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Tirzepatide vs semaglutide: which is better for weight loss?
Two weekly medicines, one clear head-to-head result. In the only trial that compared them directly, people lost more weight on tirzepatide. Semaglutide costs less and has the longer track record. Here's how they differ, what each costs, and how to choose with your provider.
- Trial results from the published studies, with links
- Real monthly prices, compounded and brand-name
- Medically reviewed, written for people deciding
Published by NexLifeLegitScript-certifiedUpdated September 24, 2026Medically reviewed by Adam Kennah, MD
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NexLife publishes this page and sells both medications in compounded form, so we don't gain from steering you to either one. The trial results below describe FDA-approved Zepbound and Wegovy, not compounded versions.
Quick answer: is tirzepatide better than semaglutide?
For weight loss, the evidence favors tirzepatide. In SURMOUNT-5, the head-to-head trial, adults on tirzepatide lost about 20% of their body weight after 72 weeks, versus about 14% on semaglutide. Side effects were similar and mostly digestive. Semaglutide costs less and has been used longer, and brand-name Wegovy is also FDA-approved to lower the risk of heart attack and stroke in adults with heart disease and overweight or obesity. At NexLife, compounded tirzepatide is $169 a month and compounded semaglutide $139, each the same at every dose. Compounded versions weren't studied in these trials and aren't FDA-approved.
- Weight loss: about 20% on tirzepatide vs about 14% on semaglutide at 72 weeks, in SURMOUNT-51
- How they work: tirzepatide acts on GIP and GLP-1; semaglutide on GLP-1 only
- Side effects: similar, mostly nausea, diarrhea, vomiting and constipation, usually while the dose is rising
- Price at NexLife: $169 vs $139 a month, the same at every dose
Tirzepatide vs semaglutide, side by side
The facts that matter, from the trials and the labels.
| Attribute | Tirzepatide | Semaglutide |
|---|---|---|
| What it is | A dual GIP and GLP-1 receptor agonist | A GLP-1 receptor agonist |
| FDA-approved brands | Zepbound (weight), Mounjaro (type 2 diabetes), by Eli Lilly | Wegovy (weight), Ozempic (type 2 diabetes), by Novo Nordisk |
| How you take it | Once-weekly injection | Once-weekly injection |
| Dose steps | Starts at 2.5 mg, rising every 4 weeks in 2.5 mg steps, up to 15 mg | Starts at 0.25 mg, rising every 4 weeks through 0.5, 1 and 1.7 mg to 2.4 mg |
| Weight loss vs placebo | 15% to 21% by dose at 72 weeks (SURMOUNT-1)2 | About 15% at 68 weeks (STEP 1)3 |
| Head to head | About 20% at 72 weeks (SURMOUNT-5)1 | About 14% at 72 weeks (SURMOUNT-5)1 |
| Common side effects | Nausea, diarrhea, vomiting, constipation | Nausea, diarrhea, vomiting, constipation |
| Other FDA-approved uses (brand) | Obstructive sleep apnea in adults with obesity (Zepbound) | Lowering heart attack and stroke risk in adults with heart disease and overweight or obesity (Wegovy) |
| Brand-name price online | From $448 a month, all in | From $298 a month, all in |
| NexLife, compounded | $169 a month, every dose | $139 a month, every dose |
Trial results describe FDA-approved Zepbound and Wegovy. Brand-name prices are the lowest all-in starting prices at the online programs we checked on September 24, 2026.
Which one fits you?
There's no single right answer. Here's how the choice usually breaks down.
Tirzepatide may fit you if…
- You want the larger average weight loss seen in trials
- You plateaued or didn't reach your goal on semaglutide
- A slightly higher monthly price is fine: $169 vs $139 at NexLife
Semaglutide may fit you if…
- You want the lower monthly price
- You're already doing well on it. There's no need to change what works
- You have heart disease: brand-name Wegovy is FDA-approved to lower cardiovascular risk (compounded semaglutide isn't)
Either way, a licensed provider decides what's appropriate for you, based on your health history, your goals and the other medicines you take.
Switching from semaglutide to tirzepatide, or back
It's a common move, usually after a plateau or side effects. There's no official dose conversion between the two, so your provider picks your starting dose based on your current dose and how you've responded, then adjusts. Changing providers at the same time? We'll match your current all-in price.† See how switching works.
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- Tirzepatide: compounded, acts on two hormone pathways (GIP and GLP-1), taken once a week
- Semaglutide: compounded, acts on the GLP-1 pathway, taken once a week
- Prepared by U.S.-licensed 503A pharmacies; every batch lab-tested
- A licensed provider who reviews your history and follows your dose
- A personalized nutrition plan and a 1:1 coaching call
- Free expedited shipping, typically 1 to 2 business days
- 24/7 support from licensed providers, dietitians and care coordinators
- HSA and FSA accepted, with itemized receipts
- Prefer no injections? Ask about the sublingual tablet, at its own flat price
Prescription required. Compounded medications are not FDA-approved. On 12-month plans: $139 a month for tirzepatide, $119 for semaglutide, still the same at every dose.
