Semaglutide vs Tirzepatide: 2026 Comparison
Separate branded-drug trial evidence, risks and Trimi plan terms to discuss with your licensed provider.
The short answer
SURMOUNT-5 directly compared branded Zepbound (tirzepatide) with Wegovy (semaglutide) in a randomized, open-label phase 3b trial of 751 adults with obesity without type 2 diabetes. Participants received weekly injections at maximum tolerated doses: tirzepatide 10 or 15 mg, or semaglutide 1.7 or 2.4 mg. At 72 weeks, average weight reduction (least-squares mean) was 20.2% with tirzepatide and 13.7% with semaglutide. These branded-drug group results do not establish outcomes for Trimi's compounded preparations or predict an individual's result. Read the SURMOUNT-5 study.
STEP 1 studied branded semaglutide 2.4 mg weekly and reported average weight reduction of 14.9% at 68 weeks. SURMOUNT-1 studied branded tirzepatide and reported 20.9% at 72 weeks in the 15 mg weekly group. Both enrolled adults with overweight or obesity without diabetes and included lifestyle support. These are separate trials, not a head-to-head comparison. Their group averages are not individual predictions or results established for Trimi's compounded preparations.
Compounded medications are not FDA-approved. FDA does not review them for safety, effectiveness or quality before marketing. A patient-specific prescription alone does not remove restrictions on preparations that are essentially copies of commercially available drugs. Where applicable, a prescriber must determine and document a change that produces a significant difference for an identified individual patient.
At Trimi, compounded semaglutide is $99/month equivalent on the annual plan, billed $1,188 upfront for a 12-month commitment, and compounded tirzepatide is $125/month equivalent on the annual plan, billed $1,500 upfront for a 12-month commitment. Monthly plans are $175 and $235 respectively. Treatment choice and prescribing require individual provider review.
Semaglutide vs Tirzepatide
The trial evidence below concerns branded medicines, not Trimi compounded preparations.
Medication Comparison
| Feature | Semaglutide | Tirzepatide |
|---|---|---|
| Mechanism | GLP-1 receptor agonist | GIP and GLP-1 receptor agonist |
| Separate branded-drug trial | STEP 1 | SURMOUNT-1 |
| Studied weekly injection dose | Semaglutide 2.4 mg | Tirzepatide 15 mg group |
| Average weight reduction in that trial | 14.9% at 68 weeks | 20.9% at 72 weeks |
| Trial population and support | Adults with overweight or obesity without diabetes; lifestyle support | Adults with overweight or obesity without diabetes; lifestyle support |
| What these figures do not establish | A personal forecast, head-to-head result or compounded-drug outcome | A personal forecast, head-to-head result or compounded-drug outcome |
| Trimi compounded annual plan | $99/month equivalent on the annual plan, billed $1,188 upfront for a 12-month commitment | $125/month equivalent on the annual plan, billed $1,500 upfront for a 12-month commitment |
| Trimi compounded monthly plan | $175, billed monthly; no multi-month commitment | $235, billed monthly; no multi-month commitment |
| Trimi compounded preparation | 503A preparation; not FDA-approved | 503A preparation; not FDA-approved |
Questions about semaglutide
Ask your provider about your medical history, the prescribed preparation, risks, monitoring and dose instructions. STEP 1 does not establish an outcome for a compounded preparation.
Trimi annual plan: $99/month equivalent on the annual plan, billed $1,188 upfront for a 12-month commitment. Monthly plan: $175, billed monthly.
Learn More About SemaglutideQuestions about tirzepatide
Ask your provider about benefits, contraindications, interactions and monitoring. The 15 mg SURMOUNT-1 trial group is not a starting-dose recommendation or a personal weight-loss forecast.
Trimi annual plan: $125/month equivalent on the annual plan, billed $1,500 upfront for a 12-month commitment. Monthly plan: $235, billed monthly.
