Zepbound (tirzepatide) and Wegovy (semaglutide) are prescription drugs used for weight loss and weight management. Both drugs come as a liquid solution for injection under the skin. Zepbound and Wegovy are not available as generic drugs.
This article explains the main ways that Zepbound and Wegovy are alike and different. Your doctor can explain the benefits and risks of these and other treatment options based on your medical history and diagnosis.
A generic drug contains an exact copy of the active ingredient in a brand-name medication. The generic availability of Zepbound and Wegovy are as follows, along with their active ingredients:
- Zepbound:
- Available as a generic: no
- Active ingredient: tirzepatide
- Wegovy:
- Available as a generic: no
- Active ingredient: semaglutide
The following table gives details about the uses of each drug.
| Use | Zepbound | Wegovy |
|---|---|---|
| help with weight loss and weight management in adults with obesity or overweight who have certain weight-related conditions, such as high blood pressure | ✓ | ✓ |
| treat moderate to severe obstructive sleep apnea in adults with obesity | ✓ | |
| lower the risk of cardiovascular problems (such as stroke and heart attack) in adults with cardiovascular disease who have obesity or overweight | ✓ | |
| treat metabolic dysfunction-associated steatohepatitis (MASH) (fatty tissue buildup and inflammation in the liver) in adults with moderate to advanced liver scarring (not cirrhosis)* | ✓ |
Doctors prescribe Zepbound and Wegovy along with exercise and a low calorie diet to support weight loss.
* For this use, Wegovy has received
Zepbound is not approved for use in children. But Wegovy is approved to help with weight loss and weight management in children ages 12 years and older who have obesity.
For more information about the use of Wegovy in children, talk with your child’s doctor.
Here’s an overview of Zepbound and Wegovy dosages and how you inject these drugs for weight loss and weight management.
Zepbound and Wegovy have other uses, but these aren’t addressed here. To learn more about the dosages for all uses of these drugs, see these articles about Zepbound dosage and Wegovy dosage.
If you have questions about dosing when switching from Wegovy to Zepbound or vice versa, talk with your doctor.
Dosage for weight loss and weight management
Zepbound and Wegovy both are prescribed to help with weight loss and weight management in certain adults who have obesity or overweight. The dosages of each drug for this use appear in the following table. Strengths are listed in milligrams per milliliter (mg/mL).
| Factor | Zepbound for weight loss | Wegovy for weight loss |
|---|---|---|
| Form | liquid solution in two forms, each for injection under your skin: • single-use pen • single-use vial, administered with a needle and syringe | liquid solution inside a single-use pen, for injection under your skin |
| Strengths | • 2.5 mg/0.5 mL • 5 mg/0.5 mL • 7.5 mg/0.5 mL • 10 mg/0.5 mL • 12.5 mg/0.5 mL • 15 mg/0.5 mL | • 0.25 mg/0.5 mL • 0.5 mg/0.5 mL • 1 mg/0.5 mL • 1.7 mg/0.75 mL • 2.4 mg/0.75 mL |
| Dose | 5 mg, 10 mg, or 15 mg weekly (your doctor will increase your dose gradually) | 1.7 mg or 2.4 mg weekly (your doctor will increase your dose gradually) |
| How often to inject | once weekly | once weekly |
Your doctor will show you or a caregiver how to inject Zepbound or Wegovy. You inject either drug under the skin of your abdomen, thigh, or upper arm.
For more information on injecting these drugs, view the instructions on the Zepbound manufacturer’s website or the Wegovy manufacturer’s website. You can also check out this article on where and how to inject Wegovy.
Some people using Zepbound or Wegovy may experience mild or serious side effects.
For more information about possible side effects, see the Zepbound side effects article and Wegovy side effects article.
