Introduction
Switching weight loss medications—from Zepbound to Wegovy—can be a strategic decision influenced by side effects, cost, coverage, and personal preference. With the recent approval of Wegovy tablets, this decision now includes a formulation choice: weekly injection or daily oral dosing. Listening to your body and understanding what works for you is always best.
Comparative Mechanisms
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- Zepbound (tirzepatide): A GLP-1/GIP agonist that increases satiety and decreases appetite, helping to control food intake. It is the superior weight-loss option
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- Wegovy (semaglutide): A GLP-1 agonist that increases satiety and decreases appetite. Now available as both a weekly injection and a daily tablet—same drug, different delivery.
Dosage Conversion
Switching from Zepbound to Wegovy (I’d recommend switching the other way) requires proper dose adjustment. Here’s a rough dosage conversion table for reference, but please note, there is no clinically agreed upon dose conversion:
| Zepbound Dose (mg) | Equivalent Wegovy Dose (mg) |
| 2.5 – 5 | 0.25 |
| 7.5 | 0.5 |
| 10 (maintenance) | 1 |
| 12.5 | 1.7 (maintenance) |
| 15 (maintenance) | 2.4 (maintenance) |
Wegovy Titration Comparison: Injectable vs. Tablet
| Timeframe | Wegovy Injectable (Weekly) | Wegovy Tablet (Daily) |
|---|---|---|
| Weeks 1–4 | 0.25 mg | 1.5 mg (days 1-30) |
| Weeks 5–8 | 0.5 mg | 4 mg (days 31-60) |
| Weeks 9–12 | 1 mg | 9 mg (days 61-90) |
| Weeks 13–16 | 1.7 mg (maintenance) | 25 mg (maintenance) |
| Week 17+ | 2.4 mg (maintenance) | 25 mg (maintenance) |
Note on tablets: Wegovy tablet dosing follows a different titration schedule (daily, not weekly). If you’re switching to the oral formulation, your provider will start fresh with the tablet-specific regimen rather than converting from injectable doses.
Always consult your healthcare provider before making adjustments.
Transition Process
Step 1: Stop Zepbound as directed. These are weekly drugs—a 1–2 week washout period may reduce overlapping side effects.
Step 2: Begin Wegovy (injection or tablet) at the starting dose. Monitor for GI side effects, which may differ in timing between formulations.
Step 3: Follow up with your provider to titrate toward maintenance. For injectables, that’s typically 1.7 mg or 2.4 mg weekly. For tablets, maintenance dosing follows a separate daily schedule.
If choosing tablets: Expect stricter administration requirements—empty stomach, plain water only, fasting window afterward. Inconsistent dosing is the most common reason patients report reduced efficacy with oral GLP-1s.
Insurance and Cost Considerations
Coverage for Wegovy can differ from Zepbound—and tablet vs. injection may be handled differently by payers.
- Both formulations are brand GLP-1s, likely subject to prior authorization
- Early tablet rollout may involve formulary delays or step therapy confusion
- Novo Nordisk is offering a savings program for Wegovy tablets: as low as $149/month for starter doses, capped at $299/month for maintenance
Most employers continue to sidestep coverage of GLP-1s specifically for weight loss, making out-of-pocket cost a barrier for many. Verify coverage with your insurer before switching.
Conclusion
Transitioning between weight loss medications should be carefully managed with professional support. You should not take both Zepbound and Wegovy together.
With Wegovy tablets now available, the question isn’t just which drug—it’s also which formulation. Tablets reduce needle burden but increase adherence demands. Each patient’s journey is unique, and finding the right fit may require some trial and adjustment.
