Semaglutide or tirzepatide? Both are proven. Here is how the choice actually works.
Semaglutide is the established GLP-1 medicine, best known as the active ingredient in Ozempic and Wegovy. Tirzepatide is the newer option, best known from Mounjaro and Zepbound, and it works on two incretin hormones instead of one. Both are prescribed here as compounded medications after review by a licensed clinician, and prepared to your individual prescription by a licensed US pharmacy.
The short answer
Semaglutide has the longest track record on the GLP-1 pathway. Tirzepatide adds a second hormone pathway, and in published head-to-head research, average weight loss has been greater with tirzepatide. Averages are not individuals: tolerance, your medication history, your goals, and your clinician's judgment decide the fit, not a league table. Many patients do well on either.
Side by side
| Compounded Semaglutide | Compounded Tirzepatide | |
|---|---|---|
| Best known from | Ozempic, Wegovy | Mounjaro, Zepbound |
| Pathway | GLP-1 | GIP and GLP-1 |
| Track record | Longest of the GLP-1 class | Newer, with strong trial results |
| Schedule | Weekly injection | Weekly injection |
| Monthly cost | From $199/mo | From $249/mo |
| Regulatory status | Compounded to your prescription; not an FDA-approved drug product | Compounded to your prescription; not an FDA-approved drug product |
Is compounded semaglutide the same as Ozempic?
No. They share the same active ingredient, which is why the name appears here, but they are different regulatory categories. Ozempic and Wegovy are FDA-approved finished drug products. No compounded medication is FDA-approved, including this one. Compounded medicines are made to your individual prescription by a licensed pharmacy rather than manufactured and approved as a finished drug product. The same distinction applies to compounded tirzepatide versus Mounjaro and Zepbound.
If tirzepatide averages better results, why would anyone choose semaglutide?
Because averages are the beginning of the conversation, not the end. Track record matters to many patients. Tolerability differs person to person. Cost differs. Your history with either molecule matters most of all. Your clinician weighs all of it against your case, which is the entire reason a clinician is in the loop.
What about the lower-dose options?
Both molecules are also available here in lower-dose forms with B12. Those are not selected by preference at checkout; a licensed clinician determines whether a lower-dose compounded prescription fits your case after reviewing it.
Questions
What happens if I am not approved?
You are not charged. Your clinician explains the reasoning and, where useful, what a better next step may be. Reviews are typically completed in under 24 hours.
Can I switch from one to the other?
With your provider, yes. Switching between GLP-1 medicines is a clinical decision with its own transition plan, managed by the clinician who knows your case.
Do I choose the medication, or does the clinician?
You can arrive knowing which one you want to discuss. The clinician makes the prescribing decision, and will tell you plainly if the other option fits your case better.
Ready when you are.
About 10 minutes. No charge unless your clinician approves.