Independent GLP-1 Comparison · Updated July 2026
GLP-1 Comparison 2026: Ozempic, Wegovy, Mounjaro, Zepbound & the New Pills
By The RX Index Editorial Team · Last verified:
The RX Index is an independent GLP-1 decision resource. This comparison is compiled from FDA labels, published trials, and official manufacturer pricing.
Here’s the honest GLP-1 comparison most pages won’t give you straight: there is no single “best” GLP-1 for everyone. In SURMOUNT-5 — the direct 72-week obesity trial comparing tirzepatide with semaglutide 1.7 or 2.4 mg — tirzepatide (Zepbound) produced 20.2% average weight loss versus 13.7% with semaglutide (Wegovy). But the right choice depends on your goal, your insurance, whether you want a shot or a pill, and what you’ll actually pay. Start with your goal, not the biggest number in the ad.
Best for
U.S. adults trying to make sense of the GLP-1 options — Ozempic, Wegovy, Mounjaro, Zepbound, and the brand-new pills — before they talk to a clinician.
Not for you if
You need urgent side-effect help, a personal prescription decision made for you, or a ranking of compounded sellers.
The GLP-1 comparison, at a glance
No single GLP-1 wins on every goal, side effect, and budget. The safest way to compare them is to start with what the drug is FDA-approved to treat, then weigh the real trial evidence, the daily routine, your coverage, and the true monthly cost.
| Your real question | Where the evidence points |
|---|---|
| Which one has the strongest direct head-to-head weight-loss result? | Tirzepatide (Zepbound) beat semaglutide (Wegovy) in the SURMOUNT-5 trial — but that doesn’t settle what’s right for you. |
| Which FDA-approved weight-loss options are pills? | The Wegovy pill and Foundayo. Their daily routines are very different. |
| Which brands share the same drug? | Wegovy and Ozempic both contain semaglutide. Zepbound and Mounjaro both contain tirzepatide. Saxenda and Victoza both contain liraglutide. |
| Which is for type 2 diabetes? | Start with the diabetes-labeled brands (Ozempic, Mounjaro, Rybelsus, Trulicity, Victoza), not a weight-loss brand. |
| Which is cheapest? | Compare the likely maintenance dose, your insurance result, and any provider fee — not the lowest starter price in the ad. |
Want the version built around your state, insurance, and goal? That’s what our matching tool does — keep reading for the full breakdown, then use it to lock in your shortlist.
What does the major U.S. GLP-1 comparison chart show?
A GLP-1 is a whole family of medicines, not one product. Quick definition: GLP-1 stands for glucagon-like peptide-1, a natural gut hormone. The drugs here are GLP-1 receptor agonists — they switch on that hormone’s receptor to curb appetite and help control blood sugar. (Tirzepatide also switches on a second receptor, GIP, so it’s technically a dual agonist.)
Here’s the chart. It covers the major U.S. products people actually compare for weight-management and type 2 diabetes decisions. Every row traces to an FDA label or a published trial, and the “cash price” column is what the maker charges you to pay out of pocket, checked July 2026.
