Semaglutide vs Tirzepatide
Both are once-weekly injectable therapies used in chronic weight management, and both are titrated upward over several weeks. The substantive difference is mechanism: semaglutide acts at the GLP-1 receptor, while tirzepatide is a dual agonist acting at both GIP and GLP-1 receptors.
| Dimension | Semaglutide | Tirzepatide |
|---|---|---|
| Mechanism | GLP-1 receptor agonist | Dual GIP and GLP-1 receptor agonist |
| Administration | Once-weekly subcutaneous injection | Once-weekly subcutaneous injection |
| Titration | Stepwise over several weeks | Stepwise over several weeks |
| Common effects | Gastrointestinal, most pronounced during escalation | Gastrointestinal, most pronounced during escalation |
| Boxed warning | Thyroid C-cell tumours (rodent studies) | Thyroid C-cell tumours (rodent studies) |
| Absolute contraindication | Personal or family history of MTC or MEN2 | Personal or family history of MTC or MEN2 |
| Oral formulation | An oral form of the branded product exists | Injectable only |
How a provider actually decides
Neither is universally preferable. The decision rests on your medical history, contraindications, how you tolerate titration, what is actually available, and cost. That is a clinical judgement made after reviewing your intake and laboratory results — not a choice made from a comparison table.
Read more on each
Semaglutide
Semaglutide is a GLP-1 receptor agonist prescribed for weight management. Learn how it is dosed, what monitoring it needs, and what a provider assesses first.
Tirzepatide
Tirzepatide is a dual GIP and GLP-1 receptor agonist used in weight management. Learn how it differs from semaglutide and what evaluation it requires.
Related questions
What is the difference between semaglutide and tirzepatide?
Semaglutide acts at the GLP-1 receptor. Tirzepatide is a dual agonist acting at both GIP and GLP-1 receptors. Both are given as weekly injections with a stepwise titration and both carry the same boxed warning regarding thyroid C-cell tumours. Which is appropriate depends on your history, tolerability, contraindications and availability — that is a clinical judgement, not a preference.
Am I eligible for GLP-1 therapy?
Eligibility generally rests on BMI thresholds, with a lower threshold applying where weight-related comorbidities are present. There are also absolute contraindications: a personal or family history of medullary thyroid carcinoma or MEN2 rules the class out entirely, and a history of pancreatitis requires careful consideration. A provider determines eligibility after reviewing your intake and laboratory results, and not everyone qualifies.