable for everyone and carry risks including pancreatitis, gallbladder disease, and thyroid tumors (in animal studies).