Learn More About TirzepatideMechanisms and safety
Semaglutide activates the GLP-1 receptor; tirzepatide activates GIP and GLP-1 receptors. This mechanism information does not determine which treatment is right for an individual or establish equivalent outcomes for a compounded preparation.
Both medicines carry important risks and contraindications. Discuss your history and current medicines with your provider, and follow your prescription and pharmacy label rather than trial doses or this comparison table.
Read Important Safety InformationFrequently asked questions
Which is more effective for weight loss, semaglutide or tirzepatide?
SURMOUNT-5 directly compared branded Zepbound (tirzepatide) with Wegovy (semaglutide) in a randomized, open-label phase 3b trial of 751 adults with obesity without type 2 diabetes. Participants received weekly injections at maximum tolerated doses: tirzepatide 10 or 15 mg, or semaglutide 1.7 or 2.4 mg. At 72 weeks, average weight reduction (least-squares mean) was 20.2% with tirzepatide and 13.7% with semaglutide. These branded-drug group results do not establish outcomes for Trimi's compounded preparations or predict an individual's result. The right treatment depends on the licensed provider's individual assessment of your history, risks, current medicines and preferences.
Is semaglutide or tirzepatide cheaper?
At Trimi, compounded semaglutide is $99/month equivalent on the annual plan, billed $1,188 upfront for a 12-month commitment, and compounded tirzepatide is $125/month equivalent on the annual plan, billed $1,500 upfront for a 12-month commitment. Monthly plans are $175 for semaglutide and $235 for tirzepatide, billed monthly with no multi-month commitment. Plan prices include medication if prescribed, injection supplies, provider access and shipping, and stay the same across prescribed doses within the selected plan. These are Trimi's own plan prices, not a claim about the price of a branded drug or another provider. Payment is taken before provider review. If treatment is not appropriate, the order is refunded in full under the published refund policy.
Are the side effects of semaglutide and tirzepatide the same?
Both can cause gastrointestinal side effects such as nausea, vomiting, diarrhea, constipation and abdominal pain. Important risks include pancreatitis, gallbladder disease and kidney injury. Approved prescribing information carries a boxed warning for thyroid C-cell tumors and contraindications for a personal or family history of medullary thyroid carcinoma or MEN 2. This is not a complete list. Risks, interactions and tolerability require individual provider review. FDA has also reported dosing errors with compounded semaglutide; confirm the prescribed dose and vial concentration with your provider and dispensing pharmacy.
Can I switch between semaglutide and tirzepatide?
Discuss a proposed switch with your licensed provider before changing treatment. Share your current prescription, dose, last dose date, response, side effects and other medicines. There is no dose-equivalence rule supplied by this page. Your provider decides whether a switch is appropriate and sets the new prescription and schedule; follow that prescription and the dispensing pharmacy's label.
How long does it take to see weight-loss results?
There is no reliable timetable that predicts an individual's weight loss. Response depends on the prescribed treatment, dose tolerated, adherence, health history and lifestyle. STEP 1 and SURMOUNT-1 measured branded-drug group outcomes at 68 and 72 weeks respectively; they do not establish a timeline or outcome for a Trimi compounded preparation. Review progress, side effects and any dose changes with your provider.
How does compounded semaglutide or tirzepatide differ from brand-name products?
Brand-name medicines are FDA-approved finished drugs with their own prescribing information. Trimi's compounded preparations are made by BelieveRx, a state-licensed 503A community sterile compounding pharmacy, for individual prescriptions. Compounded medications are not FDA-approved. FDA does not review them for safety, effectiveness or quality before marketing. A patient-specific prescription alone does not remove restrictions on preparations that are essentially copies of commercially available drugs. Where applicable, a prescriber must determine and document a change that produces a significant difference for an identified individual patient. A compounded preparation should not be described as equivalent to a branded medicine. Verify your dispensing pharmacy and follow its prescription label.
Do I need insurance to get GLP-1 medication?
