From the FDA Drug Label
2.2 Recommended Dosage in Adults and Pediatric Patients Aged 12 Years and Older Dosage Initiation and Escalation • Initiate WEGOVY with a dosage of 0.25 mg injected subcutaneously once weekly. • If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks.
The patient is switching from Wegovy (semaglutide) to Zepbound (tirzepatide), which are two different medications. Since Zepbound is a different medication, the patient should start over with dosing as if they were initiating Zepbound for the first time. The dosage escalation schedule for Wegovy does not apply to Zepbound. However, the label for Zepbound is not provided, so the exact dosing instructions cannot be determined. It is recommended to consult the label for Zepbound to determine the appropriate dosing schedule 1.
From the Research
When switching from Wegovy 1.7 mg to Zepbound, you can generally transition to the equivalent dose of Zepbound, which would be 5 mg, without needing to start over with dosing. This approach is based on the understanding that both medications, although having different active ingredients (semaglutide in Wegovy and tirzepatide in Zepbound), work similarly in terms of their effect on GLP-1 receptors, with Zepbound having the added benefit of dual GIP/GLP-1 action 2. The decision to switch directly to the corresponding dose of Zepbound is aimed at maintaining the therapeutic effect already established with Wegovy while minimizing potential side effects from restarting at a lower dose. However, it's crucial for your healthcare provider to confirm this transition plan, as individual responses to medication can vary. Monitoring by your healthcare provider during the first few weeks after switching is recommended to ensure you're tolerating the new medication well. Remember, both medications are administered via weekly injections, and it's essential to continue any dietary and exercise recommendations that were part of your original treatment plan. Given the most recent evidence from 2025, it's noted that tirzepatide shows a greater risk of gastrointestinal adverse events compared to semaglutide, but most cases are mild 2. Thus, careful monitoring for potential adverse outcomes is advised. In terms of gastrointestinal safety, both semaglutide and tirzepatide are associated with increased GI adverse outcomes compared to placebo, with tirzepatide showing a higher risk 2. Despite these considerations, the direct switch from Wegovy to Zepbound at an equivalent dose is generally recommended, prioritizing the maintenance of therapeutic effects and minimizing side effects.