Tirzepatide
Dual GIP/GLP-1 receptor agonist · Subcutaneous injection · Sold as Mounjaro, Zepbound
A dual-hormone injection (Zepbound for weight loss, Mounjaro for diabetes) that has produced the largest average weight loss of any approved GLP-1-class drug so far.
Last reviewed 2026-10-05 by the Top GLP-1 Editorial Team
Educational, not medical advice. This page explains GLP-1 medications in general terms. Only a licensed clinician who knows your history can decide what's right for you.
Key takeaways
- Activates two receptors (GIP + GLP-1), not just one.
- Zepbound = weight loss; Mounjaro = type 2 diabetes.
- Highest average weight loss of approved options (~20–23% at 15 mg).
- Once-weekly injection with a 5-step dose escalation.
Tirzepatide is a once-weekly injection that activates two gut-hormone receptors instead of one: GLP-1 and GIP. It's sold as Zepbound for chronic weight management and Mounjaro for type 2 diabetes.
In head-to-head weight-management trials it has produced larger average weight loss than semaglutide — roughly 20–23% at the highest dose — making it the current benchmark for efficacy among approved medications.
Like semaglutide, it's dosed by slow escalation and is also widely dispensed in compounded form through telehealth, though the legality of compounding shifts with the medication's FDA shortage status.
How tirzepatide works
Tirzepatide is a single molecule that switches on two receptors. The GLP-1 side does what semaglutide does — slows stomach emptying, reduces appetite, and improves insulin response. The GIP side is thought to add further appetite and metabolic benefits and may help the body tolerate the GLP-1 effect.
The practical takeaway is that combining the two pathways appears to produce more weight loss for many people than GLP-1 alone, though it also means dose escalation and side-effect management still matter.
How well it works
Up to ~20–23% average body-weight loss at the highest dose.
In the SURMOUNT weight-management program, adults without diabetes lost an average of about 15% (5 mg), 19% (10 mg) and 21–23% (15 mg) of body weight over 72 weeks. A direct comparison trial (SURMOUNT-5) found tirzepatide outperformed semaglutide for weight loss.
Dosing schedule
Zepbound starts low and increases every 4 weeks as tolerated. Not everyone needs the maximum dose — many people reach their goal at 5 or 10 mg.
Starter dose.
First therapeutic dose.
Increase only if more effect is needed and tolerated.
- Escalation is paused or slowed if side effects are significant.
- A single-dose vial form has been offered at lower cash prices for some strengths.
Side effects & safety
Common
- • Nausea
- • Diarrhea and constipation
- • Vomiting
- • Reduced appetite
- • Injection-site reactions
Serious (uncommon)
- • Pancreatitis
- • Gallbladder disease
- • Same thyroid C-cell tumor boxed warning as other GLP-1 drugs
- • Severe GI reactions leading to dehydration
The side-effect profile is similar to semaglutide and generally improves with time and slow dose increases. Because efficacy is higher, rapid weight loss makes gallbladder symptoms worth watching for.
What it costs
- Branded (cash)
- $1,000–$1,300/month list for Zepbound; lower-cost single-dose vials available in some cases
- Compounded (telehealth)
- $200–$400/month typical through telehealth when available
- Insurance
- Diabetes coverage (Mounjaro) is more common than obesity coverage (Zepbound). Manufacturer savings cards can substantially cut branded cash cost for eligible patients.
Who it's for — and who should avoid it
Often a good fit
- People who want the highest average weight loss among approved drugs
- People who didn't reach their goal on semaglutide
- Adults with type 2 diabetes (as Mounjaro)
Not recommended for
- Anyone with medullary thyroid carcinoma or MEN 2 history
- People with prior pancreatitis (discuss risk)
- People who are pregnant or breastfeeding
Common questions
How tirzepatide compares
Sources & references
Clinical figures on this page trace to peer-reviewed trials and official regulators. We link the primary record so you can verify it yourself.
- 1.Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022;387(3):205–216.Clinical trialNew England Journal of Medicine
- 2.Aronne LJ, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025.Clinical trialNew England Journal of Medicine
- 3.
- 4.U.S. Food & Drug Administration. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.RegulatoryU.S. Food & Drug Administration
Where to get tirzepatide
Telehealth programs we rate highly for accessing this medication. See all programs and pricing on our tirzepatide online page.
Exceptional
Compounded GLP-1 from $69/month, shipped in 1–2 days
Treatments offered
Semaglutide · Tirzepatide
Starting price
$69/mo (compounded semaglutide)
*Compounded medications are not FDA-approved.
- Semaglutide $69/mo, tirzepatide $119/mo — flat pricing
- Free 1–2 day shipping, no insurance required
- Licensed doctors, LegitScript-certified, 503A pharmacies
$69/mo (compounded semaglutide)
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Flat-priced compounded semaglutide and tirzepatide with fast shipping.
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Excellent
The most affordable GLP-1 program, from $89/month
Treatments offered
Semaglutide · Tirzepatide
Starting price
$89/mo (compounded semaglutide)
- Compounded GLP-1 from $89/mo, GLP-1 + GIP from $149/mo
- Brand-name options too — Zepbound and Wegovy
- No insurance required; Buy Now, Pay Later available
$89/mo (compounded semaglutide)
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Compounded semaglutide and tirzepatide, plus brand-name Zepbound and Wegovy.
Read full altRx review
Very Good
AI-driven telehealth: compounded GLP-1/GIP + longevity care
Treatments offered
Semaglutide · Tirzepatide
Starting price
50% off first month (then plan rate)
*Compounded medications are not FDA-approved.
- Compounded GLP-1/GIP (tirzepatide) — 50% off first month
- GLP-1 + NAD+/B12 microdose; board-certified specialists
- Broader platform: TRT, NAD+, hair & sexual health
50% off first month (then plan rate)
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Compounded tirzepatide (GLP-1/GIP) with add-on longevity and micronutrient support.
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Excellent
Affordable access to GLP-1 programs
Treatments offered
Semaglutide · Tirzepatide
Starting price
Competitive (varies by plan — not a single flat number)
*Compounded medications are not FDA-approved.
- Competitive monthly pricing
- Flexible treatment plans available
- Ongoing clinical guidance included
Competitive (varies by plan — not a single flat number)
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Compounded semaglutide and tirzepatide with ongoing clinical guidance.
Read full TrimRX review
Excellent
GLP-1 program from $99/month with overnight delivery
Treatments offered
Semaglutide
Starting price
$99/mo (12-month prepaid plan)
*Compounded medications are not FDA-approved.
- Semaglutide from $99/mo on a 12-month prepaid plan
- Free overnight cold-chain shipping on every plan
- LegitScript-certified; licensed 503A pharmacies
$99/mo (12-month prepaid plan)
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Compounded semaglutide with cold-chain overnight shipping.
Read full HealthRx review