Tirzepatide vs Liraglutide
Tirzepatide (Mounjaro, Zepbound) and liraglutide (Saxenda, Victoza) sit at opposite ends of this class. Tirzepatide is a newer weekly dual-receptor drug, and liraglutide is an older daily GLP-1.
GIP / GLP-1 receptor agonist
GLP-1 receptor agonist
A once-weekly injectable that activates two gut hormone receptors (GIP and GLP-1), often producing greater average weight loss than semaglutide in trials.
A once-daily injectable GLP-1, the older option in this class — dosed every day rather than weekly, with generally more modest weight loss.
Weight loss / type 2 diabetes
Weight loss / type 2 diabetes
- Chronic weight management (as Zepbound)
- Type 2 diabetes (as Mounjaro)
- Moderate-to-severe obstructive sleep apnea in adults with obesity (as Zepbound)
- Chronic weight management (as Saxenda)
- Type 2 diabetes (as Victoza)
- Reducing cardiovascular risk in adults with type 2 diabetes and known heart disease (Victoza)
- Start 2.5 mg subcutaneously once weekly for 4 weeks, then increase in 2.5 mg steps as tolerated
- Maintenance range 5–15 mg once weekly
- Doses are increased slowly to limit nausea
- Weight management (Saxenda): titrate weekly from 0.6 mg to a target of 3 mg subcutaneously once daily
- Type 2 diabetes (Victoza): 0.6 mg daily to start, then 1.2–1.8 mg once daily
- Doses are increased slowly to limit nausea
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Reduced appetite
- Injection-site reactions
- Pancreatitis
- Gallbladder disease
- Kidney injury from dehydration
- Severe low blood sugar when combined with insulin or a sulfonylurea
- Hypersensitivity reactions
- Nausea
- Diarrhea
- Constipation
- Vomiting
- Headache
- Reduced appetite
- Pancreatitis
- Gallbladder disease
- Kidney injury from dehydration
- Severe low blood sugar when combined with insulin or a sulfonylurea
- Increased heart rate
- Adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition
- Adults with type 2 diabetes
- Adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition
- Adults and select adolescents with type 2 diabetes (product-dependent)
- Personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to tirzepatide
- Personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to liraglutide
- Risk of pancreatitis — stop if suspected
- May reduce the effectiveness of oral contraceptives; a backup or non-oral method is advised after starting and after each dose increase
- May delay gastric emptying and affect absorption of oral medications
- Not for use in type 1 diabetes or diabetic ketoacidosis
- Risk of pancreatitis — stop if suspected
- Daily injection required, unlike once-weekly options in the class
- May delay gastric emptying and affect absorption of oral medications
- Not for use in type 1 diabetes or diabetic ketoacidosis
Bottom line: which should I choose?
Choose tirzepatide for substantially greater average weight loss and once-weekly dosing. Choose liraglutide only when coverage, availability, or tolerability points that way, accepting daily injections and more modest results. Both share gastrointestinal side effects and the thyroid C-cell tumor boxed warning, and both should be paused around pregnancy.
Common questions
Care for real conditions, prescribed online
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