Tirzepatide and semaglutide are the top medications for type 2 diabetes and weight loss! But which is better for you? Find out how they compare in this guide.
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Semaglutide and tirzepatide are known as leading prescription medications which are used to treat people with type 2 diabetes and maintain weight loss along with diet and exercise. Semaglutide is the main active ingredient in Wegovy, Rybelsus, and Ozempic, while Tirzepatide is found in Zepbound and Mounjaro.
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA), which mimics the natural GLP-1 hormone in the body and is known for being effective in weight loss and treatment of type-2 diabetes. It also has cardiovascular benefits with GLP 1 receptor agonism and is known for its clinical benefits with systolic blood pressure.
Tirzepatide, on the other hand, is a dual-acting glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist tirzepatide, which makes it suitable for type 2 diabetes and weight loss. In this guide, we take a closer look at the two prescription medications and how they compare in treating weight loss and type 2 diabetes.
Although semaglutide and tirzepatide are type 2 diabetes drugs, they are also used for weight loss. There have been direct and indirect treatment comparisons and sensitivity analysis of the two medications.
Wegovy (semaglutide) has been approved by the US Food and Drugs Administration for managing weight, and other semaglutide brands are off-label and used for weight loss. It is administered in both oral tablets and injections.
The difference between tirzepatide and semaglutide is that the former mimics the GLP-1 hormone and GIP hormone, which makes it more effective for weight loss. Its use in weight loss is off-label, as it is only approved for type 2 diabetes. It is only available as an injection.
Semaglutide for weight loss is administered as a weekly subcutaneous injection and has demonstrated efficacy in reduction in body weight for people with obesity. It works by decreasing appetite but also requires changes to diet and physical activity. Clinical trials have shown reductions in body weight ranging from 6 to 10 kg in patients on semaglutide.
Tirzepatide is more effective than semaglutide in weight loss, as clinical trials have shown 7 to 13 kg in patients. It reduces the appetite, slows down the time it takes for the stomach to empty, and makes your brain think you’re full. It’s not approved by the FDA for weight loss, but Zepbound (tirzepatide) is prescribed for off-label use.
Tirzepatide and semaglutide have demonstrated significant weight loss in patients who have type 2 diabetes. But, tirzepatide has a slightly higher weight loss range than semaglutide since it combines two drugs in one, making it suitable for adults with obesity.
Studies have shown that they are effective weight loss medications. This study revealed that once-weekly subcutaneous tirzepatide with diet and exercise could lead to a weight reduction of 20.9%, and continued treatment maintained the reduced weight. As for semaglutide, this study shows that the oral form offers a superior decrease in body weight in adults with obesity and without type 2 diabetes.
While both semaglutide and tirzepatide are effective in promoting weight loss, the individual patient responses differ. Factors like adherence to treatment, baseline weight, and changes to lifestyle will influence how much weight is lost with either drug. But tirzepatide has a slightly higher range for weight management.
Regarding the treatment of type 2 diabetes, semaglutide lowered the A1C levels by 1% to 2%, while tirzepatide reduced them by 2% to 2.5%. Ozempic and Rybelsus (semaglutide) and Mounjaro (tirzepatide) are effective in controlling blood sugar levels in adults with type 2 diabetes. Semaglutide also reduces the risk of major cardiovascular events in people with type 2 diabetes, but it’s not proven with tirzepatide.
Semaglutide is highly effective in the management of type 2 diabetes mellitus by reducing the A1C levels by about 1% to 2%. Semaglutide treatments are used to control blood sugar levels by stimulating insulin release from the pancreas when needed, slowing down gastric emptying, and reducing sugar production in the liver. According to this study, semaglutide 7mg and 14mg significantly lowered A1C in people with type 2 diabetes, thus reducing blood sugar levels.
As a GLP 1 agonist, semaglutide is administered through oral tablets and subcutaneous administration in the management of type 2 diabetes. If you’re taking the oral tablets, here’s the dosage plan starting with the lowest dose:
As for subcutaneous semaglutide, here’s the schedule:
It’s also possible for patients on semaglutide to switch between oral tablets and injections. If a patient is receiving 14 mg orally once a day, they can transition to 0.5 mg injections once a week after the last oral dose.
The dose of tirzepatide is administered through subcutaneous injections. The adult dosage of once weekly tirzepatide for type 2 diabetes is as follows:
Tirzepatide and semaglutide are GLP-1 receptor agonists, which replicate the action of the GLP-1 hormone found in the body. This makes it easier for them to improve blood sugar levels and improve body weight loss.
Before deciding whether you want to take semaglutide or tirzepatide, you should keep some factors in mind, like their risk assessment and potential side effects in patients with type 2 diabetes. Tirzepatide has a very high safety profile with significant efficacy. As for semaglutide, it’s also safe with cardiovascular benefits but has mild side effects. Some studies have also shown that semaglutide injection increases the risk of developing tumors in the thyroid gland.
