Comparisons
Wegovy vs Zepbound: labels, results and self-pay programs compared
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Short answer
Zepbound and Wegovy are FDA-approved weight-management medicines. In SURMOUNT-5, Zepbound (tirzepatide) averaged −20.2% vs −13.7% for Wegovy (semaglutide) at 72 weeks. Zepbound climbs from 2.5 to 15 mg; Wegovy from 0.25 to 2.4 mg. As shown on Oct 19, 2026, self-pay starts at $299 per 28 days for Zepbound 2.5 mg and $349 a month for standard Wegovy.
On this page12 sections
| Item | Value | Source |
|---|---|---|
| Zepbound molecule and targets | Tirzepatide; GIP and GLP-1 receptor agonist | Eli Lilly, May 13, 2022 |
| Wegovy molecule and target | Semaglutide; GLP-1 receptor agonist | Novo Nordisk, Jun 18, 2026 |
| First FDA approval for weight | Wegovy Jun 4, 2021; Zepbound Nov 8, 2023 | FDA, Oct 19, 2026 |
| SURMOUNT-5, week 72 | Zepbound −20.2% vs Wegovy −13.7% (open-label; least-squares mean) | N Engl J Med, Jul 3, 2025 |
| Zepbound ladder | 2.5 mg × 4 weeks, then 5 mg; +2.5 mg after ≥4 weeks; maintenance 5, 10 or 15 mg | DailyMed, Aug 28, 2026 |
| Wegovy ladder | 0.25 → 0.5 → 1 → 1.7 → 2.4 mg every 4 weeks; optional 7.2 mg (Wegovy HD) | Novo Nordisk, Jun 18, 2026 |
| Zepbound missed dose | Take within 4 days (96 hours); otherwise skip | DailyMed, Aug 28, 2026 |
| Wegovy missed dose | Give if next dose is more than 2 days away; otherwise skip | Novo Nordisk, Jun 18, 2026 |
| Out of the fridge | Zepbound single-dose pen or vial: 21 days up to 30 °C; Wegovy single-dose pen: 28 days at 8–30 °C | DailyMed, Aug 28, 2026 |
| Zepbound self-pay (LillyDirect) | $299 (2.5 mg), $399 (5 mg), $449 (7.5–15 mg, refilled within 45 days) per 28 days, as shown Oct 19, 2026 | Eli Lilly, Oct 19, 2026 |
| Wegovy self-pay (NovoCare) | $349/month for 0.25–2.4 mg; $399 for Wegovy HD 7.2 mg, as shown Oct 19, 2026 | Novo Nordisk, Oct 19, 2026 |
| Wegovy new-patient offer | $199/month for first 2 fills of 0.25 or 0.5 mg, through Dec 31, 2026 | Novo Nordisk, Oct 19, 2026 |
Also useful: Tirzepatide cost, Semaglutide cost, Tirzepatide storage dates.
Wegovy and Zepbound are the two brand-name weekly medicines most people mean when they compare “weight-loss shots”. Both are approved by FDA for chronic weight management. They contain different molecules from different companies and follow different labels. Everything below is taken from the current FDA prescribing information, the trial abstracts and the manufacturers’ own program pages. For the underlying molecules, see the semaglutide hub and the tirzepatide hub.
Side-by-side comparison table
| Item | Wegovy | Zepbound |
|---|---|---|
| Molecule (maker) | Semaglutide (Novo Nordisk) | Tirzepatide (Eli Lilly) |
| Receptor targets | GLP-1 | GIP and GLP-1 |
| First approved for weight | Jun 4, 2021 | Nov 8, 2023 |
| Other labeled uses | Cardiovascular risk reduction; MASH; ages 12 and up | Obstructive sleep apnea with obesity |
| Starting dose | 0.25 mg weekly for 4 weeks | 2.5 mg weekly for 4 weeks |
| Maintenance doses | 1.7 or 2.4 mg (2.4 mg recommended); optional 7.2 mg | 5, 10 or 15 mg |
| Half-life | Approximately 1 week | 5–6 days (label section 12.3) |
| Missed dose | Give if next dose is more than 2 days away | Give within 4 days (96 hours) |
| Oral option | Wegovy tablets (25 mg daily maintenance) | None in the current label |
Sources: Wegovy label (Novo Nordisk, Jun 18, 2026), Zepbound label (DailyMed, Aug 28, 2026), Wegovy approval record (FDA, Oct 19, 2026), Zepbound approval (FDA, Nov 8, 2023).
