What’s the difference between Zepbound and Wegovy?

In the family tree of weight-loss medications, Zepbound and Wegovy are close cousins. They have a lot of the same traits — both mimic the GLP-1 hormone and are FDA-approved for weight loss — but they aren’t identical. And knowing the key differences can help you when you’re talking with your doctor about which might be right for you. Here, we asked experts to break down the key differences between Zepbound vs. Wegovy so you can show up at your next appointment informed, confident, and ready to talk options.

What is Wegovy?

Wegovy, with the active ingredient semaglutide, is a once-weekly GLP-1 medication delivered via a pre-filled injection pen. It’s FDA approved for long-term weight management in adults with obesity or with overweight and at least one weight-related health issue like high cholesterol. It works by mimicking a hormone, GLP-1, to regulate hunger, slow digestion, and reduce food intake. In 2024, Wegovy was also approved to help lower the risk of serious heart problems — like heart attack and stroke — in adults with cardiovascular disease and either obesity or overweight.

What is Zepbound?

Zepbound is a brand name medication with the active ingredient tirzepatide. It is taken once weekly using either a prefilled injectable pen or a vial and syringe. It’s FDA approved for long-term weight management in adults with obesity and for those who are overweight with a related health condition, such as high blood pressure. More recently, Zepbound received a second FDA-approved indication for treating moderate-to-severe obstructive sleep apnea in adults with obesity.

Zepbound is like Wegovy in that it is a type of GLP-1 receptor agonist, but it goes a step further. “Zepbound is a double agonist,” explains Dr. Erin Kershaw, M.D., a Pittsburg-based board-certified physician in endocrinology, diabetes & metabolism, obesity medicine, and clinical lipidology. In addition to mimicking GLP-1, it also mimics glucose-dependent insulinotropic polypeptide (GIP). Together, they can have a bigger impact on weight because the GIP may boost the effects of the GLP-1 as it curbs appetite and slows digestion.

Do Zepbound and Wegovy have generic versions?

No, neither Zepbound nor Wegovy has a generic version available as of now. When it comes to generics, there’s typically a waiting game. Brand-name drugs are protected by patents for a set period of time. Only after those patents expire can other manufacturers apply to make a generic version.

Key differences between Zepbound and Wegovy

While these two weight-loss medications both fall under the class of GLP-1 drugs, they differ in key ways — and it may impact which is right for you. Here are some key differences to consider:

1. They work in slightly different ways. Wegovy (semaglutide) targets just one gut hormone, GLP-1. On the other hand, Zepbound (tirzepatide) targets two hormones involved in appetite and blood sugar regulation — GLP-1 and GIP. That dual-action effect sets Zepbound apart from other available GLP-1s.
2. They’re FDA approved for different uses. Both are approved for weight management in adults with obesity or overweight plus a related health condition. Each has an extra approval, as well. Wegovy is approved to reduce the risk of serious cardiovascular events — like heart attack and stroke — in adults with cardiovascular disease and either obesity or overweight and Zepbound is approved for treating moderate-to-severe obstructive sleep apnea in adults with obesity.
3. Only one has a vial option. While you can get both prescription medications in pre-filled injection pens, Zepbound also comes in a vial. The Zepbound vial requires drawing the dose into a syringe yourself, which can save you money but requires more hands-on prep.

Zepbound vs. Wegovy uses

Zepbound and Wegovy are both FDA-approved injectable medications used to support long-term weight management, but they differ when it comes to who they’re approved for and what else they’re used to treat.

Wegovy (semaglutide) is approved for adults with obesity, or who have overweight and have at least one weight-related health condition, like high blood pressure or type 2 diabetes. In 2024, it also gained FDA approval for a second use: reducing the risk of serious heart problems, such as heart attack and stroke, in adults with cardiovascular disease and obesity or overweight.

Zepbound (tirzepatide) is approved for adults with obesity or who have overweight with at least one related medical issue. It’s also approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity — a condition that impacts breathing while you sleep that’s linked to excess weight.

Zepbound vs. Wegovy dosages and administration

While Zepbound and Wegovy are both once-weekly injectable medications, they come in different forms and doses. Zepbound is available in two forms: a pre-filled auto-injector pen and a vial, which requires drawing the medication into a syringe before injecting. Zepbound dosing starts at 2.5 mg once weekly, gradually increasing every four weeks based on side effects and provider guidance. Doses include 5 mg, 7.5 mg, 10 mg, 12.5 mg, and a maximum of 15 mg per week.

Wegovy is only available in a pre-filled weekly injection pen and it starts at a lower dose of 0.25 mg per week. Similar to Zepbound, the dose is typically increased every four weeks, going to 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. You may stay at 1.7 mg if your body is responding well to that Wegovy dosage.

