The GLP-1 Dosage Chart: How Semaglutide and Tirzepatide Compare

By the Affordable GLP-1 Providers desk · label and trial figures human-verified before launch per our editorial policy · not medical advice

Put the two ladders next to each other and the first thing you learn is that milligrams lie: 2.4 of one is not "less than" 15 of the other. Here is the honest side-by-side, and the switching questions that actually matter.

The two ladders, side by side

Semaglutide (Wegovy): 0.25 → 0.5 → 1 → 1.7 → 2.4 mg weekly, in 4-week blocks, maintenance at 1.7 or 2.4. Tirzepatide (Zepbound/Mounjaro): 2.5 → 5, then optional +2.5 steps at ≥4-week intervals to 15 mg, maintenance at 5, 10, or 15. Different molecules, different potencies per milligram, different receptor targets — the numbers share a unit and nothing else.

Why mg-to-mg comparison is meaningless

Semaglutide is a single-receptor GLP-1 agonist; tirzepatide agonizes GLP-1 and GIP with its own potency at each. A milligram of one does not map to any milligram of the other, which is why no label publishes a conversion and why marketing that implies "tirzepatide 2.5 = semaglutide starter" is inventing pharmacology. The comparable things are outcomes and tolerability at each drug’s own maintenance doses.

What the head-to-head actually showed

SURMOUNT-5 (2025) compared the approved products at maximum tolerated doses: roughly 20.2% average weight loss with tirzepatide versus about 13.7% with semaglutide over 72 weeks — manufacturer-funded, open-label, brand products, wide individual variation [verify figures]. It answers "which averaged more at full dose," not "which is right for you," and it says nothing about compounded copies of either.

Switching: what it involves, what it doesn’t

Neither label publishes a switch protocol. In practice, prescribers stop one drug, respect its washout (both have ~week-scale half-lives), and start the other low on its own ladder rather than attempting a mid-rung entrance — because GI tolerance is drug-specific and does not transfer. A telehealth program that "switches" you by shipping a different vial at an assumed equivalent dose is improvising with your gut.

Reading dose-priced programs across two molecules

The two ladders create four pricing shapes in the wild: flat/flat, flat/laddered, laddered/flat, laddered/laddered. A program’s semaglutide bargain can coexist with a tirzepatide ladder that doubles by 10 mg. Our price index shows both molecules per program with the basis attached; the dose-and-cost tools turn any ladder into a 12-month number before you commit.

The only chart that overrides both

Whatever the ladders say, the prescription in your file says more: comorbidities, prior GI history, insurance, and pregnancy plans move real dosing decisions off the default path constantly. The charts are the map; your clinician is driving.

What a schedule costs — the part dose charts leave out

Every rung on these ladders is also a line on an invoice, and the pricing model decides how. Under dose-laddered pricing, the chart is a revenue plan: a program quoting $149 at the starting dose and $299 at maintenance bills roughly $3,138 across a titration year (three entry months, nine at the top), while a flat-at-every-dose program at $169 bills $2,028 for the identical clinical path — an $1,100 gap produced entirely by pricing structure, not medicine. Four-week billing quietly adds another ~8.7%, because 28-day cycles land 13.04 times a year. Run your own quote through the tirzepatide or semaglutide dose-and-cost tool before signing anything.

Restarts have economics too. A gap — shortage, travel, finances — often means re-titrating from a lower rung for tolerability, and on laddered pricing that can mean paying “intro” months again while some programs also re-charge intake fees. Ask any program two questions before enrolling: what does my price become at each dose on this chart, and what happens to my rate if I pause and restart? A seller that answers in writing in one email is telling you something; a seller that answers with a phone-only “it depends” is telling you something too.

Finally, the label-to-insurance mapping: coverage follows the product and indication, not the molecule — which is why the same milligram can be covered as one brand and denied as another, and why compounded versions sit outside coverage entirely (cash-pay, sometimes HSA/FSA-eligible, which is not the same thing). The chart you titrate on and the label your plan reads are the same document; keep both in view.

A 2026-specific footnote: post-shortage, supply is a program-level variable again. Ask how a program handles a pharmacy backlog mid-titration — does your rate and rung hold, do they transfer the prescription, do they re-charge intake? A schedule is only as stable as the supply chain and pricing model underneath it, and both are fair questions before month one.

Reading the two charts without the classic mistakes

Three errors account for most cross-chart confusion. The milligram fallacy: 15 vs 2.4 is a difference in molecules, not a 6× potency claim — there is no conversion factor, and any chart offering one is marketing arithmetic. The finish-line fallacy: Wegovy reaches its top in 16 weeks and Zepbound needs 20 to reach 15 mg — but Zepbound’s label calls 5 and 10 mg full maintenance doses, so “time to maintenance” can favor tirzepatide even though “time to top dose” doesn’t. The switching fallacy: moving between molecules is a managed re-entry at a low or intermediate rung, not a lateral step — budget a few adjustment weeks and, on laddered pricing, possibly “intro” billing again.