Indications
| Use | Wegovy | Zepbound |
|---|---|---|
| Chronic weight management, adults | Yes | Yes |
| Weight management, ages 12 and older | Yes | No |
| Lower risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight | Yes (approved Mar 8, 2024) | No |
| Noncirrhotic MASH with moderate to advanced liver fibrosis | Yes (accelerated approval Aug 15, 2025) | No |
| Moderate to severe obstructive sleep apnea in adults with obesity | No | Yes (approved Dec 20, 2024) |
Sources: (FDA, Mar 8, 2024) (Novo Nordisk, Aug 15, 2025) (FDA, Dec 20, 2024)
Wegovy’s cardiovascular indication comes from SELECT, where major cardiovascular events occurred in 6.5% on semaglutide vs 8.0% on placebo, a hazard ratio of 0.80 (New England Journal of Medicine, Dec 14, 2023). Because the labeled uses differ, the reason a prescription is written can affect which brand a health plan considers.
Dose ladders
| Weeks | Wegovy | Zepbound |
|---|---|---|
| 1–4 | 0.25 mg | 2.5 mg |
| 5–8 | 0.5 mg | 5 mg (first maintenance option) |
| 9–12 | 1 mg | 7.5 mg |
| 13–16 | 1.7 mg (maintenance option) | 10 mg (maintenance option) |
| 17–20 | 2.4 mg (recommended maintenance) | 12.5 mg |
| 21 onward | 2.4 mg; optional 7.2 mg after 4 or more weeks on 2.4 mg | 15 mg (maximum) |
Sources: (Novo Nordisk, Jun 18, 2026) (DailyMed, Aug 28, 2026)
Zepbound escalates only after at least 4 weeks on the current dose, so the right-hand column is the fastest the label allows, not a required pace. Wegovy’s label says to consider delaying a step by 4 weeks if a dose is not tolerated. Wegovy HD 7.2 mg was approved on Mar 19, 2026 (FDA, Mar 19, 2026) and applies only to adults on the weight indication.
- Weekly dose (published steps)
- Modeled amount (mg-eq)
- Stable window
- Weekly dose (published steps)
- Modeled amount (mg-eq)
- Stable window
The Wegovy dosing schedule guide and the Zepbound dosing schedule guide walk through each step. Ask your prescriber before changing a dose.
Results
| Trial | Length | Wegovy arm | Zepbound arm | Placebo |
|---|---|---|---|---|
| SURMOUNT-5 (head-to-head) | 72 weeks | −13.7% (1.7 or 2.4 mg) | −20.2% (10 or 15 mg) | None |
| STEP 1 (Wegovy pivotal) | 68 weeks | −14.9% (2.4 mg) | — | −2.4% |
| SURMOUNT-1 (Zepbound pivotal) | 72 weeks | — | −20.9% (15 mg) | −3.1% |
| Wegovy label Study 8 | 72 weeks | −18.8% (7.2 mg); −15.5% (2.4 mg) | — | −3.9% |
Sources: (N Engl J Med, Jul 3, 2025) (New England Journal of Medicine, Mar 18, 2021) (N Engl J Med, Jul 21, 2022) (Novo Nordisk, Jun 18, 2026)
SURMOUNT-5 is the only row where both drugs were given to the same population at the same time. It was open-label and funded by Lilly, and its abstract does not name the estimand, so we report the least-squares means without one. STEP 1 used a treatment-policy estimand and SURMOUNT-1 a treatment-regimen estimand; both count everyone randomized. No trial has compared Wegovy HD 7.2 mg with Zepbound.
Side effects from the labels
Both labels list nausea, diarrhea, vomiting and constipation among the most common reactions. The Wegovy pooled table reports nausea in 44% on 2.4 mg vs 16% on placebo; the Zepbound pooled table reports 28% on 15 mg vs 8% on placebo (Novo Nordisk, Jun 18, 2026) (DailyMed, Aug 28, 2026). These pools come from different trials, so the rates are not a direct comparison. Two label details stand out:
- Dysesthesia with Wegovy HD. Abnormal skin sensations were reported in 22% on 7.2 mg, 6% on 2.4 mg and 0% on placebo in the 7.2 mg trials.
