Blog/How To Safely Switch From Semaglutide To Tirzepatide (And Vice Versa)
Jennie Stanford, MD | 6/18/2024 | 5 min read

How To Safely Switch From Semaglutide To Tirzepatide (And Vice Versa)

How and when to make the transitions from semaglutide to tirzepatide and tirzepatide to semaglutide.

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Switching from one weight loss medication to another can be intimidating, even if the medications work similarly. If you're considering switching from semaglutide to tirzepatide or tirzepatide to semaglutide, we break down the necessary information you should know  to have as smooth a transition as possible. 

Understanding semaglutide and tirzepatide

Semaglutide and tirzepatide are medications that can effectively manage type 2 diabetes mellitus and obesity in patients who qualify. Semaglutide and tirzepatide share some similarities in the way they work, but they also have unique differences in their mechanisms, effectiveness, and potential side effects. To consider which one might be better for you, let’s compare and contrast each one.

What is semaglutide?

Semaglutide, known by the brand names of Ozempic® and Wegovy®, is a glucagon-like peptide 1 (GLP-1) receptor agonist. After it was originally developed to treat type 2 diabetes, semaglutide also demonstrated significant success in aiding weight loss. Glucagon-like peptide-1 (GLP-1) receptor agonists work by increasing the effects of a GLP-1, a neuroendocrine hormone that is produced in the gut in response to food intake.

GLP-1 helps lower blood glucose by distributing it to organs and tissues for use as energy. Additionally, GLP-1 slows gastric emptying, increases fullness, reduces appetite, and promotes a lower overall calorie intake. By binding to the receptors of GLP-1, GLP-1 receptor agonists increase GLP-1 activity, thus improving glucose control and increasing weight loss. 

What is tirzepatide?

Tirzepatide, known by the brand names of Mounjaro® and Zepbound®, is also designed to treat type 2 diabetes, demonstrating significant weight loss benefits as well. While semaglutide and tirzepatide work similarly, tirzepatide works on two main pathways instead of one as a dual agonist. It is a GLP-1 receptor agonist (like semaglutide) and also a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist.

Similar to GLP, GIP is another neuroendocrine hormone involved in regulating blood glucose levels and insulin release. By targeting both the GLP-1 and GIP receptors, tirzepatide delivers not only good blood glucose control but also significant weight loss through its synergistic effects on lowering appetite, decreasing fat mass, and reducing weight. 

Switching from semaglutide to tirzepatide

What the evidence says

Evidence suggests that tirzepatide is more effective at controlling blood sugar and promoting weight loss, as compared to semaglutide. In a study where semaglutide and tirzepatide were directly compared in patients who have type 2 diabetes mellitus, tirzepatide delivered larger reductions in hemoglobin A1c (HbA1c) levels and a greater weight loss than semaglutide.

Potential reasons to switch

  • Better effectiveness - Tirzepatide's dual action mechanism has been shown to provide greater reductions in blood sugar and weight. For patients who need to achieve large reductions in HbA1c levels or need to lose more weight, tirzepatide may increase their success.

  • Different side effect profile - In most cases, the potential side effects associated with tirzepatide use are more severe than those with semaglutide. However, individual results may vary, so some patients may tolerate tirzepatide better than semaglutide. 

  • Access and cost - Typically, tirzepatide is much more expensive than semaglutide. However, insurance plans may differ and offer better coverage for one than the other. Access can also vary, depending on medication availability, so this may be a reason to switch from semaglutide to tirzepatide.

How to switch from semaglutide to tirzepatide

Consult your healthcare professional

Before starting, stopping, or changing your medication, you should consult with your healthcare professional. In order to determine if switching medications is right for you, your provider should evaluate your current health status, other medical conditions, past medication history, use of other medications, response to your current use of semaglutide, and overall treatment goals.

Gradual transition

In most cases, your healthcare professional will recommend a gradual transition from semaglutide to tirzepatide to minimize the possible side effects and optimize your body’s adjustment. Tapering off semaglutide and/or overlapping doses with tirzepatide may be helpful. However, these medications are similar, and taking too much at the same time can lead to serious adverse effects. Using caution and working under the guidance of a knowledgeable healthcare professional is crucial.

Initial adjustment period

Switching from semaglutide to tirzepatide may include an adjustment period, with changes in blood sugar levels, appetite, weight, and medication side effects, especially nausea, vomiting, or diarrhea. Understanding this and allowing your body time to adjust is important for successful treatment.

Monitoring and follow-up

During and after the transition from semaglutide to tirzepatide, it is vital to continue with your follow up appointments as scheduled. This allows for regular monitoring of your blood sugar levels, other lab results, your weight trends, and any potential side effects.

 

Switching from tirzepatide to semaglutide

Switching from tirzepatide to semaglutide usually occurs less often, but it may be necessary for a number of reasons. The weight loss success of semaglutide, while usually less than tirzepatide, is still significant. According to the STEP trial, which compared the use of semaglutide 2.4 mg weekly to no medication (placebo) over two years’ time, semaglutide demonstrated a 15.2% weight loss, as compared to 2.6% without medication.

Potential reasons to switch

  • Personal preference and comfort - Semaglutide is an older medication than tirzepatide, and some patients can be less comfortable with newer medications. 

  • Less severe side effects - Patients who experience severe side effects with tirzepatide may choose to switch to semaglutide. Ast stated above, studies suggest that the side effects associated with tirzepatide use are more severe than those with semaglutide. However, individual responses vary to both medications. 

  • Medication access and cost - Trizepatide is much more expensive than semaglutide and can be a barrier.. Many insurance plans are more likely to cover semaglutide and compounded semaglutide may be more readily available, increasing access. However, insurance plans, access to medication, and supply availability may differ depending on many factors.

How to switch from tirzepatide to semaglutide

Consult your healthcare professional

You should not start the switch from tirzepatide to semaglutide before consulting with your healthcare professional. This decision requires a comprehensive assessment of other health factors, the other medications you take, your response to tirzepatide while taking it, and your overall goals of treatment. 

Gradual transition

Changing medications is sometimes best accomplished more gradually, and switching from tirzepatide to semaglutide is one of those cases (unless you are experiencing severe side effects while taking tirzepatide, in which case it may be stopped abruptly). With a gradual transition from tirzepatide to semaglutide, you may adjust better and experience fewer adverse effects. Making the switch under the guidance of a knowledgeable healthcare professional is important.

Initial adjustment period

In some patients, switching from tirzepatide to semaglutide may result in higher blood glucose levels and less weight loss. Medication side effects during this time may vary. Allowing your body time to adjust to the change in medication is necessary.

Monitoring and follow-up

During and after the switch, you should continue with your follow up visits as they are scheduled. You’ll need regular monitoring of your blood sugar levels, as they may increase, and your healthcare professional may need to make adjustments to your other medications. You’ll also need monitoring of other lab results, your weight trends, and any potential side effects you may experience.

 

Agile helps our patients see faster weight loss results

On your weight loss journey, many factors may impact the need to switch from semaglutide to tirzepatide or tirzepatide to semaglutide. While these transitions may be complex, they can be safely navigated with the help of a knowledgeable healthcare professional if you are well-informed on what to expect in the process. 

If you're looking into semaglutide for weight loss as a treatment option, Agile’s network of licensed providers are here to help! Simply fill out our quick health survey and schedule your no-cost consultation. One of our expert providers will meet with you virtually to discuss your treatment options. No initial cost, your first visit is absolutely free! We make it a priority to ensure this treatment is right for you before you pay a dime. 

Ready to make a change? Get started here!