The Short Answer
Tirzepatide produces more weight loss. In head-to-head trials, it beat semaglutide by about 47%. But semaglutide has been around longer, costs less, and works extremely well for most people.
Can You Switch Between Them?
Yes. Switching is common and straightforward. If you start on semaglutide and plateau, you can switch to tirzepatide for a potential "breakthrough." Your provider will help you determine the equivalent dose to start at.
Switching the other direction (tirz → sema) is less common but sometimes done for cost reasons or if side effects are too strong.
Bottom Line
Both medications work. Tirzepatide is stronger; semaglutide is cheaper and time-tested. There's no wrong choice—just the choice that fits your situation.
Many providers recommend starting with semaglutide since it's more affordable and effective for most people. If you're not getting the results you want after 4-6 months, tirzepatide is there as a step-up option.
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