Since semaglutide and tirzepatide are GLP-1 RAs, they work similarly and have the same side effects, although tirzepatide is a dual glucose dependent medication. They both have gastrointestinal side effects like nausea, diarrhea and vomiting. There are rare but adverse events like pancreatitis and thyroid tumors. Some of the moderate side effects of the semaglutide and tirzepatide dose are:
There’s not much difference between tirzepatide and semaglutide when looking at the side effects. If you experience any of the severe side effects below, seek medical care:
When people with type 2 diabetes are administered the GLP 1 agonist, semaglutide or tirzepatide, they mostly cause gastrointestinal events. The symptoms usually start at the beginning of diabetes treatment, ranging from mild to moderate. However, as the patient adjusts to the medication, the adverse events will diminish.
If the patient is unable to adjust to the medication, the doctor will recommend going back to the previous semaglutide or tirzepatide dose. There might also be injection site reactions in the treatment arms and hypoglycemia if it’s used concomitantly with anti-diabetic medications.
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Semaglutide has been widely studied in long-term clinical trials, which makes it very safe and efficient in managing type 2 diabetes. Some long-term cardiovascular outcome studies have shown that semaglutide reduces the risk ratio of cardiovascular risks like heart disease in people with type 2 diabetes. It reduces the risk of stroke and death from cardiovascular disease. The cardiovascular benefits are advantageous to adults with type 2 diabetes.
The long-term safety data for tirzepatide is still evolving, but it has proven itself so far as a reliable medication. However, it’s not recommended for patients with a personal or family history of medullary thyroid carcinoma and multiple endocrine neoplasia syndrome type 2 (MEN 2).
Semaglutide and tirzepatide are the active ingredients in type 2 diabetes medications that are also prescribed for weight management. Tirzepatide may be more effective because of how it works, but the current research is incomplete. Your doctor will offer the best guidance on which drug offers more clinical benefits, especially in individuals without diabetes and in adults with obesity.
In studies for weight loss, tirzepatide has been identified as a better medication. Tirzepatide is also potentially more effective in treating type 2 diabetes and provides better value for money for weight reduction. It stimulates more weight reduction than semaglutide. But, semaglutide has systolic blood pressure and cardiovascular benefits
Subcutaneous tirzepatide is more expensive than subcutaneous semaglutide when you look at the direct costs, but when looking at the cost-effectiveness, it is better. It resulted in greater weight loss even if it cost more. The total cost of 72 weeks of tirzepatide is about $17,500, but for 68 weeks of semaglutide, it costs $22,800.
It is possible to switch from semaglutide to tirzepatide as they are GLP-1 agonists, but you should talk to your primary care physician before you change your medication to avoid any adverse events. Some doctors recommend switching to tirzepatide if you have maxed out on your semaglutide dosage.
With a dose of tirzepatide, after four weeks, the average weight loss is 2% of body weight, and after eight weeks, it’s over 4%. The real effect of tirzepatide will be seen after three months. With tirzepatide, the dosage slowly increases over time, which amplifies the effect in adults with obesity.
When taking tirzepatide, you should avoid drinking alcohol and other medications like Ambien, Adderall, Claritin, and drugs that have GLP-1 RA. You should also avoid foods like fried and greasy foods, fatty foods, sugary sweets and treats. Also, refined carbohydrates and carbonated beverages should be avoided.
Those with a medical history of medullary thyroid carcinoma and multiple endocrine neoplasia syndrome type 2 cannot take doses of tirzepatide. It has also not been approved by the FDA for the treatment of weight loss in non-diabetic individuals. Those with insulin sensitivity would also be affected.
The impact of tirzepatide on the kidney differs based on the patient. However, studies have shown that there are some kidney-related side effects, such as reduced occurrence of a composite kidney outcome. This is still being studied.
Tirzepatide has implications for kidney health, but it is not bad. The effects differ from person to person. But, some studies funded by pharmaceutical companies show that those who take the GLP-1 agonist experience fewer renal complications and adverse events than those receiving basal insulin therapy, prandial insulin and other forms of insulin.
The tirzepatide dose is given once a week every seven days, and you should keep taking it unless your healthcare provider tells you to stop. When taking the medication with prandial or basal insulin, you should inject it separately from insulin and avoid mixing it together.
The best time to take tirzepatide depends on different factors, like your meal schedule and other medications. You should talk to your health care provider first.
Tirzepatide is used to treat adults with type 2 diabetes and is not typically prescribed for other purposes. It’s an off-label medication for weight loss. Seek medical care before taking tirzepatide or any other GLP-1 agonist.
Sources Used:
https://www.healthline.com/health/tirzepatide-vs-semaglutide#tirzepatide-vs-semaglutide
https://www.womenshealthmag.com/weight-loss/a46095098/tirzepatide-vs-semaglutide/
https://jamanetwork.com/journals/jama/fullarticle/2812936
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
https://www.drugs.com/dosage/semaglutide.html
https://www.drugs.com/dosage/tirzepatide.html
https://ro.co/weight-loss/foods-to-avoid-on-zepbound-tirzepatide/
Disclaimer
Off-Label Use: When discussing off-label uses, such as using Ozempic for weight loss, make it clear that this is not FDA-approved for that purpose. For example, you can add a disclaimer like: “While Ozempic is primarily approved for treating Type 2 diabetes, some healthcare providers may prescribe it off-label for weight loss. However, this use is not FDA-approved.”
Medical Advice Disclaimer: Clearly state that the article is for informational purposes only and not a substitute for professional medical advice. Encourage readers to consult with their healthcare provider before starting any new medication.
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