GLP-1 Comparison Guide 2026: Which Medication Is Right for You?
Compare all GLP-1 medications side by side: semaglutide vs tirzepatide, Wegovy vs Zepbound vs Mounjaro vs Ozempic vs Foundayo.
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All GLP-1 medications compared (August 2026)
The GLP-1 market in 2026 is confusing. Six FDA-approved brands share three active ingredients between two manufacturers, and brand names give no hint about which is which. This guide untangles everything in one place.
| Brand | Active ingredient | Manufacturer | FDA indication | Form | Avg weight loss | Cash price/mo |
|---|---|---|---|---|---|---|
| Wegovy | Semaglutide 2.4 mg | Novo Nordisk | Weight management + CV risk | Weekly injection | ~14.9% | $1,300 (retail) / $149 (NovoCare) |
| Zepbound | Tirzepatide | Eli Lilly | Weight management + OSA | Weekly injection | ~20.9% | $1,050 (retail) / $299-449 (LillyDirect) |
| Ozempic | Semaglutide (≤2 mg) | Novo Nordisk | Type 2 diabetes + CV + kidney | Weekly injection | ~11% (off-label) | ~$950 |
| Mounjaro | Tirzepatide | Eli Lilly | Type 2 diabetes | Weekly injection | ~15-22% (off-label) | ~$1,000 |
| Rybelsus | Semaglutide (oral) | Novo Nordisk | Type 2 diabetes | Daily oral tablet | ~8-10% (off-label) | ~$900 |
| Foundayo | Orforglipron | Eli Lilly | Weight management | Daily oral tablet | ~12-15% | $149 |
Semaglutide vs tirzepatide: the key difference
The fundamental difference between semaglutide and tirzepatide is the number of hormone receptors they activate:
- Semaglutide is a GLP-1 receptor agonist — it mimics one gut hormone (GLP-1) that reduces appetite and slows gastric emptying.
- Tirzepatide is a dual GIP/GLP-1 receptor agonist — it mimics two gut hormones (GLP-1 and GIP), producing superior appetite suppression and metabolic effects.
The SURMOUNT-5 trial (NEJM 2025) confirmed tirzepatide's head-to-head advantage: patients on tirzepatide lost significantly more weight than those on semaglutide. However, semaglutide has a longer real-world track record and more long-term safety data.
Read our full semaglutide vs tirzepatide guide →
Which GLP-1 should you choose?
Best for maximum weight loss: Zepbound (tirzepatide)
If your goal is the most weight loss possible and you tolerate injections, Zepbound is the evidence-based choice. At ~20.9% body weight loss on the 15 mg dose, it outperforms every other GLP-1. LillyDirect vials at $299–$449/month make it accessible without insurance.
Best for proven track record: Wegovy (semaglutide)
Wegovy has the longest real-world experience and the most robust long-term safety data. If you value a proven medication over a newer one, Wegovy at $149/month through NovoCare is an excellent choice. The STEP-1 trial showed ~14.9% weight loss at 68 weeks.
Best for oral preference: Foundayo (orforglipron)
If you cannot or will not do injections, Foundayo is the first FDA-approved oral GLP-1 for weight management. At $149/month with no fasting requirement, it is also the cheapest branded option. Weight loss is ~12–15%, slightly less than injectables but far more convenient.
Best for budget: compounded semaglutide via telehealth
If cost is your primary concern, compounded semaglutide through telehealth programs starts at $179/month. These are not FDA-approved but are produced by licensed US compounding pharmacies. Check eligibility with NewSelf.
Best if you have diabetes: Mounjaro or Ozempic
If you have type 2 diabetes, Mounjaro (tirzepatide) generally outperforms Ozempic (semaglutide) on A1C reduction (SURPASS-2 trial). Both are covered by most insurance plans for diabetes. If you also want weight loss, Mounjaro offers more off-label weight loss benefit.
Not sure which GLP-1 is right for you?
A US-licensed provider can help you choose based on your health profile, goals, and budget.
Get personalized recommendationDosage comparison
| Medication | Starting dose | Maintenance dose | Titration schedule | Frequency |
|---|---|---|---|---|
| Wegovy | 0.25 mg | 2.4 mg | 5 steps over 16 weeks | Weekly injection |
| Zepbound | 2.5 mg | 5, 10, or 15 mg | 4 steps over 12+ weeks | Weekly injection |
| Ozempic | 0.25 mg | 0.5, 1, or 2 mg | 4 steps over 12+ weeks | Weekly injection |
| Mounjaro | 2.5 mg | 5, 10, or 15 mg | 4 steps over 12+ weeks | Weekly injection |
| Rybelsus | 3 mg | 7 or 14 mg | 2 steps over 30 days | Daily oral (fasting) |
| Foundayo | Per label | Per label | Per provider guidance | Daily oral (no fasting) |
Side effect comparison
Both semaglutide and tirzepatide share similar side effect profiles (nausea, diarrhea, constipation, vomiting). Key differences:
- Tirzepatide tends to cause slightly more nausea and vomiting, especially at higher doses (10–15 mg).
- Semaglutide has a slightly longer track record, so rare side effects are better documented.
- Both carry the same boxed warning for thyroid C-cell tumors and the same contraindications (MTC/MEN2 history).
- Both can cause "Ozempic face," hair loss, and muscle loss with rapid weight loss — these are weight-loss effects, not drug-specific.
Read our complete GLP-1 side effects guide →
Insurance coverage comparison
| Medication | Commercial insurance | Medicare | Medicaid | Cash-pay option |
|---|---|---|---|---|
| Wegovy | Yes (prior auth, BMI 30+/27+) | No (weight loss only) | Varies by state | $149/mo NovoCare |
| Zepbound | Yes (prior auth, BMI 30+/27+) | No (weight loss only) | Varies by state | $299-449/mo LillyDirect |
| Ozempic | Yes (for diabetes) | Yes (for diabetes) | Yes (for diabetes) | ~$950/mo retail |
| Mounjaro | Yes (for diabetes) | Yes (for diabetes) | Yes (for diabetes) | ~$1,000/mo retail |
| Foundayo | Expanding | TBD | TBD | $149/mo LillyDirect |
Related comparisons
- Mounjaro vs Wegovy
- Mounjaro vs Ozempic
- Zepbound vs Wegovy
- Zepbound vs Mounjaro
- Saxenda vs Wegovy
- Trulicity vs Ozempic
- GLP-1 Cost Guide 2026
Affiliate disclosure: This article contains affiliate links. We may earn a commission if you sign up through them, at no extra cost to you. Medical disclaimer: This content is for informational purposes only and is not medical advice. Always consult a qualified healthcare provider before starting any medication.
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Jessica M., 38
Texas
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Compounded semaglutide
"At 52, my doctor said I was heading toward diabetes. I started tirzepatide through a telehealth program and lost 62 pounds. My A1C is back to normal, my blood pressure dropped, and I'm off two medications. Wish I'd done this years ago."
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Florida
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Tirzepatide (Zepbound)
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California
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Compounded semaglutide
Results vary. These testimonials reflect individual experiences and are not typical. Weight loss depends on diet, activity, and adherence to medication.
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