Tirzepatide
How it works
Tirzepatide activates the GIP and GLP-1 receptors, the targets for the body's own GIP and GLP-1. The Zepbound label places both in brain areas involved in appetite regulation.
Tirzepatide vs semaglutide
The short answer
In SURMOUNT-5, adults with obesity and without type 2 diabetes lost more weight on average with weekly tirzepatide injections than with weekly semaglutide injections: 20.2% versus 13.7% of starting weight over 72 weeks.
A note on semaglutide
Semaglutide appears here only as a research comparison; Sequel does not offer it.
How they work
Tirzepatide
Semaglutide
Semaglutide
How it works
Semaglutide activates the GLP-1 receptor, the target for the body's own GLP-1. The Wegovy label describes GLP-1 as a natural regulator of appetite and calorie intake.
Wegovy prescribing information, Novo Nordisk. DailyMed updated June 18, 2026.
What SURMOUNT-5 compared
SURMOUNT-5 randomly assigned 751 adults with obesity and without type 2 diabetes to 72 weeks of weekly injections under the skin: tirzepatide (10 mg or 15 mg) or semaglutide (1.7 mg or 2.4 mg), each at the highest dose the participant tolerated. It was open-label, so participants knew which medicine they received. Eli Lilly funded the trial.
Tirzepatide
Average weight reduction
In SURMOUNT-5, the tirzepatide group's estimated average weight reduction was 20.2% at 72 weeks.
Semaglutide
Average weight reduction
In SURMOUNT-5, the semaglutide group's estimated average weight reduction was 13.7% at 72 weeks.
Side effects in the trial
In SURMOUNT-5, the most common side effects in both groups affected the stomach and bowels. Most were mild to moderate and occurred mainly as doses increased.
What matters for your choice
When comparing average weight loss with these weekly injections as studied, SURMOUNT-5 showed a greater reduction with tirzepatide. Your own response can differ from a group average. These findings do not establish outcomes for Sequel's compounded injections, oral melts or nasal sprays.
Tirzepatide
Label exclusions
The Zepbound label rules out tirzepatide for anyone with a personal or family history of medullary thyroid carcinoma (a thyroid cancer), Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or a known serious allergy to tirzepatide or any of its ingredients.
Semaglutide
Label exclusions
The Wegovy label rules out semaglutide for anyone with a personal or family history of medullary thyroid carcinoma, MEN 2, or a prior serious allergic reaction to semaglutide or any of its ingredients.
Wegovy prescribing information, Novo Nordisk. DailyMed updated June 18, 2026.
Your next step
When you're ready, start with Sequel's intake and share your health history. A licensed clinician reviews it and decides whether a prescription is appropriate. Sequel serves adults in every state except Louisiana and Mississippi, and you'll see your total at checkout before you pay.
Common questions
Can you use them together?
The Zepbound label does not recommend taking tirzepatide with any GLP-1 receptor agonist, which includes semaglutide, or with other tirzepatide products.
Does compounded tirzepatide have the same approval as the branded medicine?
No. Compounded drugs are not FDA-approved, so the FDA has not verified their safety, effectiveness or quality before they are sold. That verification is what the approval process for a branded medicine provides.
Compounding and the FDA: Questions and Answers (U.S. Food and Drug Administration)