Zepbound
tirzepatide · Eli Lilly
Rybelsus
oral semaglutide · Novo Nordisk
Side by side
| Zepbound | Rybelsus | |
|---|---|---|
| Active ingredient | tirzepatide | oral semaglutide |
| Maker | Eli Lilly | Novo Nordisk |
| Class | GIP and GLP-1 receptor agonist | GLP-1 receptor agonist (tablet) |
| Approved for | Weight management | Type 2 diabetes |
| How you take it | once weekly injection | once daily tablet |
| Starting dose | 2.5 mg | 3 mg |
| Highest dose | 15 mg | 14 mg |
| Main trial result | 20.9% avg loss (SURMOUNT-1, 15 mg, 72 wk) | A1C fell about 1.0 to 1.4 points at 14 mg, with modest weight loss of a few pounds to about 9 lb |
| Nausea (label) | 25% to 29% vs 9% placebo | 11% to 20% vs 6% placebo |
| Missed-dose window | 4 days (96 hours) | skip and resume the next day |
| Out of the fridge | Up to 21 days at or below 86°F (30°C) | 68°F to 77°F in the original bottle |
| List price | $1,086/mo | $998/mo |
| Lowest self-pay | $299/mo | not offered |
Prices compiled mid-2026 from manufacturer announcements; re-checked monthly.
Key differences
- Different molecules. Zepbound is tirzepatide (GIP and GLP-1 receptor agonist); Rybelsus is oral semaglutide (GLP-1 receptor agonist (tablet)).
- Different approvals. Zepbound is approved for weight management; Rybelsus is approved for type 2 diabetes. That shapes insurance coverage.
- Different routine. Zepbound is a once weekly injection; Rybelsus is a once daily tablet.
- Head-to-head data. In SURMOUNT-5, a 72-week head-to-head trial published in 2025, adults with obesity lost an average of about 20.2% on tirzepatide vs about 13.7% on semaglutide. That's the only direct comparison; other figures come from separate trials.
Trial weight loss
Which one fits you
That's a decision for you and your prescriber. The factors that usually decide it:
- Your diagnosis, which decides the approved option and often the coverage
- Whether your plan covers one and not the other
- A shot or a pill, weekly or daily
- How you tolerate side effects
- Cost if you pay yourself: see the cost index
How to use it
- Enter your numbers. Switch between US and metric units at any time.
- Results update as you type, and the formula is shown so you can check it.
- Copy the link, save the plan on this device, or print it for your next appointment.
These are estimates, not a diagnosis. A clinician can account for your health history and medicines.
Common questions
Is Zepbound the same as Rybelsus?
No. They contain different medicines: tirzepatide and oral semaglutide.
Which works better for weight loss, Zepbound or Rybelsus?
In SURMOUNT-5, a 72-week head-to-head trial published in 2025, adults with obesity lost an average of about 20.2% on tirzepatide vs about 13.7% on semaglutide. That's the only direct comparison; other figures come from separate trials.
Can I switch from Zepbound to Rybelsus?
Only with your prescriber. Switching usually means a new starting dose, not a direct swap.
Which is cheaper, Zepbound or Rybelsus?
List prices are $1,086/mo and $998/mo a month; lowest self-pay options we track are $299/mo and not offered. Coverage usually matters more.
Sources
Clinician review pending. Drafted from primary sources and waiting for sign-off by a licensed clinician (MD, DO or PharmD) before launch. Every number is checked against its source. Drug facts are re-checked quarterly, prices monthly and whenever a label changes. How we review · Report an error