Trimi is cash-pay and does not bill insurance. For branded medications through other care pathways, coverage depends on the prescribed product, indication and current plan terms. Check your insurer's benefits and prior-authorization requirements directly. An insurance copay, program membership quote and medication-inclusive cash-pay plan are different cost components and should not be treated as the same bill.
Which medication is better for someone with type 2 diabetes?
Type 2 diabetes changes the clinical assessment, including glucose monitoring, existing medicines and the risk of hypoglycemia with some combinations. A licensed provider should decide the appropriate medicine and dose. STEP 1 and SURMOUNT-1 excluded diabetes, so the weight-loss results summarized here cannot answer which treatment is right for a person with diabetes. Do not select or change diabetes treatment using this comparison page.
Further reading
Deep-dive comparisons and clinical references that build on the topics covered above.
Tirzepatide and semaglutide clinical evidence
Updated effectiveness, cost, and clinical evidence comparison.
Ozempic vs Mounjaro 2026
Diabetes-indication head-to-head with SURPASS-2 trial data.
Wegovy vs Zepbound 2026
Weight-management indications: STEP 1 vs SURMOUNT-1 outcomes.
Compounded vs brand tirzepatide
Regulatory status, prescribing and pharmacy information.
Wegovy vs compounded semaglutide
The different regulatory status of branded and compounded preparations.
Brand vs compounded GLP-1 safety
FDA concerns and the limits of compounded-drug evidence.
Injectable vs oral semaglutide
Formulation and dosing differences to discuss with a prescriber.
GLP-1 vs phentermine, 2026 comparison
Chronic-use vs short-term agent; effect-size and risk profile differences.
GLP-1 vs metformin for weight loss
Metformin off-label vs FDA-approved GLP-1 chronic weight management.
Side effects + contraindications
MEN2 / medullary thyroid contraindication, pancreatitis risk, pregnancy.
Best GLP-1 with minimal side effects
Side effects, interactions and individualized provider review.
Semaglutide without insurance 2026
Three legitimate cash-pay paths and what to avoid.
Buy tirzepatide without insurance
Lilly vial program, compounded options, and patient-assistance programs.
Tirzepatide provider pricing and verification
Plan terms, cost components and pharmacy verification.
Wegovy cost in 2026
Brand pricing, coverage and manufacturer program information.
Semaglutide care pathways
Provider evaluation and the distinct status of compounded preparations.
Tirzepatide care pathways
Prescribing and regulatory considerations for compounded tirzepatide.
Options when Ozempic is not accessible
Discuss access, indications and appropriate treatment with your provider.
Is telehealth GLP-1 safe without an in-person exam?
What doctors say about online GLP-1 prescribing, evidence and limits.
How online GLP-1 prescriptions work
Step-by-step from intake form to clinician review to pharmacy delivery.
Is compounded semaglutide safe in 2026?
FDA concerns, pharmacy verification and individual prescribing.
Sources
The sources below support the head-to-head and separate branded-drug trial results, prescribing risks and compounding limitations. Trimi plan charges and service terms are linked separately. Trimi has a commercial interest in its own treatment plans.
- SURMOUNT-5, Aronne et al., NEJM 2025 (PubMed abstract): a randomized, open-label branded-drug head-to-head trial, published online May 11, 2025.
- STEP 1, Wilding et al., NEJM 2021: semaglutide 2.4 mg, 68 weeks, adults without diabetes, with lifestyle support.
- SURMOUNT-1, Jastreboff et al., NEJM 2022: tirzepatide, 72 weeks, adults without diabetes, with lifestyle support.
- Wegovy prescribing information and Zepbound prescribing information: approved-product indications, warnings, contraindications and monitoring.
- FDA concerns with unapproved GLP-1 drugs: compounded-drug limitations, dosing errors and sourcing concerns.
- FDA clarification of compounding policies: current restrictions on essentially copied commercially available medicines.
- Trimi cost guide, published plan charges, refund policy and Important Safety Information.
Editorial sources and Trimi terms checked on October 7, 2026. This is an editorial source check, not a clinical review or individual medical advice. See our medical review policy.