Comparison · Updated
Semaglutide VS Tirzepatide
Short answer
Semaglutide and Tirzepatide have the same evidence tier: both are tier S (Approved).
Semaglutide is FDA-approved (Ozempic, Wegovy, Rybelsus, 2017); Tirzepatide is FDA-approved (Mounjaro, Zepbound, 2022).
Neither Semaglutide nor Tirzepatide is on the WADA Prohibited List.
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Side by side
| Field | Semaglutide | Tirzepatide |
|---|---|---|
| Evidence tier | S Tier S · Approved | S Tier S · Approved |
| Tier rationale | Multiple phase 3 RCTs (SUSTAIN, STEP, SELECT); FDA-approved in 2017 (Ozempic), later as Wegovy and Rybelsus, and authorised by the EMA. | Phase 3 RCT programmes (SURPASS, SURMOUNT); FDA-approved in 2022 for type 2 diabetes (Mounjaro) and in 2023 for weight management (Zepbound). |
| FDA status | Approved (2017) Ozempic, Wegovy, RybelsusApproved for type 2 diabetes (Ozempic, 2017) and chronic weight management (Wegovy, 2021). | Approved (2022) Mounjaro, ZepboundApproved for type 2 diabetes (Mounjaro, 2022) and chronic weight management (Zepbound, 2023). |
| Other approvals | None listed | None listed |
| WADA | Not on the Prohibited List | Not on the Prohibited List |
| Family | Metabolic | Metabolic |
| Residues | 31amino acids | 39amino acids |
| Molecular weight | 4,113.6 Da | 4,813.5 Da |
| Formula | C187H291N45O59 | C225H348N48O68 |
| Discovered | 2015Discovery published by Novo Nordisk scientists (Lau et al., J Med Chem 2015). | 2018Discovery and first clinical data published by Eli Lilly as LY3298176 (Coskun et al., Mol Metab 2018). |
| Routes studied | Subcutaneous | Subcutaneous |
| Mechanism | Semaglutide is a GLP-1 receptor agonist with 94% homology to native GLP-1, modified with a C18 fatty diacid chain enabling albumin binding and once-weekly pharmacokinetics. It activates GLP-1 receptors in the pancreas (enhancing glucose-dependent insulin secretion), the gut (slowing gastric emptying), and the hypothalamus (reducing appetite and food reward signaling). | Tirzepatide is a dual GIP/GLP-1 receptor agonist built on a 39-amino-acid peptide backbone with a C20 fatty diacid moiety enabling albumin binding and once-weekly dosing. It enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and acts on hypothalamic appetite centers to reduce food intake. |
| Safety notes | FDA-approved with robust Phase III data. | FDA-approved with extensive Phase III safety data (SURPASS and SURMOUNT programs). |
| Cited studies | 3 studies | 3 studies |
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Questions
- Which has stronger evidence, Semaglutide or Tirzepatide?
- Semaglutide and Tirzepatide have the same evidence tier: both are tier S (Approved). Semaglutide: Multiple phase 3 RCTs (SUSTAIN, STEP, SELECT); FDA-approved in 2017 (Ozempic), later as Wegovy and Rybelsus, and authorised by the EMA. Tirzepatide: Phase 3 RCT programmes (SURPASS, SURMOUNT); FDA-approved in 2022 for type 2 diabetes (Mounjaro) and in 2023 for weight management (Zepbound). Tiers rate the strength of published evidence, not effectiveness.
- Is Semaglutide FDA-approved?
- Semaglutide is FDA-approved (Ozempic, Wegovy, Rybelsus, 2017). Approved for type 2 diabetes (Ozempic, 2017) and chronic weight management (Wegovy, 2021).
- Is Tirzepatide FDA-approved?
- Tirzepatide is FDA-approved (Mounjaro, Zepbound, 2022). Approved for type 2 diabetes (Mounjaro, 2022) and chronic weight management (Zepbound, 2023).
- Are Semaglutide and Tirzepatide banned in sport?
- Neither Semaglutide nor Tirzepatide is on the WADA Prohibited List.
- How do Semaglutide and Tirzepatide work?
- Semaglutide is a GLP-1 receptor agonist with 94% homology to native GLP-1, modified with a C18 fatty diacid chain enabling albumin binding and once-weekly pharmacokinetics. Tirzepatide is a dual GIP/GLP-1 receptor agonist built on a 39-amino-acid peptide backbone with a C20 fatty diacid moiety enabling albumin binding and once-weekly dosing.