Semaglutide vs. Tirzepatide: How to Choose
The two leading GLP-1 molecules, compared on mechanism, cost, and what a provider weighs when choosing.
Semaglutide and tirzepatide are the two most talked-about GLP-1 medications for weight management. They are related but not identical, and the right choice is individual. Here is a clear, side-by-side comparison to bring to your provider.
How they work
Semaglutide activates the GLP-1 receptor, which influences appetite and blood sugar. Tirzepatide activates two receptors — GLP-1 and GIP — which is why it is described as a "dual agonist." Both are once-weekly injectables used for chronic weight management under provider supervision.
Side-by-side
| Semaglutide | Tirzepatide | |
|---|---|---|
| Receptors | GLP-1 | GLP-1 + GIP (dual) |
| Brand names | Wegovy, Ozempic | Zepbound, Mounjaro |
| Dosing | Once weekly | Once weekly |
| ZENKAI cash price | From $199/mo | From $299/mo |
| Compounded option | Yes — 503A, not FDA-approved | Yes — 503A, not FDA-approved |
About compounded medications
Compounded semaglutide and tirzepatide are prepared by state-licensed 503A compounding pharmacies for an individual patient after a provider consultation. They are not FDA-approved products, are not reviewed by the FDA for safety or effectiveness, and are only appropriate when a licensed provider determines they are clinically suitable for you.
What a provider weighs when choosing
- Your medical history, current medications, and any contraindications
- Your goals and how your body tolerates a given molecule
- Cost and what you can sustain month to month
- Side-effect profile and how to titrate the dose gradually
There is no single "better" option for everyone. Many patients start on one molecule and adjust with their provider over time. The important part is that a licensed provider makes the call with you, based on your full picture.
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Start your free assessmentFrequently asked questions
Is tirzepatide better than semaglutide?
They work differently — tirzepatide is a dual GLP-1/GIP agonist and semaglutide is a single GLP-1 agonist — and individual results and tolerability vary. "Better" depends on your medical history and goals, which a licensed provider evaluates with you.
Which is cheaper?
At ZENKAI, provider-prescribed compounded semaglutide starts at $199/month and compounded tirzepatide at $299/month, cash-pay. Brand-name versions of both typically list much higher.
Can I switch between them?
Some patients switch molecules over time based on response and tolerability. This is a clinical decision made with your provider, not something to change on your own.
This page is for general education and is not medical advice. It does not establish a provider-patient relationship. Compounded semaglutide and tirzepatide are prepared by state-licensed 503A pharmacies, are not FDA-approved, and are only appropriate when a licensed provider determines they are suitable for you. Prescribing and treatment decisions are made independently by licensed providers. Results vary.