Brand trial evidence and compounded program prices are presented separately.
SemaglutideTirzepatide
In the head-to-head SURMOUNT-5 trial (NEJM, 2025), adults with obesity without type 2 diabetes lost an average 20.2% of body weight on tirzepatide and 13.7% on semaglutide at 72 weeks. Those are trial results, not REMEVi averages. They do not make either medicine right for every person or establish results for compounded preparations.
How do semaglutide and tirzepatide differ?
Quick answer: Semaglutide acts on one hormone receptor (GLP-1); tirzepatide acts on two (GIP and GLP-1). Their brands, trial results and label precautions also differ.
The trial row describes manufacturers’ medicines, at the doses tested in that trial. REMEVi’s compounded protocol and prices appear in their own rows; the products are not established as equivalent.
On small screens, scroll the table horizontally to read both columns.
Semaglutide and tirzepatide: evidence, precautions and REMEVi costs
What to compare
Semaglutide
Tirzepatide
Mechanism
GLP-1 receptor agonist
Dual GIP / GLP-1 receptor agonist
Brand medicines
Wegovy; Ozempic. Indications and doses differ by product.
Zepbound; Mounjaro. Indications and doses differ by product.
Direct comparison: SURMOUNT-5
13.7% average weight loss at 72 weeks; 1.7 or 2.4 mg weekly.
20.2% average weight loss at 72 weeks; 10 or 15 mg weekly.
Common side effects
Nausea, vomiting, diarrhea and constipation; severity varies.
Nausea, vomiting, diarrhea and constipation; severity varies.
A conversation to have
Pregnancy plans: Wegovy’s label advises stopping at least two months before a planned pregnancy.
Oral contraception: Zepbound’s label advises an alternative or added barrier method for four weeks after starting and after each dose increase.
$159 / 4 weeks equivalent. $954 upfront for 24 weeks
$225 / 4 weeks equivalent. $1,350 upfront for 24 weeks
Sources: SURMOUNT-5 and current manufacturer prescribing information, linked below. Trial doses do not describe every currently approved formulation or dose.
Which causes more weight loss in trials, semaglutide or tirzepatide?
Quick answer: In the head-to-head SURMOUNT-5 trial, tirzepatide averaged 20.2% weight loss and semaglutide 13.7% at 72 weeks. Trial results, not REMEVi averages.
The direct trial answers a more specific question than comparing percentages from separate studies.
SURMOUNT-5: a direct comparison
751 adults with obesity without type 2 diabetes were randomized in an open-label, 72-week trial. They received the maximum tolerated trial dose: tirzepatide 10 or 15 mg, or semaglutide 1.7 or 2.4 mg. Average weight reductions were 20.2% and 13.7%, respectively.
The trial was funded by Eli Lilly. It was not blinded, did not enroll people with type 2 diabetes and did not test compounded preparations. These averages are not a personal forecast.
STEP 1 reported 14.9% average loss with semaglutide 2.4 mg at 68 weeks. SURMOUNT-1 reported 20.9% with tirzepatide 15 mg at 72 weeks. Their different designs and populations prevent those numbers from serving as a direct comparison.
How do I choose between semaglutide and tirzepatide?
Quick answer: With a licensed clinician, based on your health history, other medicines, tolerability, pregnancy plans, access and full cost, not a trial percentage alone.
Both medicines have benefits, risks and reasons they may not be appropriate. A lower program price is not itself a medical reason for compounding.
Your health and treatment history
Discuss your diagnosis, other medicines, prior response, pregnancy plans and relevant family history. Neither medicine should be combined with the other. Switching requires a prescriber’s plan; there is no direct milligram conversion.
Tolerability and follow-up
Discuss gastrointestinal side effects and serious risks, including the boxed thyroid-tumor warning in approved product labels. A slower schedule may be needed; do not adjust your own dose.
Access and the full cost
Review approved options, insurance coverage where applicable, and the full charge for any prepaid plan. Include follow-up, medication, supplies and any separate fees when comparing programs.
How much does REMEVi charge for each one?
Quick answer: Each compounded plan and its full charge is listed below. These are REMEVi program prices, not prices for Wegovy, Ozempic, Zepbound or Mounjaro.
These are REMEVi’s compounded program prices, not prices for Wegovy, Ozempic, Zepbound or Mounjaro. All plans include clinical evaluation, prescribed medication if approved, required GLP-1 labs, shipping and ongoing care.
The monthly plan is billed every 4 weeks. The 12-week and 24-week plans are prepaid for the full term, with the total charge shown before you choose. Review the renewal terms at checkout and in your patient portal.
You can cancel future renewals without a cancellation fee. Prepaid terms are paid in advance; refund eligibility is governed by the Cancellation & Refund Policy. Read the policy.
What else should I ask about semaglutide vs tirzepatide?
Quick answer: The answers below cover common questions, including why compounded preparations are not established as equivalent to the brand medicines.
Which produced more weight loss in a direct comparison?+
In SURMOUNT-5, adults with obesity without diabetes lost an average 20.2% of body weight with tirzepatide and 13.7% with semaglutide at 72 weeks. The trial studied brand products at its maximum tolerated doses. These are averages, not guaranteed outcomes or evidence for compounded preparations.
How do you choose between semaglutide and tirzepatide?+
Your clinician considers your diagnosis, history, other medicines, tolerability, preferences and cost. Average weight loss alone does not determine the appropriate treatment.
Can I switch from one medicine to the other?+
Switching requires a plan from your treating clinician. There is no direct milligram conversion between these medicines. Do not combine them or choose the new dose or start date yourself.
Which side effects need attention?+
Nausea, vomiting, diarrhea or constipation can occur, particularly during dose increases. Severity and duration vary. Seek medical care for severe persistent abdominal pain, inability to keep fluids down or symptoms of a serious allergic reaction. Do not change your dose on your own.
How should I compare costs?+
REMEVi semaglutide: From $159 per 4 weeks with the 24-week plan: $954 paid upfront. Or $199 every 4 weeks without a long-term prepayment. REMEVi tirzepatide: From $225 per 4 weeks with the 24-week plan: $1,350 paid upfront. Or $269 every 4 weeks without a long-term prepayment. Four weeks is not a calendar month. Brand products may have different costs depending on insurance, presentation and savings eligibility.
Are compounded preparations equivalent to the brands?+
No. Compounded medicines are not FDA-approved, are not approved generics of brand medicines and are not established as equivalent. Discuss approved options and the specific medical reason for compounding with your clinician. A prescription or pharmacy license does not establish FDA approval.
Not sure which one fits you?
Quick answer: Start the free health questionnaire. Your clinician will review your options and decide whether treatment is appropriate.
