Zepbound vs. Wegovy for weight loss

In this article:

• Key differences
• Conditions treated
• Zepbound vs. Wegovy: Key differences
• Cost and coverage
• Side effects
• Interactions
• Warnings
• Mounjaro and Ozempic comparison

In this article

• Key differences
• Conditions treated
• Zepbound vs. Wegovy: Key differences
• Cost and coverage
• Side effects
• Interactions
• Warnings
• Mounjaro and Ozempic comparison

Zepbound and Wegovy are brand-name prescription medications used for weight loss. Both are once-weekly injections. These medicines mimic natural hormones that help regulate appetite and food intake, and reduce cravings. While both medications share some similarities, they have some differences as well. 

Zepbound vs. Wegovy: Key differences

Zepbound is a brand-name drug that contains the active ingredient tirzepatide.

Zepbound works by targeting two receptors—glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)—making it a dual GIP/GLP-1 receptor agonist. No generic alternative is available at this time.

Wegovy is a brand-name drug, and contains the active ingredient semaglutide. Wegovy acts on the GLP-1 receptor, so it is classified as a GLP-1 receptor agonist, or GLP-1 agonist. There is no generic available at this time. 

Compare Zepbound vs. Wegovy key differences
	Zepbound	Wegovy
Drug class	GIP/GLP-1 receptor agonist	GLP-1 receptor agonist
Brand/generic status	Brand	Brand
What is the generic name?	The active ingredient is tirzepatide, but there is no generic available at this time.	The active ingredient is semaglutide, but there is no generic available at this time.
What form(s) does the drug come in?	Injection: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg	Injection: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg
What is the standard dosage?	The starting dose is 2.5 mg injected subcutaneously (under the skin) once a week. Healthcare providers gradually increase the dose up to a maximum of 15 mg once weekly.	The starting dose is 0.25 mg injected subcutaneously (under the skin) once a week. Healthcare providers gradually increase the dose up to a maximum of 2.4 mg once weekly.
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults	Adults and pediatric patients 12 years and older for obesity; adults only for overweight and cardiovascular risk reduction

 

Zepbound vs. Wegovy: Conditions treated

Zepbound is approved by the Food and Drug Administration (FDA) for weight loss and long-term maintenance of weight loss in adults with obesity (body mass index, or BMI of 30 or more), or adults who are overweight (BMI of 27 to less than 30) who have at least one weight-related health condition, such as high blood pressure or high cholesterol. It is typically prescribed along with lifestyle changes like a reduced-calorie diet and exercise.

Wegovy has two FDA-approved uses. Like Zepbound, it is used for weight loss and long-term weight maintenance. It can be used in adults and pediatric patients 12 years and older with obesity, as well as adults who are overweight and have at least one weight-related medical condition. Wegovy can also be used to decrease the risk of major adverse cardiovascular events, including cardiovascular death, heart attack, or stroke, in adults who have cardiovascular disease and are either overweight or have obesity. Healthcare providers typically prescribe Wegovy along with lifestyle modifications like diet and increased physical activity.

Note: While Zepbound is not FDA approved for cardiovascular risk reduction, research suggests that it may be beneficial for this use. Therefore, some healthcare providers may prescribe it off-label (for a non-FDA-approved use) for cardiovascular risk reduction. 

Compare Zepbound vs. Wegovy conditions treated
Condition	Zepbound	Wegovy
Weight loss	Yes	Yes
Cardiovascular risk reduction	Off-label	Yes

 

Is Zepbound better than Wegovy for weight loss?

Let’s take a look at the studies, starting with the most recent study, which was the first randomized, controlled clinical trial directly comparing the two drugs. According to the results of the trial, participants who got weekly injections of Zepbound lost about 20.2% of their body weight (or 50.3 pounds) after 72 weeks (18 months). In contrast, people taking weekly injections of Wegovy lost 13.7% of their body weight (or 33.1 pounds). Eli Lilly and Company, who funded the study and is the manufacturer of Zepbound, says these results indicate that Zepbound leads to 47% more weight loss than Wegovy. 

