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GLP-1 Medications: Complete Comparison

A side-by-side reference for all FDA-approved GLP-1 receptor agonists — mechanisms, efficacy data, side effects, pricing, and practical considerations.

About This Comparison

Drugs covered: Semaglutide, Tirzepatide, Liraglutide, Dulaglutide, Exenatide
Data sources: FDA labels, published clinical trials, GoodRx pricing
Purpose: Educational reference — not a treatment recommendation
Note: All medications require a prescription

Complete Comparison Table

How to read this table: Each column represents a different GLP-1 medication. Data comes from FDA-approved prescribing information and published clinical trials. Pricing reflects approximate U.S. retail (cash) prices and may vary. Scroll horizontally on mobile.
Semaglutide Tirzepatide Liraglutide Dulaglutide Exenatide
Drug Class GLP-1 receptor agonist [1] Dual GIP/GLP-1 receptor agonist [2] GLP-1 receptor agonist [3] GLP-1 receptor agonist [4] GLP-1 receptor agonist [5]
How It Works Copies a natural gut hormone (GLP-1) that tells your brain you're full, helps your body release insulin after meals, and slows digestion so you stay satisfied longer [1] Activates two gut hormone pathways (GLP-1 + GIP) instead of one — the dual action leads to stronger appetite suppression and blood sugar control than GLP-1 alone [6] Same mechanism as semaglutide (mimics GLP-1), but leaves the body faster — which is why it needs daily injections instead of weekly [3] Works like semaglutide (mimics GLP-1), designed for once-weekly dosing with a simple pre-filled pen [4] Based on a protein found in Gila monster venom that happens to activate the same GLP-1 pathway; the original drug in this class [5]
Brand Names Ozempic (T2D), Wegovy (weight/CV), Rybelsus (oral, T2D) [7] Mounjaro (T2D), Zepbound (weight) [2] Victoza (T2D), Saxenda (weight) [3] Trulicity [4] Byetta (twice daily), Bydureon BCise (weekly) [5]
FDA-Approved For Type 2 diabetes (Ozempic, Rybelsus); Chronic weight management (Wegovy); CV risk reduction (Wegovy) [8] Type 2 diabetes (Mounjaro); Chronic weight management (Zepbound); Obstructive sleep apnea (Zepbound) [2] Type 2 diabetes (Victoza); Chronic weight management (Saxenda); Pediatric obesity ≥12 y (Saxenda) [3] Type 2 diabetes; CV risk reduction in T2D with CV disease or risk factors [4] Type 2 diabetes [5]
How Taken Subcutaneous injection (Ozempic, Wegovy) or oral tablet (Rybelsus) [7] Subcutaneous injection [2] Subcutaneous injection [3] Subcutaneous injection [4] Subcutaneous injection [5]
Frequency Once weekly (injection); Once daily (Rybelsus) [7] Once weekly [2] Once daily [3] Once weekly [4] Twice daily (Byetta) or once weekly (Bydureon) [5]
Max Dose 2.0 mg/wk (Ozempic); 2.4 mg/wk (Wegovy); 14 mg/day (Rybelsus) [7] 15 mg/week [2] 1.8 mg/day (Victoza); 3.0 mg/day (Saxenda) [3] 4.5 mg/week [4] 10 mcg twice daily (Byetta); 2 mg/wk (Bydureon) [5]
Avg Weight Loss (% body weight) ~15% at 2.4 mg (Wegovy, STEP 1); ~5–9% at 1.0–2.0 mg (Ozempic, diabetes) [9] ~21% at 15 mg (Zepbound, SURMOUNT-1); ~12–13% at 5–10 mg [6] ~8% at 3.0 mg (Saxenda, SCALE); ~3% at 1.8 mg (diabetes) [10] ~3–5% (AWARD trials, diabetes populations) [11] ~2–3% (DURATION trials, diabetes populations) [12]
HbA1c Reduction
(HbA1c = 3-month average blood sugar level; normal is below 5.7%, diabetic is 6.5%+; lower = better control)		 1.0–1.8% (Ozempic, SUSTAIN trials) [13] 1.9–2.4% (Mounjaro, SURPASS-1 to -5) [14] 0.8–1.5% (Victoza, LEAD trials) [3] 0.8–1.6% (AWARD trials) [4] 0.8–1.3% (DURATION trials) [12]
Heart Protection
(Does it reduce heart attacks and strokes?)		 Yes — strongest evidence. Reduced heart attacks, strokes, and cardiovascular death by 20%. Only weight-loss drug FDA-approved to protect the heart [15] Unknown — still being studied. A large heart outcomes trial is underway but hasn't reported results yet [16] Yes. Reduced cardiovascular events by 13% in diabetic patients with existing heart disease or high risk [17] Yes. Reduced cardiovascular events by 12% in a broad population of diabetic patients [18] Inconclusive. Showed a 9% reduction but the result wasn't statistically significant — meaning it could be due to chance [19]
Common Side Effects Nausea (≈44%), diarrhea (≈30%), vomiting (≈24%), constipation, abdominal pain [8] Nausea (≈30%), diarrhea (≈23%), decreased appetite, vomiting, constipation [2] Nausea (≈39%), diarrhea (≈21%), constipation, vomiting, headache [3] Nausea (≈29%), diarrhea (≈17%), vomiting, abdominal pain, decreased appetite [4] Nausea (≈44%), vomiting (≈13%), diarrhea, injection site nodules (Bydureon) [5]
Serious Warnings Boxed warning: thyroid C-cell tumors (animal data). Pancreatitis, gallbladder disease, acute kidney injury [8] Boxed warning: thyroid C-cell tumors (animal data). Pancreatitis, gallbladder disease, hypoglycemia with insulin [2] Boxed warning: thyroid C-cell tumors (animal data). Pancreatitis, gallbladder disease, acute kidney injury [3] Boxed warning: thyroid C-cell tumors (animal data). Pancreatitis, hypersensitivity [4] Boxed warning: thyroid C-cell tumors (Bydureon, animal data). Pancreatitis, acute kidney injury [5]
Retail Price/Month (approx.) ~$935 (Ozempic); ~$1,350 (Wegovy); ~$935 (Rybelsus) [20] ~$1,060 (Mounjaro); ~$1,060 (Zepbound) [20] ~$1,350 (Saxenda); ~$1,200 (Victoza) [20] ~$1,000 [20] ~$800 (Bydureon); ~$850 (Byetta) [20]
Insurance Coverage Notes Ozempic: widely covered for T2D. Wegovy: expanding coverage after SELECT CV data; many plans still exclude weight management drugs. Rybelsus: covered similarly to Ozempic. [21] Mounjaro: strong T2D coverage. Zepbound: growing weight management coverage; Lilly offers savings card ($550/mo cap without insurance). [21] Victoza: widely covered for T2D. Saxenda: limited weight management coverage; being replaced by newer agents in many formularies. [21] Generally well-covered for T2D. Not approved for weight management. [21] Covered for T2D. Older agent; often on lower formulary tiers. Not approved for weight management. [21]
Biggest Strength The most studied GLP-1 overall. Proven to protect the heart. Available as a pill (Rybelsus) for people who don't want injections. Covers weight loss, diabetes, and heart protection in one drug Produces the most weight loss of any approved drug (~21% of body weight). Also the strongest blood sugar reduction. Works through two pathways instead of one [6] Has been on the market since 2010 — the longest safety track record. Approved for teens with obesity. Proven heart benefits [17] The simplest to use — a pre-filled pen with no dose dial, just press a button. Well-tolerated with proven heart benefits. Good for people who want minimal hassle [18] First GLP-1 approved (2005); most prescribing experience; lowest cost among GLP-1s [5]
Key Limitation Supply constraints (Wegovy); high retail cost; significant GI side effects during titration; weight regain after discontinuation [22] No completed CV outcomes trial yet; injection only (no oral); relatively newer (less long-term safety data) [16] Daily injection required; less weight loss than semaglutide or tirzepatide; higher nausea rates; being superseded by newer agents [3] Modest weight loss (~3–5%); not approved for weight management; no obesity-specific indication [4] Lowest weight loss and HbA1c reduction in class; injection site nodules with Bydureon; CV outcomes trial did not reach significance [19]