- Hair loss with Zepbound. The pooled rate was 5% on 15 mg vs 1% on placebo, and 7.1% of women vs 0.5% of men; the label links it to weight reduction.
Presentations
| Presentation | Wegovy | Zepbound |
|---|---|---|
| Single-dose pen | 0.25, 0.5, 1 mg (0.5 mL); 1.7, 2.4, 7.2 mg (0.75 mL) | 2.5, 5, 7.5, 10, 12.5, 15 mg (0.5 mL) |
| Single-dose vial | No | All six strengths (0.5 mL) |
| Single-dose syringe | 0.25 to 2.4 mg | No |
| Multi-dose pen | FlexTouch, 9.6 mg/3 mL, four 2.4 mg doses | KwikPen, 4 doses of 2.5 to 15 mg (0.6 mL each) |
| Multi-dose vial | No | Yes, 4 doses |
| Tablets | 1.5, 4, 9, 25 mg (bottles of 30) | No |
Sources: (Novo Nordisk, Jun 18, 2026) (DailyMed, Aug 28, 2026)
Lilly announced the Zepbound KwikPen on Feb 23, 2026 (Eli Lilly, Feb 23, 2026). The Wegovy pill was approved on Dec 22, 2025 (Novo Nordisk, Dec 22, 2025). To convert between a pen and a vial strength, use the pen-to-vial tool.
Storage
| Rule | Wegovy | Zepbound |
|---|---|---|
| Refrigerated | 2–8 °C (36–46 °F), single-dose pen or syringe | 2–8 °C (36–46 °F), single-dose pen or vial |
| Out of the fridge, single-dose | Pen: up to 28 days at 8–30 °C, before cap removal | Up to 21 days total, not above 30 °C |
| Multi-dose pen in use | FlexTouch: 56 days at 15–30 °C or refrigerated | KwikPen or multi-dose vial: discard after 30 days at room temperature, 30 days after first use, or 4 weekly doses |
| Freezing | Do not freeze; do not use if frozen | Do not freeze |
Sources: (Novo Nordisk, Jun 18, 2026) (DailyMed, Aug 28, 2026)
The 21-day Zepbound allowance does not apply to KwikPens or multi-dose vials. The semaglutide storage tool and the tirzepatide storage tool count the days for you.
Missed doses
The Zepbound label says to take a missed dose within 4 days (96 hours); after that, skip it and take the next dose on the usual day (DailyMed, Aug 28, 2026). Its Medication Guide asks for at least 3 days (72 hours) between doses when changing the weekly day.
The Wegovy label uses a 2-day rule. If the next dose is more than 2 days away, give the missed dose as soon as possible; if it is less than 2 days away, skip it. If 2 or more doses in a row are missed, the label says to restart the escalation at a lower dose (Novo Nordisk, Jun 18, 2026). Check with your prescriber after any long gap.
Self-pay and savings programs on Oct 19, 2026
Both makers sell directly to people paying cash and offer copay cards to people whose commercial plans cover the drug. The figures below are what each manufacturer’s page showed on Oct 19, 2026. Both companies say terms can change at any time.
| Dose | Zepbound (LillyDirect, per 28 days) | Wegovy (NovoCare, per month) |
|---|---|---|
| Starting doses | $299 (2.5 mg); $399 (5 mg) | $199 for the first 2 fills of 0.25 or 0.5 mg (new patients, through Dec 31, 2026), then $349 |
| Higher doses | $449 (7.5–15 mg) if refilled within 45 days; otherwise $499 (7.5 mg) or $699 (10–15 mg) | $349 (1–2.4 mg) |
| Top dose | $449 (15 mg) | $399 (Wegovy HD 7.2 mg) |
Sources: (Eli Lilly, Oct 19, 2026) (Novo Nordisk, Oct 19, 2026) (Novo Nordisk, Oct 19, 2026)
Zepbound KwikPens and single-dose vials carried the same prices; vials are sold only through LillyDirect. The Wegovy new-patient offer requires the prescription to be received by Dec 31, 2026 and shipped by Jan 31, 2027 (Novo Nordisk, Oct 19, 2026).