Both medications should be injected subcutaneously (just under the skin), typically in the abdomen, thigh, or upper arm. Always follow your provider’s instructions on how and where to inject, and never change your dose without medical guidance.

Effectiveness of Zepbound vs. Wegovy

While both medications are shown to be effective for weight loss, a head-to-head trial found that Zepbound may lead to greater results. After 72 weeks, participants on Zepbound lost an average of 20.2 percent of their body weight (averaging 50 pounds), compared to 13.7 percent (around 33 pounds) for those on Wegovy. The study, published in The New England Journal of Medicine, suggests Zepbound’s dual-action approach — targeting both GLP-1 and GIP receptors — may offer an added advantage in supporting long-term weight loss.

That said, not everyone will have better results on Zepbound. “Not only are the medications slightly different, but people are also very different,” says Kershaw. “It’s possible — and even probable — that people may respond to different medications differently. So if one isn’t working, it’s worth trying another.” She also emphasizes that these medications are most effective when paired with a healthy diet, regular movement, good sleep, and stress management.

Zepbound vs. Wegovy cost and insurance coverage

These medications can have a pretty high list price: Zepbound costs around $1,086 per month and Wegovy costs $1,349 per month if paying out of pocket. That said, most people won’t pay that full amount.

If you have commercial insurance, you could pay as little as $25 for Zepbound or $0 for Wegovy, thanks to savings programs from the manufacturers. But that’s a big “if.” Insurance coverage for GLP-1 medications like Wegovy and Zepbound can vary widely, especially under Medicaid and Medicare. “Unfortunately, even though obesity is a chronic disease, the Centers for Medicare & Medicaid Services (CMS) does not recommend covering medications for obesity alone,” explains Dr. Melanie Jay, M.D., professor of medicine and population health at the NYU Grossman School of Medicine.

As a result, Medicare doesn’t cover weight-loss medications at all while Medicaid coverage depends on where you live. For example, California (Medi-Cal) covers Zepbound for weight management with no prior approval. In some other states, it might only be covered for sleep apnea and not weight loss. Wegovy tends to have broader Medicaid coverage, especially for people with heart disease and obesity.

If you are uninsured or your plan doesn’t cover GLP-1s for weight loss, you might still qualify for a savings card and pay as low as $499 a month for Wegovy and $349 a month for the vial form of Zepbound.

Zepbound vs. Wegovy side effects

As with all GLP-1 medications, the most common side effects of Zepbound and Wegovy tend to be gastrointestinal — think nausea, diarrhea, or indigestion. These symptoms often appear when you first start the medication or when your dose increases. Below, you’ll find a breakdown of the most common side effects, along with the rarer but more serious ones to be aware of.

Zepbound side effects

These are some of the most frequently reported Zepbound side effects, although everyone responds differently. You may experience one, a few, or none at all.

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Abdominal pain

• Indigestion

• Fatigue

Though less common, serious side effects may include pancreatitis, gallbladder problems, kidney issues due to dehydration, and severe allergic or stomach reactions. Zepbound may also increase the risk of low blood sugar (especially if you take insulin or sulfonylureas), changes in mood or vision, and complications during surgery if food remains in the stomach. Find a full list of Zepbound’s side effects on its website.

Wegovy side effects

Wegovy side effects are similar to Zepbound. Here are the most common ones to look out for:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Abdominal Pain

• Headache

• Fatigue

Serious side effects largely mirror those of Zepbound, including risks of low blood sugar, pancreatitis, gallbladder issues, kidney problems, allergic reactions, and mood changes. As always, check in with your provider if something feels off or persistent. And for a full list of side effects, visit Wegovy’s website.

Zepbound and Wegovy drug warnings

Both Zepbound and Wegovy carry an FDA warning about a possible link to thyroid C-cell tumors, including a rare type called medullary thyroid carcinoma. This risk has only been seen in animal studies, not in humans, but the medications still aren’t recommended if you or a family member has a history of this cancer or a condition called MEN 2.

Other potential risks include pancreatitis, gallbladder problems, kidney issues, low blood sugar (especially if you’re on diabetes meds), and serious allergic reactions. Because of these risks, it’s generally not recommended for people with a history of any of the above conditions. Talk to your doctor about your medical history, current medications, and overall health to figure out if a Zepbound or Wegovy prescription is a good fit for you.

The bottom line

Zepbound and Wegovy have more in common than not, but the differences are key for narrowing the best option for you. Both medications mimic the GLP-1 hormone, but Zepbound also mimics a second hormone: GIP. This may be why Zepbound can result in more weight loss than Wegovy. The medications are also approved for slightly different things. Yes, both are prescribed for weight loss, but Wegovy can be prescribed to improve cardiovascular health while Zepbound can be prescribed for sleep apnea. If you’re interested in either medication, talk to your doctor, ask questions, and remember: it’s not about picking the “better” drug — it’s about finding the right fit for you.