| Medication (form) | Drug | FDA-approved for | Weight loss in trials | Evidence type | Cash price / month* |
|---|---|---|---|---|---|
| Zepbound (weekly shot) | tirzepatide | Weight management; obstructive sleep apnea in adults with obesity | 20.2% vs Wegovy (head-to-head); ~21% (SURMOUNT-1) | Direct head-to-head | $299–$699 by dose |
| Mounjaro (weekly shot) | tirzepatide | Type 2 diabetes | Not a weight-loss trial (diabetes drug) | — | From $499 |
| Wegovy shot (2.4 mg) | semaglutide | Weight management; heart-risk reduction; MASH | 13.7% vs Zepbound; ~15% (STEP-1) | Separate placebo trial | $199 intro → $349 |
| Wegovy HD shot (7.2 mg) | semaglutide | Weight management (higher dose) | 18.8% (STEP UP) | Separate placebo trial | $399 |
| Wegovy pill (daily, 25 mg) | semaglutide | Weight management; heart-risk reduction | 13.6% (OASIS) | Separate placebo trial | $149–$299 by dose |
| Foundayo (daily pill) | orforglipron | Weight management | 11.1% (ATTAIN-1) | Separate placebo trial | $149–$349 by dose |
| Ozempic (weekly shot) | semaglutide | Type 2 diabetes; heart & kidney-risk reduction | Not a weight-loss trial (diabetes drug) | — | $199 intro → $349–$499 |
| Ozempic pill (daily) | semaglutide | Type 2 diabetes; heart-risk reduction | Not a weight-loss trial (diabetes drug) | — | $149–$299 by dose |
| Rybelsus (daily pill) | semaglutide | Type 2 diabetes; heart-risk reduction | Not a weight-loss trial (diabetes drug) | — | Varies |
| Trulicity (weekly shot) | dulaglutide | Type 2 diabetes; heart-risk reduction | Not a weight-loss trial (diabetes drug) | — | Varies |
| Victoza (daily shot) | liraglutide | Type 2 diabetes; heart-risk reduction | Not a weight-loss trial (diabetes drug) | — | Varies |
| Saxenda (daily shot) | liraglutide | Weight management (adults; teens 12+ over 60 kg) | ~8% (SCALE) | Separate placebo trial | Varies |
*Cash prices change often, and several offers have specific expiration dates and refill conditions. These are official self-pay figures from LillyDirect and NovoCare, checked July 17, 2026. Confirm the current price at your maintenance dose before you commit.
Two things this chart makes obvious that most articles bury:
- Read it across, not down. Only one comparison here — Zepbound vs Wegovy — is a direct head-to-head. The others were each tested against a placebo, in different patients over different lengths of time. Stacking their percentages into a ranked list looks tidy but it’s misleading. We didn’t rank these from best to worst, and neither should you.
- Diabetes labels and weight-loss labels are not the same thing. Ozempic and Mounjaro are for diabetes. Their twins — Wegovy and Zepbound — are the weight-loss brands. This distinction drives a lot of insurance decisions.
Compounded semaglutide and tirzepatide (products a pharmacy mixes to order, which are not FDA-approved) are a separate topic with real legal changes in 2025–2026. We cover them further down — but they don’t belong in the table above, and we won’t pretend they’re the same as the approved drugs.
Are Ozempic and Wegovy the same — and how do Mounjaro and Zepbound relate?
Ozempic and Wegovy contain the same drug (semaglutide). Zepbound and Mounjaro contain the same drug (tirzepatide). Saxenda and Victoza share liraglutide. But same drug does not mean same prescription — the brands differ in FDA-approved use, dose, form, and who can take them.
Semaglutide — one drug, several products:
| Brand & form | Main FDA-approved lane | The key difference |
|---|---|---|
| Wegovy shot (1.7 / 2.4 mg) | Weight, heart risk, MASH | The everyday weight-loss injection |
| Wegovy HD shot (7.2 mg) | Weight (higher dose) | A stronger step-up dose, added March 2026 |
| Wegovy pill (25 mg) | Weight, heart risk | The first oral GLP-1 for weight loss |
| Ozempic shot | Type 2 diabetes, heart & kidney | The diabetes twin, not the weight-loss brand |
| Ozempic pill | Type 2 diabetes, heart | New oral form for diabetes -- not for weight loss |
| Rybelsus pill | Type 2 diabetes, heart | Older oral diabetes brand |
Tirzepatide — one drug, two products:
| Brand | Main FDA-approved lane |
|---|---|
| Zepbound | Weight management + sleep apnea |
| Mounjaro | Type 2 diabetes |
Liraglutide — one drug, two products:
| Brand | Main FDA-approved lane |
|---|---|
| Saxenda | Weight management (adults + teens 12+ over 60 kg) |
| Victoza | Type 2 diabetes + heart-risk reduction |
The 2026 pill-naming trap (read this before you shop)
Here’s where people get burned. In 2026, Novo Nordisk added an oral Ozempic pill in the U.S. — semaglutide tablets in 1.5, 4, and 9 mg. It sounds like the weight-loss news. It isn’t. The current U.S. label covers Ozempic tablets for type 2 diabetes and heart-risk reduction only — not weight loss. They’re a newer oral form of semaglutide and are not interchangeable milligram-for-milligram with Rybelsus, the older oral diabetes brand.