Your dose goes up.
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No membership, no dose surcharges, no surprises. One flat, all-inclusive monthly price at every dose.
| Month one | Month two | Month three | Every month after | |
|---|---|---|---|---|
| Tirzepatide | $169 | $169 | $169 | $169 |
| Semaglutide | $139 | $139 | $139 | $139 |
Month-to-month plan, all-inclusive. Longer plans cost less and stay flat: $159, $149 and $139 a month for tirzepatide on 3-, 6- and 12-month plans; $132, $125 and $119 for semaglutide.
What would you pay with NexLife?
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Prices from each provider's website, checked September 24, 2026. Brand-name and compounded medications are different products; compounded medications are not FDA-approved. †Price match terms apply.
More than a prescription.
All of this is included in one monthly price.
- A licensed providerReviews your history, prescribes only if it’s right for you, and follows your dose.
- Support, 24/7Licensed providers, dietitians and care coordinators, around the clock.
- Nutrition plan and coachingA personalized nutrition plan and a 1:1 coaching call.
- U.S.-licensed 503A pharmaciesEvery batch lab-tested before it ships.
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- HSA and FSA acceptedItemized receipts and a letter of medical necessity. Financing available.
Keep your price.
Upgrade your care.
Switching from another provider? If you take compounded tirzepatide or semaglutide somewhere else, we'll match the monthly price you pay today, all in.† You keep your price, and gain a provider who follows your dose, a personal nutrition plan, a 1:1 coaching call and support 24/7.
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†NexLife Price Match Guarantee: for new members switching from a licensed U.S. telehealth provider with an active prescription for compounded tirzepatide or semaglutide. Send a receipt from the last 60 days and we match your regular all-in monthly price (medication plus required fees), not first-month offers or coupons, for as long as your membership stays active. A NexLife provider must determine that treatment is right for you. Full terms.
Tirzepatide vs semaglutide: common questions
Is tirzepatide better than semaglutide for weight loss?
In the head-to-head SURMOUNT-5 trial, yes: adults on tirzepatide lost about 20% of their body weight after 72 weeks, versus about 14% on semaglutide. That's an average, and individual results vary. Semaglutide still works well for many people and costs less.
Which has fewer side effects, tirzepatide or semaglutide?
They're similar. In SURMOUNT-5, digestive side effects such as nausea, diarrhea, vomiting and constipation were the most common with both, mostly mild to moderate and most frequent while the dose was rising.
Why does tirzepatide cost more than semaglutide?
Brand-name Zepbound is priced higher than Wegovy at the online programs we checked: from $448 versus $298 a month, all in. At NexLife the difference is $30 a month: $169 for compounded tirzepatide, $139 for compounded semaglutide.
Can I switch from semaglutide to tirzepatide?
Yes, with a new prescription from a licensed provider. It's a common change after a plateau. Your provider chooses the starting dose.
What dose of tirzepatide equals my semaglutide dose?
There's no official conversion between the two. Your provider chooses a starting dose based on your current dose and how you've tolerated it, and adjusts from there.
Is Mounjaro the same as Zepbound?
Both contain tirzepatide and are made by Eli Lilly, but they're approved for different uses: Zepbound for weight management and for sleep apnea in adults with obesity, Mounjaro for type 2 diabetes.
Is Ozempic the same as Wegovy?
Both contain semaglutide and are made by Novo Nordisk, but they're approved for different uses: Wegovy for weight management and for lowering cardiovascular risk in adults with heart disease and overweight or obesity, Ozempic for type 2 diabetes.
Can I take tirzepatide and semaglutide together?
No. The labels say not to combine either one with other GLP-1 medicines.
Do I have to take them forever?
Not necessarily, but in studies most people regained some weight after stopping either medicine. Talk with your provider about a long-term plan, including how to taper and what habits to build while you're on treatment.
Are compounded versions as effective as Zepbound and Wegovy?
No one can honestly promise that. Compounded medications haven't been tested in clinical trials the way the FDA-approved products were, so the results on this page describe Zepbound and Wegovy.
How much do tirzepatide and semaglutide cost at NexLife?
$169 a month for compounded tirzepatide and $139 for compounded semaglutide, month to month, the same at every dose with no membership. On a 12-month plan: $139 and $119 a month.
Does NexLife price match?