Which GLP-1 Might Be Discussed With Your Clinician?

Note: This section provides general informational context — not recommendations. Treatment decisions depend on individual medical history, insurance coverage, comorbidities, and clinician judgment.

General Considerations by Situation

  • Primary goal is weight management: Semaglutide (Wegovy) and tirzepatide (Zepbound) are the only GLP-1-based medications with FDA-approved weight management indications. Clinical trial data shows tirzepatide produces greater average weight loss than semaglutide at maximum doses [6].
  • Primary goal is blood sugar control (T2D): All five medications are FDA-approved for type 2 diabetes. Tirzepatide (Mounjaro) has shown the largest HbA1c reductions in head-to-head comparisons [14]. Semaglutide (Ozempic) and dulaglutide (Trulicity) also produce strong glycemic results.
  • Cardiovascular risk reduction is a priority: Semaglutide (Wegovy) has the strongest CV evidence — the SELECT trial demonstrated a 20% MACE reduction and is the only weight management drug with an FDA-approved CV indication [15]. Liraglutide (LEADER) and dulaglutide (REWIND) also have proven CV benefits in diabetes patients.
  • Preference to avoid injections: Semaglutide is available as a daily oral tablet (Rybelsus), though it produces less weight loss than the injectable versions and requires a strict fasting protocol [23].
  • Cost is a major factor: Retail prices for all GLP-1 medications are high ($800–$1,350/month). Insurance coverage, manufacturer savings programs, and formulary placement vary significantly. Some patients may find older agents (exenatide, dulaglutide) more accessible.
  • Simplicity of dosing: Dulaglutide (Trulicity) uses a single-dose, ready-to-use pen with no visible needle and no dose selection — one press. Weekly semaglutide and tirzepatide pens are also straightforward but require dose-dial selection.

What These Drugs Have in Common

  • All carry a boxed warning for thyroid C-cell tumors (based on rodent studies) and are contraindicated in patients with personal/family history of medullary thyroid carcinoma or MEN 2 syndrome
  • All can cause gastrointestinal side effects (nausea, vomiting, diarrhea), particularly during dose escalation
  • All require a prescription and are not available over-the-counter
  • None are approved for type 1 diabetes
  • Weight regain after discontinuation has been documented across the class
  • All should be discontinued at least 2 months before planned pregnancy

Sources

References

Medical Disclaimer
This content is for informational and educational purposes only. It is not intended as, and should not be interpreted as, medical advice. The information provided does not cover all possible uses, precautions, interactions, or adverse effects, and may not reflect the most recent medical research or guidelines. It should not be used as a substitute for the advice of a qualified healthcare professional. Never disregard professional medical advice or delay seeking treatment because of something you have read here. Always speak with your doctor or pharmacist before starting, stopping, or changing any prescribed medication or treatment. If you think you may have a medical emergency, call your doctor or emergency services immediately. GLPbase does not recommend or endorse any specific tests, physicians, products, procedures, or opinions. Use of this information is at your own risk.

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