The weight-loss pill you’re probably thinking of is the Wegovy pill (semaglutide 25 mg), approved December 2025. Same drug as Ozempic, completely different job. So if a site markets an “Ozempic pill” as FDA-approved for weight loss, that claim is wrong — the FDA-approved Ozempic tablets are labeled for diabetes and heart risk.
Why “same drug” doesn’t mean “swap freely”: different strengths, different instructions, different approved uses, and very different insurance coverage. Switching between any of these is a clinician’s call, not a DIY move.
Which GLP-1 is FDA-approved for your goal?
Start with the condition the medicine is FDA-approved to treat — not the brand with the loudest ads. Weight loss, type 2 diabetes, heart-risk reduction, kidney protection, sleep apnea, and liver disease (MASH) each point to a different short list. Match the drug to your goal.
If your goal is long-term weight loss:
- Zepbound (tirzepatide, weekly shot) — strongest in head-to-head data
- Wegovy shot (2.4 mg), and Wegovy HD (7.2 mg) for qualifying adults who’ve tolerated 2.4 mg for at least four weeks
- Wegovy pill (25 mg) — for people who’d rather not inject
- Foundayo (orforglipron pill) — the pill with no food-timing rules
- Saxenda (liraglutide, daily shot) — an older option, approved for teens 12+ over 60 kg; average weight loss (~8%) is lower than the newer weekly options
If your goal is type 2 diabetes:
Ozempic (shot or pill), Mounjaro, Rybelsus, Trulicity, Victoza
If you also have heart disease:
The Wegovy shot and the Wegovy pill carry an FDA-approved use to reduce the risk of cardiovascular death, heart attack, or stroke in qualifying adults with known heart disease plus overweight or obesity. Several diabetes brands (Ozempic shot and pill, Rybelsus, Trulicity, Victoza) have their own heart-risk labels for their diabetes populations. The exact qualifying group differs by product, so ask specifically.
If you have type 2 diabetes and kidney disease:
The Ozempic injection carries an FDA-approved use to reduce kidney-disease risk in that group. See our GLP-1 and kidney disease guide.
If you have obesity and moderate-to-severe sleep apnea:
Zepbound became the first FDA-approved medicine for obstructive sleep apnea (OSA) in December 2024. In SURMOUNT-OSA trials it cut breathing interruptions by about 25 fewer events per hour (versus about 5 with placebo) in people not using a CPAP machine, and about 29 fewer in people using one. An OSA diagnosis can change which coverage path applies. See our sleep apnea coverage guide.
If you have liver disease (MASH):
The Wegovy injection was approved in August 2025 for noncirrhotic MASH with moderate-to-advanced fibrosis. It’s an accelerated approval — the FDA cleared it while a confirming study continues.
If it’s for a teenager:
A few products have pediatric approvals — Wegovy (shot) for ages 12+, Saxenda for ages 12+ over 60 kg, and several diabetes brands for age 10+ — but the exact age, weight, dose, and condition matter. Don’t assume the adult rules apply.
Your goal, your state, and your coverage change the answer here more than anything else on this page:
Which GLP-1 causes the most weight loss?
In SURMOUNT-5, the published direct obesity trial comparing tirzepatide with semaglutide 1.7 or 2.4 mg, tirzepatide produced more average weight loss — 20.2% versus 13.7% over 72 weeks, in adults with obesity who did not have diabetes. That’s strong direct evidence for those two regimens in that population. It is not proof that Zepbound is the right pick for every person.
That trial was published in the New England Journal of Medicine and enrolled 751 adults. Here’s what it actually found:
- Tirzepatide: 20.2% average weight loss (~22.8 kg / 50 lbs)
- Semaglutide: 13.7% average weight loss (~15.0 kg / 33 lbs)
- About twice as many people on tirzepatide hit 25% or more weight loss (31.6% vs 16.1%)
- Side effects were mostly stomach-related for both — nausea, diarrhea, constipation — and mostly mild to moderate, occurring during dose increases
Why Wegovy HD changes the conversation — but not this trial
In March 2026, the FDA approved Wegovy HD (semaglutide 7.2 mg). In its own STEP UP trial, the 7.2 mg dose produced about 18.8% average weight loss, versus 15.5% for the 2.4 mg dose and 3.9% for placebo. That narrows the gap on paper. But SURMOUNT-5 compared tirzepatide against the 2.4 mg dose — not 7.2 mg. There’s no head-to-head trial of tirzepatide vs Wegovy HD yet, so nobody can claim the higher dose ties or beats it.