For people with commercial coverage, both cards advertise paying as little as $25. The Zepbound card caps savings at $100 per 1-month fill and $1,300 per calendar year, and expires Dec 31, 2026 (Eli Lilly, Sep 1, 2026). The Wegovy offer caps savings at $100 a month, $200 per 2-month and $300 per 3-month fill (Novo Nordisk, Oct 19, 2026). Both exclude government-insured patients such as Medicare and Medicaid enrollees. Separately, Novo lists a $50-a-month Medicare GLP-1 Bridge copay for eligible Part D beneficiaries from Jul 1, 2026 to Dec 31, 2027 (Novo Nordisk, Jul 1, 2026).
Full terms, fills per year and eligibility are in the Zepbound savings card guide and the Wegovy savings card guide. The tirzepatide cost tool and the semaglutide cost tool estimate a yearly total along the ladder.
Using them together or switching
The Zepbound label says not to use it with other tirzepatide-containing products or with any GLP-1 receptor agonist (DailyMed, Aug 28, 2026), so Wegovy and Zepbound are not taken together. Neither label gives a dose conversion between the two. Compounded semaglutide and compounded tirzepatide are not FDA approved and are not interchangeable with either brand. Talk to your prescriber before switching.
Frequently asked questions
Wegovy vs Zepbound: which is better for weight loss?
- In SURMOUNT-5, a 72-week open-label trial in 751 adults with obesity and no diabetes, Zepbound's molecule (tirzepatide, 10 or 15 mg) averaged −20.2% body weight vs −13.7% for Wegovy's molecule (semaglutide, 1.7 or 2.4 mg), per the NEJM 2025 abstract. Lilly funded the trial. Individual results vary, and side effects, coverage and other conditions matter too. Talk to your prescriber.
What is the difference between Wegovy and Zepbound?
- Wegovy is semaglutide from Novo Nordisk, a GLP-1 receptor agonist. Zepbound is tirzepatide from Eli Lilly, which acts on both GIP and GLP-1 receptors. Their labels differ in doses (Wegovy up to 2.4 mg, or 7.2 mg as Wegovy HD; Zepbound up to 15 mg), in second indications (Wegovy: cardiovascular risk and MASH; Zepbound: obstructive sleep apnea), in presentations and in missed-dose rules.
How much does Zepbound cost compared with Wegovy without insurance?
- As shown on Oct 19, 2026, LillyDirect listed Zepbound KwikPens and single-dose vials at $299 for 2.5 mg, $399 for 5 mg and $449 for 7.5 to 15 mg per 28 days when refilled within 45 days. Novo Nordisk listed Wegovy at $349 a month for 0.25 to 2.4 mg, $399 for Wegovy HD 7.2 mg, and $199 a month for a new patient's first two fills of 0.25 or 0.5 mg through Dec 31, 2026. Programs can change at any time.
Can you take Wegovy and Zepbound together?
- No. The Zepbound label says not to use it with other tirzepatide-containing products or with any GLP-1 receptor agonist, and Wegovy's semaglutide is a GLP-1 receptor agonist. If you are moving from one to the other, your prescriber decides the timing and the starting dose.
How long can Wegovy and Zepbound stay out of the fridge?
- Per the labels, a Zepbound single-dose pen or single-dose vial can be kept unrefrigerated up to 30 °C (86 °F) for a total of 21 days. An unopened Zepbound KwikPen or multi-dose vial can stay at room temperature for 30 days. A Wegovy single-dose pen can be kept at 8 to 30 °C (46 to 86 °F) for up to 28 days before the cap is removed, and an in-use Wegovy FlexTouch pen lasts 56 days.
What are the Wegovy and Zepbound dosing schedules?
- The Wegovy label starts at 0.25 mg once weekly and steps up every 4 weeks through 0.5, 1 and 1.7 mg to the 2.4 mg maintenance dose, with an optional 7.2 mg for adults who tolerated 2.4 mg for at least 4 weeks. The Zepbound label starts at 2.5 mg for 4 weeks, then 5 mg, rising in 2.5 mg steps after at least 4 weeks to a maximum of 15 mg. Your prescriber sets the pace.