Mild side effects
Zepbound and Wegovy may cause mild side effects. The following table lists examples of mild side effects that have been reported with these drugs.
| Mild side effect | Zepbound | Wegovy |
|---|---|---|
| injection site reaction, such as itching or changes in skin color | ✓ | ✓ |
| digestive side effects, such as constipation, diarrhea, nausea, or vomiting | ✓ | ✓ |
| dizziness | ✓ | ✓ |
| fatigue (low energy) | ✓ | ✓ |
| hair loss | ✓ | ✓ |
| headache | ✓ | |
| anxiousness | ✓ | |
| change in taste | ✓ | ✓ |
| stomach flu | ✓ | |
| common cold | ✓ |
This table may not include all mild side effects of these drugs. For more information on possible mild side effects of the two drugs, see the Zepbound prescribing information and Wegovy prescribing information.
Serious side effects
Serious side effects also may occur in people using Zepbound or Wegovy. See the following table for a list of side effects reported with these drugs.
| Serious side effect | Zepbound | Wegovy |
|---|---|---|
| acute pancreatitis (sudden swelling of the pancreas) | ✓ | |
| severe digestive problems, which can lead to dehydration and kidney damage | ✓ | ✓ |
| acute gallbladder disease, such as cholecystitis (swelling of the gallbladder) or gallstones | ✓ | ✓ |
| low blood pressure | ✓ | ✓ |
| increased heart rate | ✓ | ✓ |
| low blood sugar levels | ✓ | ✓ |
| diabetic retinopathy (an eye condition) in people who have type 2 diabetes | ✓ | |
| boxed warning: risk of thyroid cancer (see the following note) | ✓ | ✓ |
| appendicitis | ✓ | |
| increased risk of broken bones | ✓ |
To learn about your specific risk of serious side effects from Zepbound or Wegovy, talk with your doctor or pharmacist.
Note: Zepbound and Wegovy have a boxed warning for the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Warnings for Zepbound and Wegovy” section.
ALLERGIC REACTIONFor some people, Zepbound and Wegovy can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They also can determine whether you should keep using Zepbound or Wegovy.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
Your doctor can confirm whether you’ve had a serious allergic reaction to Zepbound or Wegovy. If you have, they may switch you to a different treatment.
Here are answers to some frequently asked questions about Zepbound and Wegovy.
Which drug has fewer side effects: Zepbound, Wegovy, or Mounjaro?
Zepbound, Wegovy, and Mounjaro can cause similar side effects. Some people are able to tolerate one drug better than another. The type and severity of side effects may vary from person to person.
Common side effects of all three drugs include:
- nausea
- diarrhea
- constipation
These side effects typically are mild and may ease as your body adjusts to the medication. However, severe digestive problems are possible with all three drugs.
Zepbound and Wegovy are approved for weight loss and weight management, while Mounjaro is not. But doctors may prescribe Mounjaro off-label for this purpose. (Off-label use means a drug is prescribed for a purpose other than what it’s approved to treat or help prevent.)
If you have bothersome side effects, your doctor may adjust your dosage or recommend switching to a different medication. They can help determine the best option. They’ll base this on your health, weight loss goals, and how well your body tolerates Zepbound, Wegovy, or Mounjaro.
How do Zepbound and Wegovy compare with similar drugs, such as Rybelsus?
Zepbound and Wegovy are approved for weight loss and weight management in certain adults. Other drugs, such as Rybelsus, Ozempic, and Mounjaro, are not approved for this purpose but may be prescribed off-label for weight loss. (Off-label use means a drug is prescribed for a purpose other than what it’s approved to treat or help prevent.)
These medications work in similar ways but differ in their active ingredients, approved uses, and more. The following table compares Zepbound and Wegovy with similar drugs.
| Factor | Zepbound | Wegovy | Rybelsus | Ozempic | Mounjaro |
|---|---|---|---|---|---|
| Active ingredient | tirzepatide | semaglutide | semaglutide | semaglutide | tirzepatide |
| Drug class | dual glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist | GLP-1 | GLP-1 | GLP-1 | dual GIP receptor and GLP-1 |
| Form | liquid solution for injection under your skin | liquid solution for injection under your skin | oral tablet | liquid solution for injection under your skin | liquid solution for injection under your skin |
| Approved uses | • help with weight loss and weight management in adults with obesity or overweight who have certain weight-related conditions • treat moderate to severe obstructive sleep apnea in adults with obesity | • help with weight loss and weight management in adults with obesity or overweight who have certain weight-related conditions • lower the risk of cardiovascular problems (such as stroke and heart attack) in adults with cardiovascular disease who have obesity or overweight • treat metabolic dysfunction-associated steatohepatitis in adults with moderate to advanced liver scarring | help manage blood sugar levels in adults with type 2 diabetes | • help manage blood sugar in adults with type 2 diabetes • lower the risk of cardiovascular problems in certain adults • lower the risk of worsening kidney disease and death from cardiovascular disease in adults with chronic (long-term) kidney disease and type 2 diabetes | help manage blood sugar in adults with type 2 diabetes |
To learn more about how these medications compare, talk with your doctor or pharmacist. You can also check out these related articles:
Zepbound and Wegovy are prescribed to help with weight loss and weight management in certain adults who have obesity or overweight. Studies of Zepbound and Wegovy have shown that both drugs are effective for this use.