The other trials — and why you can’t just line up the numbers
Wegovy, Foundayo, and Saxenda were each tested against a placebo, not against each other:
| Drug (trial) | Result | Evidence type |
|---|---|---|
| Tirzepatide vs semaglutide (SURMOUNT-5) | 20.2% vs 13.7% at 72 weeks | Direct head-to-head |
| Wegovy HD 7.2 mg (STEP UP) | 18.8% vs 3.9% placebo | Separate placebo trial |
| Wegovy 2.4 mg (STEP-1) | ~14.9% vs 2.4% placebo, 68 weeks | Separate placebo trial |
| Wegovy pill 25 mg (OASIS) | 13.6% vs 2.4% placebo, 64 weeks | Separate placebo trial |
| Foundayo 17.2 mg (ATTAIN-1) | 11.1% vs 2.1% placebo, 72 weeks | Separate placebo trial |
| Saxenda (SCALE) | ~8% vs ~3% placebo, 56 weeks | Separate placebo trial |
Should you choose a GLP-1 pill or an injection?
A pill gets rid of the needle, but it doesn’t automatically make treatment easier. The Wegovy pill and the Ozempic pill both require an empty stomach and a 30-minute wait. Foundayo can be taken with or without food, any time. Weekly shots mean fewer doses to remember; daily shots (Saxenda, Victoza) mean the most.
| Form | Best part | The catch |
|---|---|---|
| Daily pill with fasting (Wegovy pill, Ozempic pill, Rybelsus) | No needle | Morning empty stomach, small sip of water, wait 30 minutes before food or other pills |
| Daily pill, no fasting (Foundayo) | No needle, flexible timing | Still a daily habit; drug interactions still need a check |
| Weekly shot (Zepbound, Wegovy, Ozempic, Mounjaro, Trulicity) | Only once a week; includes the strongest direct weight-loss result | Injection comfort, storage, weekly technique |
| Daily shot (Saxenda, Victoza) | Established options for some patients | The most frequent dosing of all |
The Wegovy pill routine is strict: take it in the morning on an empty stomach with no more than 4 ounces of plain water, then wait at least 30 minutes before eating, drinking, or taking anything else. The Foundayo pill is a non-peptide small molecule — which is why, unlike the peptide pills, it has no label-mandated food or water timing rules. But “no needle” still doesn’t mean “no medical review.”
Want to compare the two daily weight-loss pills in detail? Wegovy Pill vs Foundayo — full breakdown.
How do GLP-1 side effects and safety compare?
There is no honest “GLP-1 with the fewest side effects” winner. Stomach problems — nausea, vomiting, diarrhea, constipation — show up across the whole class, usually worst while you’re increasing the dose. The serious warnings, contraindications, and interactions differ by product, and side-effect rates from separate trials can’t be compared head-to-head.
Common label-listed reactions across these products: nausea, vomiting, diarrhea, constipation, and belly discomfort. They’re most common during dose increases, but they can persist or become severe for some people.
Serious warnings to review on each drug’s label with your clinician:
- Thyroid C-cell tumor warning. The semaglutide, tirzepatide, liraglutide, dulaglutide, and Foundayo labels all carry a boxed warning for thyroid C-cell tumors, and all are contraindicated for people with a personal or family history of medullary thyroid cancer (MTC) or the genetic condition MEN2. Don’t read “non-peptide” as “thyroid-safe.”
- Pancreatitis (inflamed pancreas), gallbladder problems, kidney injury from dehydration, severe stomach reactions, and — if you also take insulin or certain diabetes drugs — low blood sugar.
- Eye disease: people with a history of diabetic retinopathy need monitoring.
- Surgery and sedation: these drugs slow stomach emptying, which matters before anesthesia. Tell your surgeon.
