Zepbound vs Wegovy: Which Weight-Loss Drug Wins?
In the only head-to-head trial, SURMOUNT-5, adults without diabetes lost 20.2% of their weight on Zepbound (tirzepatide 10 or 15 mg) versus 13.7% on Wegovy (semaglutide 1.7 or 2.4 mg) after 72 weeks. Wegovy now has a higher 7.2 mg dose (Wegovy HD) that averaged 18.8% in its own 72-week trial, but it has not been tested against Zepbound directly. Self-pay, on Oct 11, 2026: Zepbound cost $299 to $449 a month through LillyDirect, Wegovy pens $349 a month after two $199 starter fills ($399 for 7.2 mg), and the Wegovy pill $149 to $299. Both carry the same thyroid C-cell boxed warning.
Quick answer
- More weight loss: Zepbound. SURMOUNT-5 (751 adults, open-label, 72 weeks): 20.2% vs 13.7% average loss, and a 5.4 cm larger drop in waist size (grade B, one Lilly-funded trial).
- Wegovy HD 7.2 mg closes some of the gap: 18.8% vs 15.5% on Wegovy 2.4 mg in its 72-week trial, with no head-to-head data against Zepbound.
- Cheapest start: the Wegovy pill at $149 a month (1.5 mg). At maintenance doses, Zepbound costs $449 a month with on-time refills vs $349 for Wegovy 2.4 mg pens.
- Side effects: mostly stomach-related for both and most common while the dose is going up. Label nausea rates were 44% for Wegovy 2.4 mg and 25% to 29% for Zepbound, but from different trials, so they are not directly comparable.
Get a prescription online
Both partners below are vetted telehealth services that prescribe brand-name Zepbound and Wegovy. Found starts with a free insurance check; MEDGm lists Zepbound and the Wegovy pill or pen at a $99 membership plus the medication cost (read on its site Oct 11, 2026). Medication is billed separately on brand-name plans.
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Self-pay prices, cheapest first
| Seller | Product | Price | Status | Includes |
|---|---|---|---|---|
| NovoCare Pharmacy | Wegovy pill (oral semaglutide), 30 tablets | $149 (1.5 mg), $199 (4 mg), $299 (9 or 25 mg)seller's list price | FDA-approved brand | Self-pay; home delivery or pharmacy pickup |
| NovoCare Pharmacy | Wegovy pen, 4 pens (0.25–2.4 mg) | $199 for 2 starter fills, then $349seller's list price | FDA-approved brand | $199 is for new patients’ first 2 fills of 0.25 or 0.5 mg through Dec 31, 2026 |
| NovoCare Pharmacy | Wegovy HD pen, 7.2 mg | $399/moseller's list price | FDA-approved brand | Self-pay; for people already on 2.4 mg for at least 4 weeks |
| LillyDirect | Zepbound (tirzepatide) KwikPen or vialsSorted by the maintenance-dose price. | $299 (2.5 mg), $399 (5 mg), $449 (7.5–15 mg)seller's list price | FDA-approved brand | $449 needs each refill within 45 days, otherwise $499 (7.5 mg) or $699 (10–15 mg); needles or syringes extra |
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Sorted by the lowest published monthly cost. "Starting at" prices can change after a clinician sets your dose. Linked brands are affiliate or applied-for programs (rel="sponsored"); other sellers are listed as plain text for price context only.