In addition, the American Gastroenterological Association includes both drugs in its treatment recommendations for obesity.
It’s important to note that your results from Zepbound or Wegovy may differ from those reported in studies. Talk with your doctor about whether one of these drugs is right for you.
If you’d like to read more about how each drug performed in studies, including for their other uses, see the Zepbound prescribing information and Wegovy prescribing information.
Whether or not you have health insurance, cost may be a factor when you’re considering these drugs. Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use.
Zepbound and Wegovy are brand-name drugs with no generic forms. You’ll usually pay more for brand-name drugs than for generics.
For other resources that might help you save on the price of these drugs, see these articles on Zepbound cost and Wegovy cost.
Zepbound and Wegovy may not be right for you if you have certain medical conditions or other factors that affect your health. The prescribing information for these drugs refers to these factors as warnings.
The two drugs share some of the same warnings, but they also have different ones. Some warnings are mentioned here. Before you start Zepbound or Wegovy, be sure to talk with your doctor to learn whether these warnings apply to you.
Boxed warning: Risk of thyroid cancer
Zepbound and Wegovy have a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
This warning is based on animal studies. Researchers studied tirzepatide (the active ingredient in Zepbound) and semaglutide (the active ingredient in Wegovy). In the studies, the researchers found a link between the medications and thyroid cancer in animals.
That said, it’s unclear whether Zepbound or Wegovy increases thyroid cancer risk in humans. This is because animal studies don’t always predict what will happen in humans.
Due to this possible risk, doctors typically avoid prescribing Zepbound and Wegovy to certain people. These people have one of the following risk factors for thyroid cancer:
- a rare genetic (inherited) condition called multiple endocrine neoplasia type 2
- a personal or family history of medullary thyroid cancer
If you have symptoms of thyroid cancer during treatment with Zepbound or Wegovy, tell your doctor right away. Your doctor may order tests to check for thyroid cancer. Symptoms may include:
- difficulty swallowing
- a hoarse voice
- a lump in your neck
For more information about this warning for either Zepbound or Wegovy, talk with your doctor.
Other warnings
In addition to their boxed warning, Zepbound and Wegovy have other warnings. Before starting Zepbound or Wegovy, talk with your doctor if any of the following conditions or health factors apply to you:
- if you’ve ever had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or planning to become pregnant
- if you’re breastfeeding or planning to breastfeed
- if you have diabetic retinopathy (an eye condition)
- if you have a mental health condition or have ever had suicidal thoughts or behaviors
- if you have a pancreas problem
- if you have severe gastroparesis (a stomach condition)
- if you have type 2 diabetes
- if you have a kidney problem
- if you have a surgery or medical procedure planned
To learn more about either drug, see this Zepbound overview and this Wegovy overview.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you’re not in the same household, stay on the phone with them until help arrives.
It may be possible to switch between these two drugs.
Details: Doctors prescribe Zepbound and Wegovy along with exercise and a low calorie diet to support weight loss. In some cases, it may be possible to switch from one drug to the other for this use.
But Zepbound and Wegovy also have other approved uses. If you’re using one of these drugs for a purpose other than weight loss, it’s unlikely that your doctor will switch you to the other drug.
Reminder: You should not switch drugs or stop your current treatment unless your doctor recommends it. If you have questions about the uses of Zepbound or Wegovy, talk with your doctor.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.