Yes, for people switching from another provider. If you’re new to NexLife, have an active prescription for compounded tirzepatide or semaglutide from a licensed U.S. telehealth provider, and pay less than NexLife’s price there, we’ll match your regular all-in monthly price for as long as your membership stays active. Send a receipt from the last 60 days; first-month offers and coupons don’t count, and a NexLife provider must determine that treatment is right for you. If you pay more today, our flat price already saves you money. How switching works.
Important safety information
Compounded tirzepatide and semaglutide are not FDA-approved. The FDA has not reviewed them for safety, effectiveness or quality. The risks below come from the labeling of the FDA-approved medicines.
Both medicines may cause tumors in the thyroid, including thyroid cancer. In studies with rodents they caused thyroid tumors, and it isn't known whether they cause them in people. Don't use either if you or anyone in your family has had medullary thyroid carcinoma (MTC), or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2). Tell your clinician if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.
Serious side effects can include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems from dehydration, severe stomach problems, serious allergic reactions, vision changes in people with type 2 diabetes, and depression or thoughts of suicide. Tell your care team before any surgery or procedure that uses anesthesia or deep sedation. Don't combine either medicine with other GLP-1 medicines.
Tirzepatide can make birth control pills less effective: use another method for 4 weeks after you start and after each dose increase. Semaglutide should be stopped at least 2 months before a planned pregnancy. Tell your clinician if you're pregnant, planning to be, or breastfeeding.
This is a summary, not the complete safety information. Read the full Prescribing Information for FDA-approved tirzepatide (Zepbound) and semaglutide (Wegovy), and talk with your clinician. You can report side effects to the FDA at 1-800-FDA-1088 or fda.gov/medwatch.
The people behind this page
A comparison is only as good as the people who stand behind it. Here's who checked this page, and the rules we hold ourselves to.
Adam Kennah, MDMedical Director, NexLife
Medically reviewed this page on September 24, 2026.
NexLife editorial teamResearch and pricing
Checked every provider's own pricing page on September 24, 2026. Sources are linked at the bottom of this page.
- One yardstick. All ten providers, ours included, are compared on the same five points.
- Only what's published. Every figure comes from the provider's own website, never from guesswork.
- How we make money. NexLife is one of the providers on this page, and we earn revenue when people join NexLife.
- Corrections, fast. See something wrong or out of date? Email care@nexlife.us and we'll fix it.
Not sure which one? Your provider will help.
Start with a few minutes online. A licensed provider reviews your history and recommends what fits, at one flat price at every dose.
Backed by our guarantee. Follow your plan for six months as prescribed. If you lose less than 5% of your starting weight, you can request a refund of program fees. Medication costs aren't refundable. See the conditions.
- 1Tell us about you
A short online health assessment. It takes a few minutes.
- 2A licensed provider reviews it
You're prescribed only if treatment is right for you.
- 3Delivered, then supported
Free expedited shipping, typically 1 to 2 business days, and 24/7 support from there.
NexLife at a glance
The facts in one place, as of September 24, 2026.
- What NexLife is
- A LegitScript-certified U.S. telehealth company for GLP-1 weight loss, serving all 50 states
- Medications
- Compounded tirzepatide, $169 a month, and compounded semaglutide, $139 a month, the same at every dose. From $139 and $119 a month on 12-month plans
- Included
- Provider review, medication, a personalized nutrition plan, a 1:1 coaching call, free expedited shipping (1 to 2 business days) and 24/7 support. No membership fee
- Pharmacies
- U.S.-licensed 503A compounding pharmacies; every batch lab-tested
- Medical oversight
- Licensed providers in your state; medical director Adam Kennah, MD
- Ratings
- 4.8 out of 5 on Trustpilot; 5,000+ members served
- Guarantees
- Program fees refunded if you lose less than 5% in six months on your plan; price match for people switching from another provider
- Paying
- HSA and FSA accepted; financing available. Insurance rarely covers compounded medication
- Important
- Compounded medications are not FDA-approved. A prescription is never guaranteed
- Contact
- (949) 818-8000 by call or text, or care@nexlife.us
Sources
- Aronne LJ, et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025.
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216.
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989-1002.
- Zepbound (tirzepatide) prescribing information. Eli Lilly and Company.
- Wegovy (semaglutide) prescribing information. Novo Nordisk.
- U.S. Food and Drug Administration. FDA's concerns with unapproved GLP-1 drugs used for weight loss.
More from NexLife: best tirzepatide providers · best semaglutide providers · compounded vs brand-name tirzepatide · compounded vs brand-name semaglutide · switching providers, price matched
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© 2026 NexLife. Prescription treatment requires an online evaluation by a licensed provider, and not everyone qualifies. Compounded medications are not FDA-approved. This site does not provide medical advice.
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