What to know about switching from semaglutide to tirzepatide

Interested in switching from semaglutide to tirzepatide? Understanding the differences between these medications can help you and your healthcare provider decide which one may be right for you, or if it's time to make a move from one to the other.

In this article, we’ll cover how to switch from semaglutide to tirzepatide and answer other frequently asked questions about this process.

Both semaglutide and tirzepatide are once-weekly injections that can help you lose weight by making you feel less hungry. Both drugs are used alongside regular physical activity and a reduced-calorie diet, but they act in slightly different ways in your body.

Semaglutide mimics a naturally occurring hormone in your body called glucagon-like peptide-1 (GLP-1), which helps regulate your appetite and slows stomach emptying, which can help increase feelings of satiety. 

In 2021, the FDA approved semaglutide for weight loss under the brand Wegovy. Taking Wegovy can help you feel fuller for longer and eat less, which can help you lose weight.

Approved in 2023, Zepbound is a newer weight management medication that contains tirzepatide as its active ingredient. Tirzepatide mimics not just one but two hormones—GLP-1 and GIP. By acting on both, Zepbound may offer a more effective approach to weight loss (more about this later).

Semaglutide and tirzepatide also work to lower blood sugar levels in people with type 2 diabetes and are approved for this purpose under the brands Ozempic and Mounjaro, respectively, both of which are commonly prescribed off-label for weight loss. For simplicity, the rest of this article will mainly refer to these medications by their active ingredients—semaglutide or tirzepatide.

Yes, if you and your healthcare provider decide that tirzepatide would be a better option for you. The first thing to consider is whether you’re a candidate for tirzepatide based on who it's meant for and what it’s been proven effective to treat. As Zepbound, tirzepatide is approved for long-term weight management, alongside diet and exercise, in adults with:

• Obesity, defined as a body mass index (BMI) of 30 or higher, or

• Overweight with BMI of 27 or higher and at least one weight-related condition, such as high blood pressure, high cholesterol, type 2 diabetes, sleep apnea, or heart disease

If you’re already using semaglutide, either for managing weight or type 2 diabetes, it’s likely you can check one of those boxes.   

There are many potential reasons why switching from semaglutide to tirzepatide might be beneficial.

Efficacy for weight loss. Research suggests that tirzepatide leads to more weight loss than semaglutide. In a study comparing the two drugs for weight loss, people lost an average of 5.9% of their body weight in three months with tirzepatide, compared to 3.6% with semaglutide. After a year, tirzepatide led to a 15.3% decrease in body weight versus 8.3% for semaglutide. If you’re not losing weight as expected or think you’ve hit a plateau, tirzepatide could be worth a try.

Side effects. Both tirzepatide and semaglutide have similar side effects like nausea, vomiting, and diarrhea. These side effects usually subside over time as your body gets used to the medication. Most evidence shows higher rates of these side effects with tirzepatide. However, everyone's body reacts differently and studies don’t always predict individual experiences. 

Drug availability. While both drugs are facing shortages due to high demand, tirzepatide may be easier to find in stock right now. As of mid-August 2024, the FDA reports all strengths of tirzepatide as available, while some doses of semaglutide are in limited supply.

Cost. Both medications are expensive, but tirzepatide is around $300 less per month based on the retail prices without insurance or discounts. Zepbound’s list price is $1,059.87 for a month's supply, while Wegovy is listed at $1,349.02 for a month's supply. If cost is a concern, switching could save you money. 

Diabetes. Both medications help with weight loss and managing type 2 diabetes, but tirzepatide may have the edge. Study results show that tirzepatide outperforms semaglutide in controlling blood sugar levels at the 40-week mark. If you’re managing your weight alongside diabetes, tirzepatide’s dual action as both a GLP-1 and GIP receptor agonist might offer more benefits.

If any of these reasons resonate with you, it might be time to talk with your healthcare provider about making the switch. They can help determine if tirzepatide may be a better fit.

The first step to switching from semaglutide to tirzepatide is to schedule an appointment with a healthcare provider. Tell them you’re interested in switching to tirzepatide and why. They’ll likely want to discuss how well you’ve tolerated semaglutide, your weight loss progress, and whether you’re meeting your health goals. 

Both medications are injected under the skin (subcutaneously) once weekly. If you switch from one to the other, it’s likely you’ll start tirzepatide one week after your last dose of semaglutide. Your healthcare provider will provide you with specific instructions on how to switch from semaglutide to tirzepatide. 

In research involving people with type 2 diabetes who switched from semaglutide to tirzepatide, participants stopped semaglutide 3 to 10 days before starting tirzepatide. After the switch, some people experienced gastrointestinal side effects like nausea, constipation, and diarrhea. It’s important to be aware of these side effects and report any new or severe symptoms to your provider. 

If you still have semaglutide left, you shouldn’t continue to use it with tirzepatide. The drug label advises against using tirzepatide with other weight loss treatments including GLP-1 agonists because there’s not enough research on the efficacy or safety of combining them.

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Current version

August 30, 2024

Written by

Patricia Weiser, PharmD

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.