From the Guidelines
When switching from Zepbound (tirzepatide) to Wegovy (semaglutide), the recommended approach is to start Wegovy at 0.25 mg weekly for the first month, then follow the standard Wegovy titration schedule (0.5 mg, 1 mg, 1.7 mg, and finally 2.4 mg weekly, each dose for 4 weeks). This conservative approach is recommended regardless of what dose of Zepbound you were taking previously, as stated in the study 1. While both medications are injectable GLP-1 receptor agonists used for weight management (with Zepbound also activating GIP receptors), they have different potencies and side effect profiles. Starting at the lowest Wegovy dose and gradually increasing helps minimize gastrointestinal side effects like nausea, vomiting, and diarrhea that commonly occur during initiation, as noted in the study 1. Some key points to consider when switching from Zepbound to Wegovy include:
- The importance of gradual dose titration to minimize side effects, as recommended in the study 1
- The need to maintain dietary and exercise habits during the transition, as patients should stay well-hydrated
- The importance of discussing the switch with a healthcare provider to customize the approach based on individual medical history and weight management goals, as emphasized in the study 1 It's also worth noting that the study 1 highlights the variation in glucose-lowering efficacy among GLP-1 receptor agonists, with semaglutide having one of the greatest effects. However, the primary concern when switching medications should always be the patient's safety and well-being, prioritizing morbidity, mortality, and quality of life as the outcome. Therefore, a cautious and gradual approach to switching from Zepbound to Wegovy is recommended, with close monitoring and adjustment as needed.
From the Research
Dose of Tirzepatide When Switching from Zepbound (Ozempic, Semaglutide) to Wegovy (Semaglutide) is Not Directly Relevant
- The provided studies do not directly address the dose of tirzepatide when switching from zepbound (ozempic, semaglutide) to wegovy (semaglutide) 2, 3, 4, 5, 6.
- However, study 6 discusses switching to tirzepatide 5 mg from glucagon-like peptide-1 receptor agonists, including semaglutide, and reports improved glycemic outcomes and weight reduction.
Clinical Expectations When Switching to Tirzepatide
- Study 6 found that participants who switched to tirzepatide 5 mg from GLP-1 RAs, including semaglutide, experienced improved glycemic outcomes and additional weight reduction over 12 weeks.
- The study reported a mean HbA1c change from baseline of -0.43%, fasting serum glucose change of -7.83 mg/dL, and body weight change of -2.15 kg at week 12.
- Gastrointestinal events were reported in 13.2% of participants, and 2% of participants discontinued tirzepatide due to adverse events.
No Direct Evidence for Switching from Zepbound to Wegovy
- There is no direct evidence in the provided studies to support a specific dose of tirzepatide when switching from zepbound (ozempic, semaglutide) to wegovy (semaglutide) 2, 3, 4, 5, 6.
- Study 6 provides some insight into switching to tirzepatide from GLP-1 RAs, but the specific context of switching from zepbound to wegovy is not addressed.