Sources
- ZEPBOUND (tirzepatide) injection, for subcutaneous use - Full Prescribing Information, Medication Guide and Instructions for Use (DailyMed SPL set ID 487cd7e7-434c-4925-99fa-aa80b1cc776b, version 40). U.S. National Library of Medicine (DailyMed) / Eli Lilly and Company, Aug 28, 2026. Accessed Oct 19, 2026.
- WEGOVY (semaglutide) injection, for subcutaneous use; WEGOVY (semaglutide) tablets, for oral use - Full Prescribing Information (SPL, Revised 6/2026). Novo Nordisk / National Library of Medicine DailyMed, Jun 18, 2026. Accessed Oct 19, 2026.
- Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med 2025;393(1):26-36 (Aronne LJ et al.; PubMed PMID 40353578; doi:10.1056/NEJMoa2416394), Jul 3, 2025. Accessed Oct 19, 2026.
- Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022;387(3):205-216 (Jastreboff AM et al.; PubMed PMID 35658024; doi:10.1056/NEJMoa2206038), Jul 21, 2022. Accessed Oct 19, 2026.
- Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine (Wilding JPH et al.; PMID 33567185), Mar 18, 2021. Accessed Oct 19, 2026.
- Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine (Lincoff AM et al.; PMID 37952131), Dec 14, 2023. Accessed Oct 19, 2026.
- FDA approves Lilly's Mounjaro™ (tirzepatide) injection, the first and only GIP and GLP-1 receptor agonist for the treatment of adults with type 2 diabetes. Eli Lilly and Company (investor.lilly.com), May 13, 2022. Accessed Oct 19, 2026.
- FDA Approves New Medication for Chronic Weight Management. U.S. Food and Drug Administration, Nov 8, 2023. Accessed Oct 19, 2026.
- FDA Approves First Medication for Obstructive Sleep Apnea. U.S. Food and Drug Administration, Dec 20, 2024. Accessed Oct 19, 2026.
- Drugs@FDA record NDA215256 (WEGOVY semaglutide injection) - submissions history. U.S. Food and Drug Administration (openFDA Drugs@FDA API), Oct 19, 2026. Accessed Oct 19, 2026.
- FDA Approves First Treatment to Reduce Risk of Serious Heart Problems Specifically in Adults with Obesity or Overweight. U.S. Food and Drug Administration, Mar 8, 2024. Accessed Oct 19, 2026.
- Novo Nordisk A/S: Wegovy® approved in the US for the treatment of MASH. Novo Nordisk A/S, Aug 15, 2025. Accessed Oct 19, 2026.
- FDA Approves Oral Wegovy® Pill. Novo Nordisk Inc. (US), Dec 22, 2025. Accessed Oct 19, 2026.
- FDA Approves Fourth Product Under National Priority Voucher Program, Higher Dose Semaglutide. U.S. Food and Drug Administration, Mar 19, 2026. Accessed Oct 19, 2026.
- Zepbound (tirzepatide), the most prescribed weight management medication in 2025, now available in multi-dose KwikPen. Eli Lilly and Company (investor.lilly.com), Feb 23, 2026. Accessed Oct 19, 2026.
- Authentic Zepbound® (tirzepatide) Shipped to You | LillyDirect®. Eli Lilly and Company (LillyDirect), Oct 19, 2026. Accessed Oct 19, 2026.
- Savings & Insurance Options | Zepbound® (tirzepatide). Eli Lilly and Company (zepbound.lilly.com; page code CMAT-26402 09/2026), Sep 1, 2026. Accessed Oct 19, 2026.
- Price your Wegovy®. Novo Nordisk (NovoCare), Oct 19, 2026. Accessed Oct 19, 2026.
- Wegovy® Cost & Coverage Information | Wegovy® (semaglutide). Novo Nordisk (wegovy.com), Oct 19, 2026. Accessed Oct 19, 2026.
- Terms and conditions of use (NovoCare Pharmacy - Wegovy self-pay). Novo Nordisk (NovoCare), Oct 19, 2026. Accessed Oct 19, 2026.
- Wegovy® Savings Offer - Eligibility and Restrictions / Offer Details (WegovyTerms.com). Novo Nordisk (NovoCare), Oct 19, 2026. Accessed Oct 19, 2026.
- Wegovy® Medicare GLP-1 Bridge Access. Novo Nordisk Inc. (US), Jul 1, 2026. Accessed Oct 19, 2026.