Semaglutide vs Tirzepatide: Injection Schedule, Tracking Considerations, and Research Comparison

Both are once-weekly subcutaneous injections in the GLP-1 receptor agonist class. SEMAGLUTIDE (Novo Nordisk; Wegovy for chronic weight management, Ozempic for type 2 diabetes) is a single GLP-1 receptor agonist available in 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, 2.4 mg weekly doses. Standard titration takes ~16 weeks from start to maintenance dose. TIRZEPATIDE (Eli Lilly; Zepbound for chronic weight management, Mounjaro for type 2 diabetes) is a dual GLP-1/GIP receptor agonist available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg weekly doses. Standard titration takes ~20 weeks from start to maintenance. Tirzepatide has shown higher average weight loss in head-to-head studies (SURPASS, SURMOUNT trials) but with similar side effect profiles. Always consult your prescriber for medication choice. This content is for educational and tracking purposes only and does not constitute medical advice.

SEMAGLUTIDE Wegovy: weeks 1-4 = 0.25 mg, weeks 5-8 = 0.5 mg, weeks 9-12 = 1.0 mg, weeks 13-16 = 1.7 mg, weeks 17+ = 2.4 mg maintenance. TIRZEPATIDE Zepbound: weeks 1-4 = 2.5 mg, weeks 5-8 = 5 mg, weeks 9-12 = 7.5 mg (some patients), weeks 13-16 = 10 mg (some patients), weeks 17-20 = 12.5 mg (some patients), weeks 21+ = 15 mg maintenance. Many patients stay at intermediate doses if side effects are problematic at higher doses. Your prescriber may modify based on tolerability and response. Tracking specifically: log the dose change date, the prior dose duration, and any side effects in the 2-3 weeks following each escalation (when side effects are most likely to appear or intensify).

Both medications commonly cause gastrointestinal effects (nausea, vomiting, diarrhea, constipation), most pronounced after titration steps and typically decreasing over 2-4 weeks at a given dose. Less common but worth tracking: injection site reactions, fatigue, headache, dizziness. Rare but require prescriber attention: pancreatitis (severe upper abdominal pain radiating to back), gallbladder issues (right upper quadrant pain), thyroid concerns (boxed warning for medullary thyroid cancer in animal studies, contraindicated with personal or family history of MTC or MEN2). Track which side effects appear at which dose level, when they peak, and when they resolve — this pattern data is valuable for prescriber visits.

SEMAGLUTIDE: pre-filled pens with single-use needles. Some doses available in multi-dose pens (Wegovy) or single-dose pens (Ozempic 0.25 mg starter). Track pen lot numbers and expiration dates; refrigerate unopened pens. After first use, room temperature OK for 56 days. TIRZEPATIDE: single-dose pens. Track each pen individually with lot, dose, and injection details. Available as either pre-filled pen or single-dose vial in some markets. Both medications require careful tracking of injection sites (rotate among abdomen, thigh, upper arm) to prevent lipohypertrophy. Both work best with consistent weekly day-of-week injection — log time and day to support consistency.

SEMAGLUTIDE: if missed dose is <5 days late, take as soon as possible and continue the regular schedule. If >5 days late, skip the missed dose and resume on the regular schedule. TIRZEPATIDE: if missed dose is <4 days late, take as soon as possible and continue regular schedule. If >4 days late, skip and resume. Always log missed doses with the reason and any side effects in the recovery period. Frequent missed doses may suggest the day of the week or dose timing needs adjustment — discuss with your prescriber. For both medications, getting back on schedule is important because long gaps can result in returning side effects when the medication is resumed.

STEP trials (semaglutide): average 14.9% body weight loss at 68 weeks (Wegovy 2.4 mg). SURMOUNT-1 trial (tirzepatide): average 20.9% body weight loss at 72 weeks (Zepbound 15 mg). SURMOUNT-5 head-to-head (tirzepatide vs semaglutide): tirzepatide produced significantly greater weight loss (20.2% vs 13.7%) at 72 weeks. Both medications have shown cardiovascular benefit in patients with type 2 diabetes (SUSTAIN-6 for semaglutide; SURPASS-CVOT for tirzepatide). Outcomes vary substantially by individual; tracking your specific weight, food intake, and adherence over time produces the most relevant data for your prescriber visits.

Dosed supports both semaglutide and tirzepatide tracking. The app pre-populates standard titration schedules for both medications and tracks the dose, day of week, injection site, lot number, and side effects across the entire protocol timeline. The calendar view distinguishes scheduled, taken, missed, and held doses for clean provider visit reporting. PDF export combines all schedule data and side-effect trends for review. This content is for educational and tracking purposes only and does not constitute medical advice. Always work with a qualified healthcare professional.