- Pregnancy and contraception — instructions differ by product. Semaglutide labels say to stop at least two months before a planned pregnancy. Foundayo says to stop when pregnancy is recognized, and — because it can affect oral birth-control absorption — to use a non-oral method or add a barrier method for 30 days after starting and after each dose increase. Zepbound gives a similar contraception instruction for four weeks after starting and after each dose increase. Ask your clinician which rule applies to your medication.
Before you start, be ready to tell a clinician about: any personal or family thyroid cancer or MEN2, pregnancy plans, past pancreatitis or gallbladder disease, severe stomach conditions, other diabetes medicines, eye disease, a planned surgery, and any other daily pills whose timing matters.
Want the full side-by-side of side effects and the hard “do not take” list? See our GLP-1 side effects comparison and who should not take a GLP-1.
How much do GLP-1 medications cost without insurance in 2026?
Official self-pay prices start around $149 a month and can reach $699 a month — but the cheapest number in the ad is often not what you’ll pay long term. Compare the drug price at your likely maintenance dose, plus any provider fee, minus any insurance or savings help.
| Medication | Cash price / month | The conditions that matter |
|---|---|---|
| Zepbound (LillyDirect) | $299–$699 by dose | $299 (2.5 mg starter) · $399 (5 mg) · $449 (7.5–15 mg) with the 45-day refill program; $499–$699 outside that program |
| Mounjaro (LillyDirect) | From $499 | Diabetes brand; terms and eligibility apply |
| Wegovy shot (NovoCare) | $199 → $349 | $199/month for the first two fills (through Dec 31, 2026); then $349/month |
| Wegovy HD (NovoCare) | $399 | Higher dose is a clinical step-up decision |
| Wegovy pill (NovoCare) | $149–$299 | $149 (1.5 mg) · $149–$199 (4 mg, intro expiring Aug 31, 2026) · $299 (9 mg and 25 mg) |
| Foundayo (LillyDirect) | $149–$349 | $149 (0.8 mg) · $199 (2.5 mg) · $299 (5.5/9 mg) · $349 (14.5/17.2 mg); top two doses qualify for $299 with 45-day refill program |
| Ozempic shot (NovoCare) | $199 → $349–$499 | $199 intro (through Dec 31, 2026); then $349 (0.25–1 mg) and $499 (2 mg). Diabetes brand. |
| Ozempic pill (NovoCare) | $149–$299 | $149 (1.5 mg) · $199 (4 mg) · $299 (9 mg). Diabetes brand. |
Eligibility, taxes, and fees can apply, and offers expire — reconfirm the current price before you commit.
Monthly total = medicine + provider fee + labs - insurance / savingsDon’t let anyone add a $149 medicine to a $149 membership and call the whole thing “$149.”
Watch your insurance — it may pick the winner for you. Coverage depends on your plan’s formulary, whether the drug needs prior authorization, and whether your plan covers weight-loss drugs at all. A diabetes or sleep-apnea diagnosis can open coverage that “weight loss” alone won’t.
Ro runs a free GLP-1 coverage check and offers prior-authorization support for the insurance-eligible medications it carries. Ro also offers cash-pay FDA-approved options including Foundayo and the Zepbound KwikPen. Ro Body membership is $39 for the first month, then $149/month — or as low as $74/month with an annual plan paid upfront (medicine billed separately).
Ro offers a free coverage check and prior-authorization support. The RX Index may earn a commission.
Prefer to compare FDA-approved cash-pay options and pick your own provider? Sesame is a solid secondary path. Its Success by Sesame program starts at about $59/month with an annual subscription (medicine separate), and Sesame says its providers can help with prior-authorization paperwork.
The RX Index may earn a commission.
What each provider says vs. what we verified
| Claim | What they state | What we verified (July 17, 2026) |
|---|---|---|
| Ro membership price | $39 first month, then $149/mo or as low as $74/mo on annual prepay; medicine separate | Confirmed on Ro’s official pricing page; medicine billed separately |
| Ro insurance help | Free coverage check + prior-auth support | Confirmed Ro advertises a free coverage checker and insurance support for eligible medications |
| Ro FDA-approved options | Foundayo, Zepbound KwikPen (among others) | Confirmed on Ro’s weight-loss pages |
| Sesame price | Success by Sesame from $59/mo on annual billing; medicine separate | Confirmed on Sesame’s official program page |
For current numbers across all providers, see our GLP-1 price tracker.
