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Semaglutide vs Tirzepatide

Semaglutide and tirzepatide compared from their U.S. labels and head-to-head trials: indications, shared warnings, differences in evidence, and why there is no universal winner.

Content last updated . This page has not been medically reviewed.

Quick answer
Semaglutide and tirzepatide are both prescription peptide medicines for type 2 diabetes and weight management. In the two head-to-head trials read for this page, tirzepatide produced larger average changes in the measured outcomes. That does not make it the better choice for any one person: the labels differ in who they cover, both carry the same type of boxed warning, and the trials do not answer long-term or individual questions. Decisions belong with a prescriber.

Molecule, brand and formulation are different things

  • Semaglutide is a GLP-1 receptor agonist. Its label describes it as a GLP-1 analogue with 94% sequence homology to human GLP-1. [1] U.S. brands read here: Ozempic (diabetes) and Wegovy (weight, and more). [2][1]
  • Tirzepatide is a GIP receptor and GLP-1 receptor agonist (two targets). [3] U.S. brands: Mounjaro (diabetes) and Zepbound (weight and sleep apnea). [4][3]
  • Formulation. The Wegovy label covers an injection and tablets. [1] The Mounjaro and Zepbound labels read describe injected products (pens or vials). [4][3]

Same molecule under two brand names means different approved indications, not different drugs. Pages on each: semaglutide and tirzepatide.

What the U.S. labels say (read 2026-10-22)

BrandMoleculeIndications, in short
OzempicSemaglutideType 2 diabetes blood sugar control; lower risk of major cardiovascular events in type 2 diabetes with established heart disease; kidney outcomes in type 2 diabetes with chronic kidney disease [2]
WegovySemaglutideWeight reduction and maintenance in adults and in children 12 and older with obesity; lower cardiovascular risk in adults with established disease and obesity or overweight; MASH liver disease with fibrosis (accelerated approval) [1]
MounjaroTirzepatideType 2 diabetes in adults and in children 10 and older; lower cardiovascular events in adults with type 2 diabetes at high risk [4]
ZepboundTirzepatideWeight reduction and maintenance in adults; moderate to severe obstructive sleep apnea in adults with obesity [3]

Labels change; check the current one. In the European Union, Mounjaro's single authorization covers both type 2 diabetes and weight management, which differs from the two U.S. brand names. [5]

Head-to-head evidence

  • Type 2 diabetes (SURPASS-2). In a 40-week open-label trial of 1,879 adults, tirzepatide at all three doses tested lowered HbA1c more than semaglutide at one dose and reduced body weight more. [6] The study was funded by Eli Lilly, which makes tirzepatide.
  • Obesity without diabetes (SURMOUNT-5). In a 72-week open-label trial of 751 adults, average weight change was -20.2% with tirzepatide and -13.7% with semaglutide at each person's maximum tolerated dose. [7] Also funded by Eli Lilly.

Limits: both are open-label (participants knew which drug they received), both measured surrogate outcomes such as HbA1c or weight, and neither tells us about one person's response, cost, or tolerability. Trial results come from controlled settings with specified populations. No head-to-head heart-attack or stroke trial was found in the sources read: Proper evidence not found (checked PubMed and the four labels).

No universal winner

Differences in average results do not decide which suits a person with a given health history, other medicines, pregnancy plans, cost or coverage. Anyone on either drug should not start, stop or change it without their prescriber. More: GLP-1 medicines overview, weight management evidence, and weight-loss medications and medical care.

Frequently asked questions

Is tirzepatide stronger than semaglutide?

In two trials funded by the maker of tirzepatide, it lowered HbA1c and weight more on average. [6][7] Averages do not predict an individual's results or safety.

Do both have the same boxed warning?

Yes, each label carries a boxed warning on thyroid C-cell tumors in rodents. [1][3]

Are Ozempic and Wegovy different drugs?

Same active ingredient, different labeled indications and products. [2][1]

More details: evidence, limits and cautions

The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.

How to read the evidence labels

Labels used on this page: approved medicine (regulator and indication named), established, mixed, and Proper evidence not found.

Shared safety information
All four labels carry a boxed warning about thyroid C-cell tumors seen in rodents, with unknown relevance to humans, and are contraindicated in people with a personal or family history of medullary thyroid carcinoma or MEN 2. [2][1][4][3] In SURMOUNT-5 and SURPASS-2, the most common adverse events for both drugs were gastrointestinal. [7][6] The Zepbound label also describes an interaction with oral hormonal contraceptives; ask a prescriber or pharmacist. [3]
Regulatory side note
FDA warns that unapproved or compounded versions of these drugs do not go through FDA review for safety, effectiveness and quality, and reports adverse events linked to dosing errors. [8] See compounded and unapproved GLP-1 products.
References
  1. Wegovy (semaglutide) injection and tablets prescribing information, Novo Nordisk, DailyMed, U.S. National Library of Medicine. Read 2026-10-22.
  2. Ozempic (semaglutide) injection prescribing information, Novo Nordisk, DailyMed, U.S. National Library of Medicine. Read 2026-10-22.
  3. Zepbound (tirzepatide) prescribing information, Eli Lilly, DailyMed, U.S. National Library of Medicine. Read 2026-10-22.
  4. Mounjaro (tirzepatide) prescribing information, Eli Lilly, DailyMed, U.S. National Library of Medicine. Read 2026-10-22.
  5. European Medicines Agency. Mounjaro: EPAR medicine overview and product details. Read 2026-10-22.
  6. Frías JP et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2). N Engl J Med 2021. PubMed. Read 2026-10-22.
  7. Aronne LJ et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025. PubMed. Read 2026-10-22.
  8. U.S. Food and Drug Administration. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.