Wegovy (oral 25mg) vs Zepbound
Side-by-side comparison based on OASIS-4 and SURMOUNT-1 phase 3 trial data plus April 2026 pricing.
Wegovy (oral 25mg)
semaglutide (tablet)
Peak weight loss13.6%
TrialOASIS-4
Administrationoral
FDA statusweight-loss
List price$1,349/mo
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
Weight loss comparison (220 lbs starting weight)
% of body weight lost over 18 months, modeled from phase 3 trial data
Monthly cost by payment channel
| Channel | Wegovy (oral 25mg) | Zepbound | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $63 | $88 | $25 (Wegovy (oral 25mg) cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | $499 | $349 | $150 (Zepbound cheaper) |
| Telehealth — brand name (Hims, Ro, Found) | $449 | $499 | $50 (Wegovy (oral 25mg) cheaper) |
| Cash retail (full list price) | $1,349 | $1,059 | $290 (Zepbound cheaper) |
Wegovy (oral 25mg) pros and cons
Pros
- ✓ No injections — daily oral pill
- ✓ Same molecule as Wegovy injection
- ✓ 13.6% average weight loss in OASIS-4
- ✓ Easier to skip a dose without long-acting tail
Cons
- ✗ Strict fasting requirements before/after dose
- ✗ Slightly lower weight loss than injection (13.6% vs 14.9%)
- ✗ Daily dosing may hurt adherence vs weekly injection
- ✗ Newer drug — fewer real-world data points
Zepbound pros and cons
Pros
- ✓ Highest efficacy of any FDA-approved GLP-1 (22.5% in SURMOUNT-1)
- ✓ Dual GLP-1/GIP mechanism
- ✓ LillyDirect self-pay vials starting around $349/mo for lower doses
- ✓ FDA-approved for chronic weight management
Cons
- ✗ List price still high ($1,059/mo)
- ✗ Insurance coverage varies more than for Wegovy
- ✗ GI side effects can be more pronounced at higher doses
- ✗ Periodic supply constraints during demand spikes
Common side effects
Wegovy (oral 25mg)
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
Which should you choose: Wegovy (oral 25mg) or Zepbound?
Choose Wegovy (oral 25mg) if: you prefer a daily pill over a weekly injection.
Choose Zepbound if: you want maximum weight loss (22.5% vs 13.6%); you prefer a weekly injection over a daily pill; cash-pay cost matters most to you.
Final decisions should always be made with a licensed prescriber. This is educational content only.
Medical disclaimer: This calculator provides estimates only based on phase 3 clinical trial data and publicly listed prices. It is not medical advice. Real-world weight loss varies significantly. Consult a licensed healthcare provider before starting any medication.