Which GLP-1 fits your real-life situation?
These are editorial shortlists based on current FDA labels, trial evidence, form, and cost — not prescriptions. A clinician still has to weigh your history, other medicines, and what you can realistically follow.
- 1You want the strongest proven weight loss and can inject → talk to a clinician about Zepbound, remembering SURMOUNT-5’s limits.
- 2You have heart disease plus overweight or obesity → Wegovy (shot or pill) is worth discussing for its heart-risk label.
- 3You have type 2 diabetes and kidney disease → the Ozempic injection’s kidney label fits this group; see our kidney coverage guide.
- 4You have obesity and sleep apnea → Zepbound is the only FDA-approved OSA option; see our sleep apnea coverage guide.
- 5You want a weight-loss pill → compare Wegovy pill vs Foundayo — same idea, very different routines. See our full Wegovy Pill vs Foundayo breakdown.
- 6You want a pill but won't do the fasting routine → Foundayo is the more realistic pill for you, if it’s medically appropriate.
- 7You're comparing for a teenager → check the exact pediatric label; don’t assume adult doses apply.
- 8Insurance covers one option but not the strongest one → the covered drug is often the smarter real-world start, as long as it’s clinically appropriate. A medicine you can actually afford beats one that lands you in debt.
What happens if you stop a GLP-1, and how long do people stay on one?
Weight-management GLP-1s are generally used as long-term treatments — as long as they keep working, stay tolerable, and remain medically appropriate. They’re not usually a short course you finish and walk away from.
In the STEP 1 trial extension, participants who stopped semaglutide 2.4 mg and the lifestyle program regained about two-thirds of the weight they’d lost over the following year. That was an exploratory result specific to semaglutide — not a fixed percentage for every drug — but it points to the same pattern seen across the class: for most people, appetite and weight tend to drift back when the medicine stops.
That doesn’t mean “forever or nothing.” It means a good plan is built around staying on an effective dose you can afford and tolerate, checking in with a clinician, and knowing that stopping usually isn’t a clean exit. Before you start, it’s worth asking your clinician what maintenance looks like: the target dose, the check-in schedule, and the plan if you ever need to come off.
What to do before you choose a GLP-1
Start with your goal, confirm the drug’s FDA-approved use fits it, review your history and other medicines with a clinician, then check the real cost at your maintenance dose and pick a form you can stick with.
- 1
Name your goal.
Weight, diabetes, heart risk, kidney, sleep apnea, or MASH.
- 2
Shortlist by label.
Start with what's FDA-approved for your goal. (A clinician can discuss off-label options too, but start from the approved list.)
- 3
Review your health.
Thyroid history, other meds, pregnancy plans -- with a clinician, not a chart.
- 4
Pick a form you'll keep up with.
Weekly shot, daily shot, fasting pill, or flexible pill.
- 5
Check real access.
Coverage, prior authorization, maintenance-dose price, provider fee.
- 6
Set your follow-up plan.
Dose increases, side-effect check-ins, and what to do if it isn't working -- or if you need to stop.
Where do compounded GLP-1s fit — and where don’t they?
Compounded GLP-1s are made to order by a pharmacy and are not FDA-approved finished drugs. They should never be shown as equal to Wegovy, Zepbound, Ozempic, Mounjaro, or Foundayo. And in 2025–2026 the rules around them changed a lot.
What “FDA-approved” and “compounded” actually mean: The FDA reviews approved drugs for their exact formula, safety, and effectiveness. Compounded products don’t go through that approval. Compounded is not the same as generic — a generic is an FDA-approved copy; a compounded product is not.
What changed: The FDA resolved the tirzepatide shortage in December 2024 and the semaglutide injection shortage in February 2025, and the related enforcement-discretion periods ended in 2025. On April 30, 2026, the FDA proposed — not finalized — removing semaglutide, tirzepatide, and liraglutide from the 503B “bulks” list. That proposal is about outsourcing-facility compounding and does not, by itself, ban all patient-specific 503A compounding.