In a clinical study for Zepbound (tirzepatide) published in 2022, there were about 2,500 participants divided into four groups. Each group received either tirzepatide 5 mg, 10 mg, 15 mg, or placebo (inactive medicine) for 72 weeks with a gradual increase to the target dose. In terms of weight loss results:

• About 48% of people who injected tirzepatide 5 mg weekly lost about 15% of their body weight, and 85% of people in this group lost at least 5% of their body weight.
• About 50% of people who injected tirzepatide 10 mg weekly lost about 20% of their body weight, and 89% of people in this group lost at least 5% of their body weight.
• About 57% of people who injected tirzepatide 15 mg weekly lost 20% of their body weight or more, and 91% of people in this group lost at least 5% of their body weight.
• About 35% of people who injected a placebo weekly lost at least 5% of their body weight, and 3% lost 20% or more.

In a clinical study for Wegovy (semaglutide) published in 2021, there were about 1,960 participants. Two-thirds of the participants received 2.4 mg semaglutide (with a gradual increase to this dose), and the other third received a placebo for 68 weeks. Here are the weight loss results:

• About 86% of people who injected semaglutide weekly lost at least 5% of their body weight, with 69% losing 10% or more and 51% losing 15% or more.
• About 32% of people who injected a placebo weekly lost at least 5% of their body weight, with 12% losing 10% or more and 5% losing 15% or more.
• The mean weight loss for people who used semaglutide was about 34 pounds, compared to about 6 pounds for those who used a placebo.

Regardless of the results of clinical studies, individual responses may vary widely, especially taking into account lifestyle changes that may add to a more successful outcome. Only your healthcare provider can determine which medication is best for you based on individual considerations such as your medical conditions and history as well as other medications you take. 

It is also important to note that you should talk with your healthcare provider about long-term use of these medicines. Research has found that people who stop treatment may gain much of the weight back. For example, one study found that one year after stopping Wegovy, people gained back two-thirds of their previous weight loss. This suggests that ongoing treatment may be required to maintain weight loss and health benefits. 

Zepbound vs. Wegovy cost and coverage

According to Lilly, private insurance coverage varies for Zepbound. Insurance plans that provide coverage for this medicine will generally require a prior authorization (PA) first. This means that the healthcare provider must give the insurance company more information about why you need this medicine before the insurance company determines whether it will cover it. Private insurance coverage will vary for Wegovy as well. If your plan covers Wegovy, it may require a PA. 

Check with your insurance plan provider for more information on Zepbound or Wegovy coverage and your costs. You can also check the manufacturers’ websites for insurance coverage information. They may also share more information on various ways to save on Zepbound or Wegovy. 

In terms of Medicare prescription plans, most do not cover weight-loss drugs such as Zepbound or Wegovy. However, some Medigap or Medicare Advantage plans may cover your medicine in certain cases. You can call your plan for more information about coverage and costs. 

A one-month supply of Zepbound costs about $1,472 out of pocket without insurance. Using a free SingleCare coupon could bring the price down to as low as $907, depending on the pharmacy—a savings of $565 per month.

A one-month supply of Wegovy without insurance costs about $1,840, with a free SingleCare coupon bringing the price down to $1,194, depending on the pharmacy—a savings of $646 per month.

Compare Zepbound vs. Wegovy cost and coverage
	Zepbound	Wegovy
Typically covered by insurance?	Varies	Varies
Typically covered by Medicare Part D?	No, but may be covered by some Medigap or Medicare Advantage plans	No, but may be covered by some Medigap or Medicare Advantage plans
Quantity	1 box of 4 injections (28-day supply)	1 box of 4 injections (28-day supply)
SingleCare cost*	$907	$1,194

*Cost at time of publication. Drug prices fluctuate and vary by pharmacy.

Zepbound vs. Wegovy side effects

The most common side effects of both drugs are stomach problems such as nausea, vomiting, diarrhea, constipation, stomach pain, and indigestion. Other common side effects of Zepbound include fatigue, injection site reactions, and hair loss. Other common side effects of Wegovy include headache, fatigue, runny nose, and sore throat. 

Serious side effects, such as allergic reactions, may occur in rare cases. If you have symptoms such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, get emergency medical help. This is not a full list of side effects, and others may occur. Consult your healthcare provider for more information about the side effects of Zepbound and Wegovy.

