From the Guidelines
Zepbound (tirzepatide) and Wegovy (semaglutide) have similar safety profiles, but with some notable differences in adverse effects, with tirzepatide showing slightly higher rates of gastrointestinal side effects and similar rates of hypoglycemia and pancreatitis compared to semaglutide. When comparing the two medications, it's essential to consider their potential to cause hypoglycemia, pancreatitis, and other major adverse effects.
- Hypoglycemia rates for tirzepatide were 1.7-5.4% compared to semaglutide's 0.8-4% in clinical trials 1.
- Both medications carry warnings for pancreatitis, with tirzepatide showing rates of about 0.2-0.6% and semaglutide around 0.2-0.3% in trials 1.
- The most common side effects for both medications are gastrointestinal, including nausea, vomiting, and diarrhea, which tend to be dose-dependent and often improve over time 1.
- Both medications carry similar boxed warnings for thyroid C-cell tumors based on animal studies, though human relevance remains unclear 1.
- Other potential adverse effects for both include gallbladder issues, kidney injury, and hypersensitivity reactions. When starting either medication, patients should begin with the lowest dose and gradually increase to minimize side effects, stay well-hydrated, and immediately report severe abdominal pain, vision changes, or allergic reactions to their healthcare provider 1. It's also important to note that GLP-1 RAs, such as semaglutide, have been shown to have beneficial effects on cardiovascular outcomes and weight management, which may be considered when choosing between these medications 1. Ultimately, the choice between Zepbound and Wegovy should be based on individual patient factors, including their medical history, current medications, and personal preferences, as well as careful consideration of the potential benefits and risks of each medication 1.
From the Research
Comparison of Zepbound and Wegovy
- Zepbound (tirzepatide) and Wegovy (semaglutide) are both glucagon-like peptide-1 (GLP-1) receptor agonists used to manage type 2 diabetes and obesity.
- The risk of hypoglycemia with these medications is not directly compared in the provided studies, but it is known that GLP-1 receptor agonists can increase the risk of hypoglycemia when used with other diabetes medications 2.
- Regarding pancreatitis, a study found that tirzepatide did not significantly increase the risk of pancreatitis compared to placebo or basal insulin 3.
- However, another study reported a case of acute pancreatitis in a patient taking semaglutide, highlighting the need for clinicians to be aware of this potential risk 4.
- A case study also reported acute pancreatitis in a patient who was switched from semaglutide to tirzepatide, suggesting that switching between GLP-1 agonists may increase the risk of adverse effects 5.
- A retrospective cohort study found that semaglutide and tirzepatide were associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity, with tirzepatide showing the lowest recurrence risk 6.
Major Adverse Effects
- The most common adverse effects of tirzepatide and semaglutide are gastrointestinal, including nausea, diarrhea, and vomiting 2.
- A systematic review and meta-analysis found that tirzepatide was associated with an increased risk of gallbladder or biliary disease compared to placebo or basal insulin 3.
- The safety profiles of tirzepatide and semaglutide were similar in a phase 1 clinical trial, with no deaths reported 2.