Tirzepatide vs Saxenda: Weight Loss, Side Effects, Price
Tirzepatide and Saxenda (liraglutide) are both GLP-1 medicines, weekly injection versus daily injection. In their own trials, average weight loss was 20.9% and 7.4%. Tirzepatide self-pay starts at $299 per month.
Zepbound and Saxenda in brief
Saxenda compared with Tirzepatide
| Tirzepatide | Saxenda | |
|---|---|---|
| Medicine | tirzepatide |  Saxenda |
| Active ingredient | tirzepatide | liraglutide |
| Manufacturer | Eli Lilly | Novo Nordisk |
| How it is taken | Weekly injection | Daily injection |
| Approved for | Weight loss, Type 2 diabetes, sleep apnea and heart risk | Weight loss |
| First FDA approval | 2022 | 2014 |
| Average weight loss in trials | 20.9% (SURMOUNT-1, 72 weeks) | 7.4% (SCALE Obesity and Prediabetes, 56 weeks) |
| Most common side effect | Nausea 18% vs 4% on placebo | Nausea 39.3% vs 13.8% on placebo |
| List price | $1,112.16 per fill | $1,349.02 per 5 pens |
| Self-pay from | $299 per month | Not listed |
| Medicare GLP-1 Bridge | $50 per month, eligible Part D | Not listed |
| FDA shortage | Resolved December 19, 2024 | On the FDA shortage list |
Sources: FDA label, FDA label (DailyMed), pricinginfo.lilly.com, Novo Nordisk pricing.
Comparing weight loss
No trial has compared the two directly, so the figures come from separate trials with different participants and different lengths.
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| 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 with obesity or overweight who also have type 2 diabetes | 72 weeks | Tirzepatide 10 mg weekly | 12.8% | 3.2% |
| SURMOUNT-2 | Adults with obesity or overweight who also have type 2 diabetes | 72 weeks | Tirzepatide 15 mg weekly | 14.7% | 3.2% |
| SCALE Obesity and Prediabetes | Adults with obesity or overweight who do not have type 2 diabetes | 56 weeks | Liraglutide 3.0 mg daily | 7.4% | 3% |
Trial sources: SURMOUNT-1 (FDA label (DailyMed)), SURMOUNT-2 (PubMed), SCALE Obesity and Prediabetes (FDA label (DailyMed)).
Side effects compared
Each label tested its participants against its own placebo group, so compare each drug with that placebo first.
| Side effect | Mounjaro | Placebo (Mounjaro trials) | Saxenda | Placebo (Saxenda trials) |
|---|---|---|---|---|
| Nausea | 18% | 4% | 39.3% | 13.8% |
| Diarrhea | 17% | 9% | 20.9% | 9.9% |
| Decreased Appetite | 11% | 1% | Not listed | Not listed |
| Vomiting | 9% | 2% | 15.7% | 3.9% |
| Dyspepsia | 8% | 3% | 9.6% | 2.7% |
| Constipation | 7% | 1% | 19.4% | 8.5% |
| Abdominal Pain | 6% | 4% | Not listed | Not listed |
| Injection Site Reaction | Not listed | Not listed | 13.9% | 10.5% |
| Headache | Not listed | Not listed | 13.6% | 12.6% |
| Hypoglycemia in T2DM | Not listed | Not listed | 12.6% | 6.6% |
Prices and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
 Mounjaro | List price before insurance | $1,112.16 per fill |
| Mounjaro | Mounjaro Savings Card (insured) | from $25 for up to a 3-month fill |
| Mounjaro | Commercial plan that does not cover it | $499 per month |
 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 | Self-pay: LillyDirect vial or KwikPen 2.5 mg | $299 per month |
| Zepbound | Commercial plan that does not cover it | $299 per month |
| Zepbound | Medicare GLP-1 Bridge (Zepbound KwikPen, eligible Part D) | $50 per month |
| Saxenda | List price before insurance | $1,349.02 per 5 pens |
Prices checked November 2026 (7)
pricinginfo.lilly.com 1 2, mounjaro.lilly.com, zepbound.lilly.com, Eli Lilly, CMS, Novo Nordisk pricing.
Who should pick which?
- Type 2 diabetes: only Tirzepatide has a diabetes approval.
- Sleep apnea: Tirzepatide is approved to treat it.
- Heart risk: Tirzepatide is approved to lower heart attack and stroke risk.
- Medicare: Tirzepatide is one of the drugs named in the Medicare GLP-1 Bridge.
- Paying cash: Tirzepatide's published self-pay price is $299 per month.
The other medicines you take, your health history and your coverage all matter to your prescriber. They decide whether to switch between them.