Compare Zepbound vs. Wegovy side effects
	Zepbound		Wegovy
Side effect	Applicable?	Frequency*	Applicable?	Frequency*
Nausea	Yes	25%–29%	Yes	44%
Diarrhea	Yes	19%–23%	Yes	30%
Vomiting	Yes	8%–13%	Yes	24%
Constipation	Yes	11%–17%	Yes	24%
Stomach pain	Yes	9%–10%	Yes	20%
Indigestion	Yes	9%–10%	Yes	9%
Injection site reactions	Yes	6%–8%	Yes	1.4%
Fatigue	Yes	5%–7%	Yes	11%
Hair loss	Yes	4%–5%	Yes	3%
Headache	No	N/A	Yes	14%
Runny nose and sore throat	No	N/A	Yes	12%

*Frequency varies by dose. Sources: DailyMed

Zepbound and Wegovy drug interactions

Before you take Zepbound or Wegovy, tell your healthcare provider about all the medications you take, including prescription and over-the-counter (OTC) drugs, vitamins, and supplements. 

Because Zepbound and Wegovy lower blood sugar levels, you may have an increased risk of hypoglycemia (low blood sugar), especially if you use insulin or take certain medications (such as glimepiride, glipizide, or glyburide) for Type 2 diabetes. Your healthcare provider may need to adjust your doses, and you will have to carefully monitor your blood sugar.  

Zepbound and Wegovy both affect stomach emptying, which can possibly affect how oral medicines are absorbed when taken around the same time. This may be more likely to affect medicines that have a narrow therapeutic index, such as warfarin. 

If you take birth control pills, talk to your healthcare provider about birth control while taking Zepbound. The prescribing information recommends using a non-oral contraceptive method—or adding a barrier method such as condoms—for four weeks after starting Zepbound and for four weeks after each dose increase. 

Talk to your healthcare provider for more information about drug interactions and how they may affect you. 

Compare Zepbound vs. Wegovy drug interactions
Drug	Drug class	Interacts with Zepbound?	Interacts with Wegovy?
Humalog Lantus Novolog	Insulin	Yes	Yes
Glimepiride  Glipizide  Glyburide	Sulfonylureas	Yes	Yes
Nikki Tri-Sprintec	Oral contraceptives (birth control pills)	Yes	No
Oral medications	Oral medications	Check with your healthcare provider	Check with your healthcare provider

 

Zepbound and Wegovy drug warnings

Both Zepbound and Wegovy have a boxed warning, which is the most serious warning required by the FDA. The warning states that these medications have caused thyroid tumors in animal studies. It is not known whether this applies to humans. People with a history or family history of medullary thyroid carcinoma, as well as people with multiple endocrine neoplasia syndrome type 2 (MEN 2), should not use Zepbound or Wegovy. Anyone who uses Zepbound or Wegovy should be alert to symptoms of a thyroid tumor, such as a lump in the neck, trouble breathing or swallowing, or hoarseness. Report any of these symptoms to your healthcare provider right away.  

Zepbound and Wegovy can cause serious side effects, such as:

• Kidney problems
• Gallbladder disease
• Pancreatitis (inflammation of the pancreas)
• Allergic reactions 
• Low blood sugar
• Diabetic retinopathy complications in people with Type 2 diabetes
• Suicidal thoughts and behaviors
• Increased heart rate

Before taking Zepbound or Wegovy, tell your healthcare provider about any medical conditions you have, especially if:

• You have or have had kidney or pancreas problems
• You have stomach problems such as gastroparesis (slowed stomach emptying) or digestion problems
• You have Type 2 diabetes
• You have a history of diabetic retinopathy
• You are having a surgery or procedure with anesthesia or sedation

Tell your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Zepbound and Wegovy should not be used during pregnancy. If you are using one of these medicines and find out you are pregnant, stop using the medicine and call your healthcare provider. Also, because these medications stay in the body for a long time, your healthcare provider will tell you when you should stop using Zepbound or Wegovy and how long you should wait before trying to conceive. Those who are breastfeeding should consult their healthcare provider for medical advice. 

Is Zepbound the same as Mounjaro? Is Wegovy the same as Ozempic?

Many people ask which weight loss medications are similar to other injectable drugs used for diabetes. Zepbound and Mounjaro contain the same active ingredient, tirzepatide. Mounjaro is FDA approved to improve blood sugar control in adults with Type 2 diabetes, not for weight loss. Eli Lilly and Company manufactures both of these medications.  

Wegovy contains the same active ingredient as Ozempic, semaglutide. Ozempic is FDA-approved for Type 2 diabetes, not for weight loss. It also has an FDA-approved use for reducing the risk of major adverse cardiovascular events in adults with both Type 2 diabetes and cardiovascular disease. 

Novo Nordisk manufactures both of these medications. Healthcare providers sometimes prescribe Mounjaro or Ozempic off-label for weight loss.