If you’re considering a compounded product, verify: the prescriber’s name and state license, which pharmacy makes it and its license, the exact formula and strength, why compounding is appropriate for you, the full ongoing price, cancellation terms, and whether the seller ever implies it’s “FDA-approved” or “the same as” the brand (it isn’t, and that’s a warning sign).
For a cash-pay path when a compounded option is genuinely the right fit for your situation and it’s available in your state, Embody is one telehealth program that offers compounded GLP-1 care with online onboarding and provider support if treatment is medically appropriate (sponsored). Confirm its current pricing, the states it serves, and its pharmacy details before you commit — the same checklist above applies.
The RX Index may earn a commission. Embody is a sponsored partner.
Want the current legal status in plain English? See Is Compounded GLP-1 Still Available in 2026?
How we built this GLP-1 comparison
We put current FDA prescribing information and published head-to-head trials first, then official manufacturer pricing, then provider details. Every claim you can act on has a source and a date. We label direct trials as direct, and separate trials as separate — we don’t dress one up as the other.
Our source order:
- FDA approval letters and drug labels (Drugs@FDA, DailyMed)
- Published head-to-head trials (like SURMOUNT-5 in NEJM)
- Other published pivotal trials
- Official manufacturer use and pricing pages (LillyDirect, NovoCare)
- Official provider pricing pages (Ro, Sesame)
- Reputable medical sources for background only
What we left out on purpose: unverified availability claims, “least side effects” rankings the evidence can’t support, cross-trial league tables, compounded products in the approved-drug table, and testimonials used to prove medical results.
Found something out of date? Prices and labels move fast. Send us the current primary source and we’ll review it and update the “Last verified” date.
The RX Index is independent guidance for choosing your GLP-1 path. We compile this comparison from FDA labels, published trials, current manufacturer pricing, and current provider documentation, and we update it as those sources change.
GLP-1 comparison FAQ
- Are Ozempic and Wegovy the same?
- They contain the same drug -- semaglutide -- but they're different brands with different doses, forms, and FDA-approved uses. Ozempic is approved for type 2 diabetes and heart/kidney-risk reduction. Wegovy is approved for weight loss, heart-risk reduction, and noncirrhotic MASH. You can't swap them on your own.
- Are Mounjaro and Zepbound the same?
- Same drug -- tirzepatide -- with different jobs. Mounjaro is FDA-approved for type 2 diabetes. Zepbound is approved for weight management and, since December 2024, for moderate-to-severe obstructive sleep apnea in adults with obesity.
- Which GLP-1 causes the most weight loss?
- In SURMOUNT-5, the direct 72-week obesity trial comparing tirzepatide with semaglutide 1.7 or 2.4 mg, tirzepatide produced 20.2% average weight loss versus 13.7%. That's the strongest direct evidence for that comparison -- but the best choice still depends on your goal, coverage, preferred form, and cost.
- Is tirzepatide better than semaglutide?
- For weight loss in that trial and those doses, tirzepatide produced more. But semaglutide has FDA-approved heart-risk and liver-disease (MASH) uses that tirzepatide doesn't, so 'better' depends on what you need.
- Which GLP-1 has the fewest side effects?
- There's no proven winner. All of them cause mostly stomach side effects, and the trials weren't built to compare side-effect rates head-to-head. The serious warnings differ by drug, so review each label with a clinician.
- Which GLP-1 medications are FDA-approved for weight loss?
- Zepbound, Wegovy (shot, HD, and pill), Foundayo, and Saxenda. Ozempic, Mounjaro, Rybelsus, Trulicity, and Victoza are diabetes brands, not weight-loss brands.
- Which GLP-1 medications are pills?
- For weight loss: the Wegovy pill (25 mg) and Foundayo. For diabetes: the Ozempic pill and Rybelsus. The weight-loss pills and diabetes pills are not interchangeable.
- What's the difference between the Wegovy pill and Foundayo?
- Both are daily weight-loss pills. The Wegovy pill (semaglutide) needs an empty stomach and a 30-minute wait. Foundayo (orforglipron) can be taken any time, with or without food. Foundayo is also the first non-peptide pill in the class.
- Is Ozempic approved for weight loss?
