Liraglutide vs Semaglutide vs Tirzepatide

Liraglutide, semaglutide, and tirzepatide are all the generic drug names for various brand-name type 2 diabetes medications and weight loss medications. While they work in similar ways by mimicking natural gut hormones that regulate blood sugar and appetite, there are important differences in how they’re taken, how effective they are, and who they’re best suited for. Understanding these similarities and differences can help you make informed decisions when discussing treatment options with your doctor.

GLP-1 vs. GLP-1 RA: What’s the Difference?

A glucagon-like peptide-1, otherwise known as a GLP-1, is a natural hormone that helps your body regulate blood sugar levels. It’s produced in the intestines after eating, and GLP-1 has several different important roles in the body. For example, it:

• Stimulates insulin secretion from the pancreas to lower blood sugar
• Suppresses glucagon secretion from the pancreas, a hormone that raises blood sugar
• Slows gastric emptying by slowing the absorption of food to help prevent blood sugar spikes
• Promotes satiety by signalling your brain that you are full, reducing your appetite

GLP-1 receptor agonists (GLP-1 RAs) are synthetic medications that mimic the effects of natural GLP-1s. The three current GLP-1 RAs available are liraglutide, semaglutide, and tirzepatide. These three drugs can be helpful for people with type 2 diabetes or people who want to lose weight, as they can help lower blood sugar levels, promote weight loss, reduce cardiovascular risk, and potentially even improve metabolic health.

However, before you ask your doctor about a prescription, there’s a lot to know about these drugs.

What is Liraglutide?

Liraglutide is the generic name for the type 2 diabetes medication Victoza and the weight loss medication Saxenda. It was originally FDA approved in 2010 and 2014, respectively, and is an injectable medication. Liraglutide is known to help stabilize blood pressure and cholesterol levels, and it can also improve cardiovascular risk factors.

Liraglutide works by stimulating the pancreas to release more insulin when blood sugar levels are high and prevents the liver from producing and releasing too much sugar that would otherwise cause blood sugar spikes. It also slows down how quickly food leaves the stomach, which helps regulate post-meal blood sugar levels, makes you feel fuller longer, and decreases feelings of hunger.

There is a possibility of encountering side effects when taking Liraglutide. Common side effects can include nausea and vomiting, diarrhea or constipation, and headaches. There is also a possibility of more serious side effects, though they aren’t common. These side effects include pancreatitis and hypoglycemia. In animal studies, thyroid tumors have also been found, but it’s currently unknown if this risk extends to humans taking the drug.

What is Semaglutide?

Semaglutide is the generic name for Ozempic, Rybelsus, and Wegovy. Ozempic is a weekly subcutaneous injection for type 2 diabetes, Rybelsus is a daily oral medication, also for type 2 diabetes, and Wegovy is a weekly injection used for weight loss in adults.

Semaglutide works by activating GLP-1 receptors in the body to stimulate insulin release in response to high blood sugar and suppressing the release of glucagon to lower the amount of sugar the liver releases into the bloodstream. Like Liraglutide, semaglutide injections also help you feel fuller longer by slowing digestion and delaying gastric emptying, helping regulate your appetite.

Taking semaglutide does come with a risk of side effects, and common ones include nausea, vomiting, stomach pain, constipation, bloating, headache, fatigue, and dizziness. Serious but rare side effects can include pancreatitis, gallbladder disease, and thyroid tumors.

What is Tirzepatide?

Tirzepatide is the generic name for the type 2 diabetes medication Mounjaro and the weight loss medication Zepbound. Additionally, Zepbound can also be used as a sleep apnea treatment in obese adults.

Tirzepatide is part of the incretin mimetics drug class, and it works by mimicking both GLP-1s and glucose-dependent insulinotropic polypeptides (GIP). Because it acts on both GIP and GLP-1 receptors, tirzepatide can help increase insulin production when blood sugar is high, decrease the amount of sugar produced by the liver, and make you feel fuller longer to regulate your appetite.

Common side effects of taking tirzepatide include nausea, vomiting, diarrhea, decreased appetite, abdominal pain or discomfort, and constipation. Serious but rare side effects include pancreatitis, gallbladder disease, gastroparesis (stomach paralysis), hypoglycemia, and kidney disease.

Brand-Name vs. Generic: What’s the Difference?

If you’ve ever looked for painkillers at your local pharmacy, you’ve seen the difference between name-brand and generic medications. Like with Advil versus ibruprofen, liraglutide, semaglutide, and tirzepatide all have name-brand forms that your doctor may choose to prescribe over the generic version, or vice versa. Here’s what you need to know about the difference between brand-name and generic medications.

Generic Medications Are Cheaper

GLP-1 RAs can be very expensive. Without insurance coverage, one month of Ozempic can cost around $1,350, and with insurance coverage, the price can vary widely depending on factors like your specific insurance plan, your diagnosis, the dosage your doctor prescribes, and even the pharmacy you use to fulfill the prescription.

In contrast, generic semaglutide may cost as little as $200 to $300 without insurance coverage, making it far more cost-effective.

The Active Ingredient Remains the Same

The FDA requires that all generic drug manufacturers use the same active ingredient in generics as the name-brand counterparts. For Ozempic, the active ingredient is semaglutide. So, when you get generic semaglutide from your pharmacy, you can be assured that you’re getting the same semaglutide that’s used in brand-name Ozempic. Other ingredients such as preservatives and flavors (for oral medications) may differ, but the active ingredient will always be the same.

