A side-by-side comparison of Wegovy®, Ozempic®, Zepbound®, Mounjaro®, compounded semaglutide, compounded tirzepatide and compounded oral GLP-1 tablets: how each one works, typical dosing, clinical trial weight loss, and who each option suits. Individual results vary and compounded medications are not FDA-approved.
Compounded and branded medicines are different regulatory categories. Branded medicines are FDA-approved; compounded medicines are prepared by a licensed pharmacy for an individual patient and are not FDA-approved. Here is exactly how five GLP-1 options stack up on mechanism, dosing, trial results, and who each one may be right for.
| Treatment | Mechanism | Format | Dosing | Trial weight loss | Requires insurance | Best for | Important notes |
|---|---|---|---|---|---|---|---|
| Compounded Semaglutide | GLP-1 receptor agonist | Weekly self-injection | 0.25 mg titrated to 2.4 mg weekly | ~15% at 68 weeks (STEP 1 reference) | No | Patients who want proven semaglutide without using a branded injection pen | Contains semaglutide and is prepared by a state-licensed US compounding pharmacy on a prescription for an individual patient. It is not FDA-approved and is not an approved generic or substitute for Wegovy® or Ozempic®. |
| Compounded Tirzepatide | Dual GIP + GLP-1 receptor agonist | Weekly self-injection | 2.5 mg titrated to 15 mg weekly | ~21% at 72 weeks (SURMOUNT-1 reference) | No | Patients with more weight to lose or plateaued on semaglutide | Contains tirzepatide and is prepared by a state-licensed US compounding pharmacy on a prescription for an individual patient. It is not FDA-approved and is not an approved generic or substitute for Zepbound® or Mounjaro®. |
| Oral GLP-1 Tablets | Oral semaglutide analog | Daily tablet | Once daily, titrated over 8 to 12 weeks | Modest vs injectable; individual variability high | No | Patients who cannot or will not inject | Take on empty stomach with a small glass of water; wait 30 minutes before food. |
| Wegovy® (branded) | GLP-1 receptor agonist | Weekly self-injection pen | 0.25 mg titrated to 2.4 mg weekly | ~15% at 68 weeks (STEP 1) | Yes | Patients with insurance coverage for Wegovy® specifically | Novo Nordisk brand. Requires a HELiXVi membership to route the prescription. |
| Zepbound® (branded) | Dual GIP + GLP-1 receptor agonist | Weekly self-injection pen | 2.5 mg titrated to 15 mg weekly | ~21% at 72 weeks (SURMOUNT-1) | Yes | Patients with insurance coverage for Zepbound® specifically | Eli Lilly brand. Requires a HELiXVi membership to route the prescription. |
Trial percentages are for the FDA-approved branded medicines. Compounded preparations are not FDA-approved, have not been reviewed by the FDA for safety, efficacy or quality, and those trial results should not be assumed to apply to them. Individual results vary.
No insurance needed. Ships to your door after a licensed clinician review. It is not FDA-approved and is not an approved generic of the branded medicines. Recommended: Compounded Semaglutide
Dual GIP + GLP-1 mechanism drove ~21% weight loss on average in SURMOUNT-1, higher than semaglutide's ~15% in STEP 1. Recommended: Compounded Tirzepatide
We route brand prescriptions through your pharmacy through a HELiXVi membership. You keep your coverage benefits. Recommended: Wegovy® or Zepbound®
No. Wegovy® is an FDA-approved medicine from Novo Nordisk. Compounded semaglutide is prepared by a state-licensed US compounding pharmacy on a prescription for an individual patient. It contains semaglutide, but it is not FDA-approved, is not an approved generic, and has not been reviewed by the FDA for safety, efficacy or quality. Trial results for Wegovy® should not be assumed to apply to it. Your clinician decides which option is appropriate for you.
In pivotal trials, semaglutide averaged about 15% total body weight loss at 68 weeks (STEP 1) and tirzepatide averaged about 21% at 72 weeks (SURMOUNT-1). Individual results vary based on dose, adherence, diet, activity, and medical history. Some patients lose more; some lose less.
Most patients feel reduced appetite within the first two weeks. Meaningful weight change typically shows between weeks 4 and 8 as the dose titrates up. Full trial-level results emerge over 12 to 18 months of continuous use at the target dose.
No. No insurance is required for compounded programs, and HSA and FSA are accepted. Branded Wegovy® and Zepbound® require a HELiXVi membership to route the prescription through your pharmacy benefit.
Nausea, constipation, diarrhea, fatigue, and mild reflux are the most reported. They usually appear during dose escalation and settle within a few weeks. More serious risks (pancreatitis, gallbladder, thyroid) are rare but real. Your HELiXVi clinician reviews your history and monitors you throughout treatment.
Yes. Switches happen for tolerability, availability, or plateau reasons. Your clinician re-titrates you at the appropriate starting dose for the new medication so you don't restart at zero unnecessarily.
Compounding is a regulated activity. State-licensed pharmacies may prepare a compounded medicine on a prescription from a licensed clinician for an individual patient, under federal and state rules. Compounded medicines are not FDA-approved, and the circumstances in which a pharmacy may compound a version of a commercially available approved medicine are limited and have changed since the FDA declared the semaglutide and tirzepatide shortages resolved. HELiXVi supplies only what a licensed clinician prescribes for you, and availability can change. This is general information and not legal advice.