- No. Ozempic -- shot or pill -- is FDA-approved for type 2 diabetes and heart/kidney-risk reduction. People may lose weight on it, but its twin, Wegovy, is the weight-loss brand.
- Is there really an Ozempic pill now?
- Yes -- an oral Ozempic pill (semaglutide 1.5, 4, and 9 mg) was FDA-approved in 2026, but it's for type 2 diabetes and heart-risk reduction, not weight loss. The weight-loss pill is the separate Wegovy pill.
- Can you switch from one GLP-1 to another?
- Sometimes, but it's a clinician's decision based on the specific drugs, doses, and your situation. There's no reliable DIY equal-dose chart.
- Are compounded GLP-1s FDA-approved?
- No. Compounded semaglutide and tirzepatide products aren't FDA-approved drugs or FDA-approved generics. Patient-specific compounding may still be lawful when all the applicable rules are met, but it must never be presented as equivalent to an approved brand.
- What's the cheapest GLP-1 without insurance?
- It depends on the drug, your dose, and the current offer. Starter doses can run around $149; maintenance doses cost more. Compare the maintenance price plus any provider fee -- not the lowest sticker.
- How long do people stay on a GLP-1, and what happens if they stop?
- Weight-management GLP-1s are generally long-term treatments. In a semaglutide study, people who stopped regained about two-thirds of their lost weight within a year -- a pattern seen across the class. Plan for maintenance, and talk to a clinician before starting or stopping.
- Does Medicare or Medicaid cover GLP-1 medications?
- Medicare: Since July 1, 2026, eligible Medicare Part D members can get certain weight-management GLP-1s through the new Medicare GLP-1 Bridge for a $50 monthly copay, subject to clinical criteria and prior authorization; diabetes and other non-weight-loss uses go through the regular Part D pathway. Medicaid: coverage is state-specific.
Still deciding?
You don’t have to turn one comparison chart into a medical decision by yourself. Use your goal, coverage, preferred form, and budget to narrow the paths worth discussing with a clinician — with the pricing shown up front, so there are no surprises.
Take Find My GLP-1 PathSources (verified July 17, 2026)
- FDA drug labels (DailyMed / Drugs@FDA): Zepbound, Wegovy (injection, Wegovy HD, tablets), Foundayo, Ozempic (injection and tablets), Rybelsus, Mounjaro, Saxenda, Trulicity, Victoza — used for FDA-approved uses, dosing, boxed warnings, contraindications, and pregnancy/contraception instructions.
- SURMOUNT-5 head-to-head trial — New England Journal of Medicine (tirzepatide 20.2% vs semaglutide 13.7% at 72 weeks).
- STEP-1 (semaglutide), STEP UP (Wegovy HD 7.2 mg), OASIS (Wegovy pill), ATTAIN-1 (Foundayo), SCALE (Saxenda), SURMOUNT-OSA (Zepbound for sleep apnea), and the STEP 1 extension (weight regain after stopping).
- FDA approvals: Zepbound OSA (Dec 2024), Wegovy MASH (Aug 2025), Wegovy HD (Mar 2026), Wegovy tablets (Dec 2025), Foundayo/orforglipron (2026), oral Ozempic (2026).
- FDA compounding: shortage resolutions (tirzepatide Dec 2024, semaglutide Feb 2025), 503A patient-specific rules, and the April 30, 2026 proposal on the 503B bulks list.
- Official self-pay pricing: LillyDirect (Zepbound, Mounjaro, Foundayo) and NovoCare (Wegovy shot/HD/pill, Ozempic).
- CMS: Medicare GLP-1 Bridge (launched July 1, 2026).
- Provider pages: Ro and Sesame official pricing and program pages.
Related guides
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Find My GLP-1 Path
The right GLP-1 provider isn't the same for everyone. It depends on your state, your insurance and formulary, whether you want an FDA-approved or compounded medication, your preferred route (injection or oral), and your budget. Because a general answer can't resolve those for you, use The RX Index's Find My GLP-1 Path tool to get a personalized provider match with source-verified pricing before you choose.
- What it asks: your state, insurance situation, medication preference, budget, and support needs
- What you get: a personalized shortlist of GLP-1 providers matched to your situation, with verified pricing and the right questions to ask
- Cost: free · about 2 minutes · no signup