Zepbound vs Wegovy side by side
| Zepbound | Wegovy | |
|---|---|---|
| Molecule | Tirzepatide: acts on GIP and GLP-1 receptors | Semaglutide: acts on GLP-1 receptors |
| Forms | Weekly KwikPen or single-dose vials | Weekly pen (up to 2.4 mg, or 7.2 mg Wegovy HD) or a daily pill (25 mg) |
| Dose steps | 2.5 mg for 4 weeks, then up 2.5 mg at least every 4 weeks; maintenance 5, 10 or 15 mg | 0.25, 0.5, 1, 1.7 mg every 4 weeks; maintenance 2.4 mg (or 1.7 mg) from week 17; 7.2 mg optional |
| Average weight loss | SURMOUNT-1: 20.9% at 72 weeks on 15 mg (placebo 3.1%) | STEP 1: 14.9% at 68 weeks on 2.4 mg (placebo 2.4%); 7.2 mg: 18.8% at 72 weeks |
| Head to head (SURMOUNT-5) | 20.2% at 72 weeks | 13.7% at 72 weeks |
| Nausea in label trials | 25% to 29% (placebo 8%) | 44% on 2.4 mg (placebo 16%) |
| Stopped for side effects | 4.8% to 6.7% (placebo 3.4%) | 6.8% (placebo 3.2%); 5% on 7.2 mg |
| Half-life | About 5 days | About 1 week |
| Other approved uses | Sleep apnea with obesity | Cardiovascular risk reduction; MASH |
| Self-pay at maintenance | $449/mo (LillyDirect, on-time refills) | $349/mo pens, $399 for 7.2 mg; pill $299 |
Which one fits you
- If the goal is the most weight loss: Zepbound has the stronger head-to-head result. Wegovy HD 7.2 mg is an option if you are already doing well on Wegovy and need more.
- If you prefer a pill: only Wegovy comes as a daily tablet (13.6% average loss at 64 weeks in its trial). Foundayo is Lilly’s pill, a different molecule.
- If you have heart disease: Wegovy carries an approved indication to reduce major cardiovascular events in adults with established heart disease and obesity or overweight.
- If you have sleep apnea with obesity: Zepbound is approved to treat it.
- If you take birth control pills: the Zepbound label says to switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase.
- Insurance often decides it. Ask your plan which one is on its formulary before you compare self-pay prices.
FAQ
Is Zepbound better than Wegovy for weight loss?
In the SURMOUNT-5 head-to-head trial, adults without diabetes lost an average of 20.2% of body weight on Zepbound versus 13.7% on Wegovy after 72 weeks. The trial was open-label and funded by Eli Lilly, and it used Wegovy’s 2.4 mg dose, not the newer 7.2 mg Wegovy HD dose.
Which is cheaper, Zepbound or Wegovy?
On Oct 11, 2026, self-pay Zepbound cost $299 (2.5 mg), $399 (5 mg) or $449 (7.5–15 mg) a month through LillyDirect with on-time refills. Wegovy pens cost $349 a month after two $199 starter fills ($399 for 7.2 mg), and the Wegovy pill $149 to $299 by dose.
Does Zepbound have fewer side effects than Wegovy?
Both mainly cause nausea, diarrhea, vomiting and constipation, mostly while the dose is being raised. The labels list nausea in 25% to 29% on Zepbound and 44% on Wegovy 2.4 mg, but those numbers come from different trials and are not a fair head-to-head comparison.
Can I switch from Wegovy to Zepbound?
Switching is a prescriber decision. They will choose a starting Zepbound dose and timing based on your current Wegovy dose and how you tolerate it; there is no FDA-labeled conversion between the two drugs.
What is Wegovy HD?
Wegovy HD is the 7.2 mg weekly dose of semaglutide. The label allows it for adults who have tolerated 2.4 mg for at least 4 weeks and need more weight loss; in its 72-week trial it averaged 18.8% versus 15.5% on 2.4 mg. NovoCare listed it at $399 a month self-pay.
Related
Sources
Prices and product facts come from each seller’s own pages, read Oct 11, 2026. We link only to sellers we have an affiliate relationship with and to government and research sources; other sellers' prices are quoted as plain text.
- Aronne LJ et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025;393:26-36 (PubMed 40353578) (opens in new tab)
- Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med 2022 (PubMed 35658024) (opens in new tab)
- Wilding JPH et al. STEP 1. N Engl J Med 2021 (PubMed 33567185) (opens in new tab)
- Zepbound prescribing information, DailyMed (revised 08/2026) (opens in new tab)
- Wegovy prescribing information, DailyMed (revised 06/2026) (opens in new tab)