Saxenda vs Zepbound: Weight Loss, Dosing, Cost Compared
Saxenda (liraglutide) and Zepbound (tirzepatide) are both GLP-1 medicines, daily injection versus weekly injection. In their own trials, average weight loss was 7.4% and 20.9%. Zepbound self-pay starts at $299 per month.
Saxenda and Zepbound: a quick look
Zepbound and Saxenda side by side
| Saxenda | Zepbound | |
|---|---|---|
| Medicine | Saxenda |  Zepbound |
| Active ingredient | liraglutide | tirzepatide |
| Manufacturer | Novo Nordisk | Eli Lilly |
| How it is taken | Daily injection | Weekly injection |
| Approved for | Weight loss | Weight loss and sleep apnea |
| First FDA approval | 2014 | 2023 |
| Average weight loss in trials | 7.4% (SCALE Obesity and Prediabetes, 56 weeks) | 20.9% (SURMOUNT-1, 72 weeks) |
| Most common side effect | Nausea 39.3% vs 13.8% on placebo | Nausea 29% vs 8% on placebo |
| List price | $1,349.02 per 5 pens | $499 to $1,086 per fill |
| Self-pay from | Not listed | $299 per month |
| Medicare GLP-1 Bridge | Not listed | $50 per month, eligible Part D |
| FDA shortage | On the FDA shortage list | Resolved December 19, 2024 |
Sources: FDA label, FDA label (DailyMed), Novo Nordisk pricing, pricinginfo.lilly.com.
Weight loss comparison
Because no trial has compared the two drugs head to head, the numbers here come from separate studies with different groups and different lengths.
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| SCALE Obesity and Prediabetes | Adults who have obesity or are overweight and do not have type 2 diabetes | 56 weeks | Liraglutide 3.0 mg daily | 7.4% | 3% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 5 mg weekly | 15% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 10 mg weekly | 19.5% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 15 mg weekly | 20.9% | 3.1% |
| SURMOUNT-2 | Adults who have obesity or are overweight and have type 2 diabetes | 72 weeks | Tirzepatide 10 mg weekly | 12.8% | 3.2% |
| SURMOUNT-2 | Adults who have obesity or are overweight and have type 2 diabetes | 72 weeks | Tirzepatide 15 mg weekly | 14.7% | 3.2% |
Trial sources: SCALE Obesity and Prediabetes (FDA label (DailyMed)), SURMOUNT-1 (FDA label (DailyMed)), SURMOUNT-2 (PubMed).
Side effect comparison
Every label ran tests on its own people against a placebo group of its own. Compare each drug with the placebo used for it first.
| Side effect | Saxenda | Placebo (Saxenda trials) | Zepbound | Placebo (Zepbound trials) |
|---|---|---|---|---|
| Nausea | 39.3% | 13.8% | 29% | 8% |
| Diarrhea | 20.9% | 9.9% | 23% | 8% |
| Constipation | 19.4% | 8.5% | 17% | 5% |
| Vomiting | 15.7% | 3.9% | 13% | 2% |
| Injection Site Reaction | 13.9% | 10.5% | 8% | 2% |
| Headache | 13.6% | 12.6% | Not listed | Not listed |
| Hypoglycemia in T2DM | 12.6% | 6.6% | Not listed | Not listed |
| Dyspepsia | 9.6% | 2.7% | 10% | 4% |
| Abdominal Pain | Not listed | Not listed | 10% | 5% |
| Fatigue | Not listed | Not listed | 7% | 3% |
Prices and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Saxenda | List price before insurance | $1,349.02 per 5 pens |
| Zepbound | List price before insurance | $499 to $1,086 per fill |
| Zepbound | Zepbound Savings Program (insured) | from $25 for up to a 3-month fill |
| Zepbound | Commercial plan that does not cover it | $299 per month |
| Zepbound | Self-pay: LillyDirect vial or KwikPen 2.5 mg | $299 per month |
| Zepbound | Self-pay: LillyDirect vial or KwikPen 5 mg | $399 per month |
| Zepbound | Self-pay option: LillyDirect doses from 7.5 mg up to 15 mg, refill within 45 days | $449 per month |
| Zepbound | Without a refill within 45 days, you pay the regular self-pay price | each month costs $499 ($7.5 mg) or $699 for $10 to $15 mg |
| Zepbound | Self-pay via TrumpRx | $299 per month |
| Zepbound | Medicare GLP-1 Bridge (Zepbound KwikPen, eligible Part D) | $50 per month |
The price check from November 2026 covered Novo Nordisk pricing, pricinginfo.lilly.com, zepbound.lilly.com, Eli Lilly, TrumpRx, CMS.
Who should pick which?
- Zepbound is approved to treat sleep apnea.
- Saxenda is approved for some children under 18.
- Zepbound appears on the list of the Medicare GLP-1 Bridge program under Medicare.
- For cash payment, Zepbound's published self-pay cost amounts to $299 per month.
Your prescriber considers your health history, coverage, and other medicines; the choice to switch rests with them.