What is the equivalent dose of Ozempic (semaglutide) 1 mg per week to Zepbound (semaglutide)?

From the Guidelines

There is no direct equivalent dose between Ozempic 1 mg weekly and Zepbound, as they contain different active ingredients, semaglutide and tirzepatide, respectively. When considering a transition between these medications, it's essential to understand their distinct pharmacological properties, as outlined in a recent consensus statement 1. The properties of GLP-1 receptor agonists, such as semaglutide (Ozempic), and dual GIP and GLP-1 receptor agonists, like tirzepatide (Zepbound), differ significantly, including their administration routes, pharmacokinetics, and total dose ranges. Key points to consider include:

• Semaglutide (Ozempic) has a total dose range of 0.25 - 4.5 mg weekly, with a bioavailability of 10.3 nmol/l and an elimination half-life of 7 days 1.
• Tirzepatide (Zepbound), on the other hand, has a total dose range of 15 mg weekly, with a bioavailability of 1250 ng/ml and an elimination half-life of 5 days 1. Given these differences, if transitioning from Ozempic to Zepbound, the typical approach would be to start Zepbound at its lowest recommended dose, taking into account the patient's specific medical needs and response to the medication. The recommended starting dose for Zepbound is 2.5 mg weekly for 4 weeks, followed by an increase to 5 mg weekly, with potential further adjustments based on clinical response and tolerability. Any transition between these medications should be supervised by a healthcare provider to determine the appropriate dosing schedule. It's also important to note that tirzepatide, as a dual GIP and GLP-1 receptor agonist, may offer different efficacy profiles for weight loss and glycemic control compared to semaglutide, a GLP-1 receptor agonist only, as discussed in the context of their pharmacological properties 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Equivalent Dose of Ozempic (Semaglutide) to Zepbound (Tirzepatide)

The equivalent dose of Ozempic (semaglutide) 1 mg per week to Zepbound (tirzepatide) is not directly stated in the provided studies. However, we can look at the comparison between semaglutide and tirzepatide in the study titled "Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes" 2.

Key Findings

• The study compared the efficacy and safety of once-weekly tirzepatide with semaglutide in patients with type 2 diabetes.
• The results showed that tirzepatide was noninferior and superior to semaglutide in terms of glycated hemoglobin level reduction.
• The study used tirzepatide doses of 5 mg, 10 mg, and 15 mg, and semaglutide dose of 1 mg per week.

Dose Comparison

• Although the exact equivalent dose of Ozempic (semaglutide) 1 mg per week to Zepbound (tirzepatide) is not provided, we can see that tirzepatide at doses of 5 mg, 10 mg, and 15 mg was compared to semaglutide 1 mg per week.
• Based on the study, tirzepatide at all doses (5 mg, 10 mg, and 15 mg) was noninferior and superior to semaglutide 1 mg per week in terms of glycated hemoglobin level reduction.

Limitations

• The provided studies do not directly address the equivalent dose of Ozempic (semaglutide) 1 mg per week to Zepbound (tirzepatide).
• Further studies are needed to determine the exact equivalent dose of semaglutide to tirzepatide.
• The studies 3, 4, 5, 6 provide information on semaglutide and its effects on type 2 diabetes and obesity, but do not directly compare the doses of semaglutide and tirzepatide.