And the money overlay: a taller ladder only costs more where pricing climbs with dose. Flat-at-every-dose programs make the two charts financially identical; laddered programs make tirzepatide’s extra rungs a surcharge. The dose-and-cost tools put real numbers on both — the gap over a year is regularly four figures.

Safety, before anything else. Semaglutide and tirzepatide carry a boxed warning: thyroid C-cell tumors occurred in rodents, and the drugs are contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2. Stop and seek care for severe, persistent abdominal pain (with or without vomiting) — the classic pancreatitis presentation. Gallbladder disease, dehydration-driven kidney injury, and hypoglycemia when combined with insulin or sulfonylureas are on the labels. Tell every clinician you take a GLP-1 before any procedure requiring sedation — anesthesia societies advise holding these drugs beforehand because of delayed stomach emptying [verify current guidance]. Do not use in pregnancy. In an emergency, call 911. Report side effects to your clinician and FDA MedWatch (1-800-FDA-1088).

Where this fits the pricing picture. Everything above describes the FDA-approved brand products and their labels. The compounded semaglutide and tirzepatide sold by the telehealth programs in our price index are not FDA-approved, are not reviewed for safety or effectiveness, and vary by pharmacy — trial results and label percentages do not transfer to them. If cost is what brought you here, start with the true-month calculator and the dose-and-cost ladders, and read the full safety page before comparing a single price. One more habit that pays: before enrolling anywhere, check whether the program publicly names its dispensing pharmacy — our pharmacy disclosure index tracks who does, because in a market of not-FDA-approved preparations, the pharmacy is the product and silence about it is information.

The bottom line

The GLP-1 Dosage Chart is a topic where the label, the trials, and the marketing routinely tell three different stories. The version above sticks to the first two, flags what still needs verification, and leaves the clinical decisions where they belong — with a prescriber who knows your history. When you’re ready to compare what any of this costs in practice, the price index carries every price we track with its source and its date.

Questions worth bringing to your prescriber

Print or paraphrase; the point is walking in with structure. Which product and label are we dosing from, and why that one for me? What is our escalation plan — and our hold-the-rung plan if a step is rough? Which maintenance dose are we aiming for, and what result would make a lower one acceptable? What exactly should I do about a missed dose on this product — what window, and where is it written? If I pause for travel, illness, or cost, how do we restart — same rung or re-titrate? Do any of my other medications need timing changes around slowed stomach emptying? A prescriber who enjoys these questions is the one you want; a program whose intake flow can’t handle them is answering a different question — about itself.

How to read this article — and everything else on this site

House rules, so you can audit us: label claims cite labels, trial numbers cite the named trial, and a bracketed [verify] marks a figure our desk re-checks against the current source before each publication cycle rather than trusting memory. Dates matter as much as numbers — labels get revised, prices move — so treat anything undated (here or anywhere) as a rumor with good typography. Nothing above transfers to compounded copies: they are pharmacy preparations that are not FDA-approved, and a trial that tested the brand tested the brand. If you catch an error, [email protected] reaches a human with a 72-hour target; the corrections log shows we mean it.

Two more reading habits pay for themselves. First, separate frequency from severity: a 40% side effect that fades in a week and a 1% one that ends up in an emergency department are different kinds of facts, and sentences that blur them are selling something. Second, notice denominators — “in trials” means the approved product at protocol doses in monitored adults, which is the strongest evidence available and still not a promise about a different product, a different dose, or you.

Frequently asked questions

Is 15 mg tirzepatide stronger than 2.4 mg semaglutide?

They are different molecules with different potencies per milligram, so the numbers cannot be compared directly. At maximum tolerated doses, tirzepatide averaged more weight loss in the SURMOUNT-5 head-to-head — averages, for the brand products, with wide individual spread.

Can I switch from semaglutide to tirzepatide at the "same" dose?

There is no same dose. Switches are prescriber-managed: stop one, respect washout, start low on the other’s ladder. Tolerance does not transfer between molecules.

Which drug’s ladder is cheaper to climb?

Depends entirely on the program’s pricing shape — flat versus dose-laddered matters more than the molecule. The dose-and-cost tools model both.

Sources. FDA prescribing information for Wegovy, Ozempic, Rybelsus, Mounjaro, and Zepbound (dosage & administration sections); FDA drug-shortage and compounding communications. Figures marked [verify] are checked by a human editor against the current label before launch, per our editorial policy. Compounded products are not FDA-approved; label schedules describe the brand products only.