Semaglutide vs Tirzepatide: Which GLP-1 Is Right for You?

Semaglutide and tirzepatide are both once-weekly injections that lower appetite and help you feel full sooner. Semaglutide acts on one gut hormone receptor, GLP-1, while tirzepatide acts on two, GLP-1 and GIP. In a 2025 head-to-head trial of the brand-name medicines, tirzepatide led to greater average weight loss than semaglutide, with similar stomach side effects. The right choice depends on your health history, how you tolerate side effects and your budget, and a licensed provider helps you decide.

Key takeaways

Both medicines are injected under the skin once a week, and the dose is raised slowly.
Tirzepatide acts on GLP-1 and GIP receptors; semaglutide acts on GLP-1 receptors.
In the SURMOUNT-5 trial, brand-name tirzepatide led to greater average weight loss than brand-name semaglutide.
Nausea, diarrhea, constipation and vomiting are the most common side effects of both.
At Golden Glow, compounded semaglutide is $205 a month and compounded tirzepatide is $330 a month, at every dose.

How they work

GLP-1 is a hormone your gut releases after you eat. It slows how quickly your stomach empties and signals fullness to the brain. Semaglutide mimics GLP-1. Tirzepatide mimics GLP-1 and also GIP, a second gut hormone involved in blood sugar and fat storage.

NIDDK lists both as prescription options for adults with a BMI of 30 or more, or 27 or more with a weight-related condition such as high blood pressure, prediabetes or high cholesterol. They are meant to be used with changes in eating and activity, not instead of them.

What the trials found

The STEP 1 trial, published in 2021, studied once-weekly semaglutide in adults with overweight or obesity and found meaningful average weight loss compared with placebo over 68 weeks. The SURMOUNT-1 trial, published in 2022, studied once-weekly tirzepatide and also found meaningful average weight loss compared with placebo over 72 weeks.

In 2025, the SURMOUNT-5 trial compared the two directly in adults with obesity and without diabetes. Over 72 weeks, people taking tirzepatide lost more weight on average, and more of them reached larger weight-loss goals, than people taking semaglutide. Waist size followed the same pattern.

These trials studied the FDA-approved brand-name medicines. Compounded semaglutide and tirzepatide are prepared by licensed US pharmacies for individual patients, are not FDA-approved, and were not tested in these trials. Individual results vary.

Side by side

	Semaglutide	Tirzepatide
How it works	GLP-1 receptor	GLP-1 and GIP receptors
How it is taken	Injection under the skin, once a week	Injection under the skin, once a week
Head-to-head result (brand-name)	Less average weight loss	Greater average weight loss
Common side effects	Nausea, diarrhea, constipation, vomiting	Nausea, diarrhea, constipation, vomiting
Golden Glow price	$205 a month or $420 a quarter	$330 a month or $795 a quarter

Side effects and safety

Stomach side effects are most common when the dose goes up, which is why providers raise it slowly. Eating smaller meals, stopping when you feel full and limiting greasy foods often helps.

Neither medicine is for use during pregnancy or for anyone with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2. Get help right away for severe stomach pain that does not go away, pain in the upper right belly or yellowing skin, or signs of dehydration. Tirzepatide can make birth control pills less effective after you start and after each dose increase, so ask your provider about a backup method.

The FDA has received reports of dosing errors with compounded GLP-1 medicines, often from confusion about units and syringes. Measure every dose exactly as your label explains, and message your care team if anything is unclear.

How to choose

Budget: semaglutide costs less each month.
Goals: tirzepatide led to greater average weight loss in the head-to-head trial.
Tolerance: some people tolerate one better than the other; a provider can switch you if needed.
Needles: if you strongly prefer no needles, ask about tirzepatide sublingual drops, keeping in mind that evidence for that form is limited.
A gentler start: microdose options use lower doses, and research on very low doses is limited.

Frequently asked questions

Can I switch from semaglutide to tirzepatide?

Often, yes. A licensed provider reviews how you are doing and sets a starting dose for the new medicine, since doses are not interchangeable.

Is compounded semaglutide the same as the brand?

It contains the same active ingredient, but compounded medicines are prepared by licensed pharmacies for individual patients, are not FDA-approved and were not tested in the brand-name trials.

How much do they cost at Golden Glow?

Compounded semaglutide is $205 a month or $420 a quarter, and compounded tirzepatide is $330 a month or $795 a quarter, at every dose, including the online visit, provider review, medication, supplies and shipping.

Do I need to stay on a GLP-1 forever?

Not necessarily, but studies show that weight often returns after stopping. Your provider can plan maintenance with you, which may include a lower dose.

Talk to a licensed provider

Not sure which fits you? Learn more about compounded semaglutide and compounded tirzepatide, or see all GLP-1 weight loss options, then start an online visit. This article is educational and does not determine eligibility for any treatment.

Sources

This article is educational and is not medical advice. Golden Glow content is written to be accurate and is reviewed against the sources above. Rx programs require an online visit with a licensed provider. Results vary.