Similarities & Differences Between Liraglutide, Semaglutide, and Tirzepatide

How to Procure Each Drug

All three drugs must be acquired via a prescription from a doctor. You may be prescribed a name-brand drug or a generic version, which is often cheaper. Generic versions may need to be compounded, so you would need to acquire them from a compounding pharmacy in that case.

Uses for Each Drug

All three drugs can be used to regulate type 2 diabetes symptoms and weight management. However, tirzepatide is also known to help with sleep apnea in overweight patients.

How Each Drug is Taken

All three drugs can be taken as a subcutaneous injection that can be performed at home once per week. However, semaglutide is the only one of the three that also has the option to be taken as a daily oral tablet.

How Each Drug Works

All three drugs mimic GLP-1s in the body. However, tirzepatide also mimics GIPs, giving it two courses of action instead of just one.

Drug Effectiveness

• Liraglutide: A study using the 3mg dose of liraglutide on 311 participants found that participants lost an average of 6.5% of their body weight.
• Semaglutide: A study conducted on 175 participants found that an average of 5.9% of body weight was lost over three months and 10.9% over six months.
• Tirzepatide: A study conducted on 7,062 participants found that people with and without type 2 diabetes can see a reduction in body weight from taking tirzepatide.

Available Doses

Liraglutide:

• Victoza: .6mg, 1.2mg, 1.8mg
• Saxenda: 3mg

Semaglutide:

• Ozempic: .25mg, .5mg, 1mg
• Wegovy: .25mg, .5mg, 1mg, 1.7mg, 2.4mg
• Rybelsus: 3mg, 7mg, 14mg

Tirzepatide

• Mounjaro: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg
• Zepbound: .5mg, 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg

Other Benefits of Use

Liraglutide:

• Stabilizes blood pressure and cholesterol levels
• Improves cardiovascular risk factors

Semaglutide:

• Reduces cholesterol levels
• Improves cardiovascular risk factors and heart health
• Reduces inflammation

Tirzepatide:

• Improves cardiovascular risk factors
• Help with sleep apnea symptoms

Possible Side Effects

Similar side effects of all three drugs include: gastrointestinal side effects such as nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, abdominal distension, burping, colitis, gastroesophageal reflux disease, headache, fatigue, dizziness, hypoglycemia, and diabetic retinopathy.

Serious but very rare side effects can include symptoms such as pancreatitis, kidney disease, gastroparesis, gallbladder disease, and thyroid tumors.

Eligible Age Groups for Each Drug

Liraglutide:

• Saxenda: Children aged 12 to 17 years old who have type 2 diabetes and adults with type 2 diabetes
• Victoza: People over 10 years of age who have type 2 diabetes

Semaglutide:

• Ozempic: Adults who are 18 or older
• Rybelsus: Adults who are 18 or older
• Wegovy: Children 12 years or older and adults

Tirzepitide:

• Mounjaro: Adults who are 18 or older
• Zepbound: Adults who are 18 or older

How to Get the Most From Using GLP-1 RAs

Just using your GLP-1 RAs as prescribed may not give you the desired results you’re looking for. Lifestyle changes are also important when using GLP-1 RAs. Here are some things to consider when taking them:

• Adopt a GLP-1 diet: Prioritize high-protein and high-fiber foods like eggs, poultry, fish, and vegetables to ensure you’re getting enough energy during your day.
• Don’t overeat: GLP-1 RAs make you feel less hungry, and you will feel fuller faster while on them. Don’t force yourself to eat when you aren’t hungry. Instead, try cutting your meals in half and saving them for later if you get hungry again.
• Start an exercise program: Exercise is essential for a healthy body. Whether it’s taking walks around your neighborhood, doing yoga at home, or going to the gym after work, try to find something that fits your lifestyle.

Which GLP-1 Receptor Agonist is Right For You?

Choosing between liraglutide, semaglutide, and tirzepatide depends on your individual health goals, medical history, and lifestyle. While all three medications can support weight loss and improve blood sugar control, each has unique features worth considering. Speaking with a healthcare provider is the best way to determine which option is right for you.

For added support on your journey, consider consulting with a registered dietitian who can help you develop sustainable habits around food, physical activity, and medication use. Sign up today to speak with a registered dietitian at no cost to you, and take the next step toward better health outcomes!

GLP-1 RAs FAQ

Can You Combine GLP-1 RAs With Other Weight Loss Drugs?

No, combining GLP-1 RAs with other weight loss and weight management drugs, whether they’re prescribed by a doctor or over-the-counter.

How Long Do You Use GLP-1 Receptor Agonists?

GLP-1 receptor agonists are intended for long-term use, particularly for chronic conditions such as type 2 diabetes and obesity. Real-world data show that many patients discontinue much sooner than optimal, often before the full benefits can be realized.

Ongoing treatment paired with support like dose titration, side-effect management, dietary guidance, and regular follow-ups can help patients stay on therapy and sustain its benefits.

Is a GIP/GLP-1 RA Combo Better Than Just a GLP-1 RA?

Yes, current clinical trial data indicate that dual-agonists like tirzepatide, which engage both GIP and GLP‑1 receptors, generally outperform selective GLP‑1 RAs in measures of weight reduction and blood sugar control.