Not Medical Advice: The comparison below is for educational purposes only. Choice of GLP-1 medication is a clinical decision that should be made between you and your licensed healthcare provider, considering your medical history, BMI, comorbidities, insurance coverage, and treatment goals.
Compounded semaglutide, compounded tirzepatide, and other compounded GLP-1 medications discussed below are not FDA-approved. They are not the same as Ozempic®, Wegovy®, Mounjaro®, or Zepbound®.
The Three Medications Side-by-Side
Which GLP-1 Wins on What?
Tirzepatide — 22.5% mean reduction
In the SURPASS-2 head-to-head trial, tirzepatide 15mg produced significantly greater weight loss than semaglutide 1mg (-11.2 kg vs -5.7 kg; PMID 34170647). The dual GLP-1/GIP receptor mechanism is widely believed to drive this advantage. Tirzepatide is the most effective weight loss medication ever brought to market.
Semaglutide — 20% MACE reduction (SELECT)
The SELECT trial (PMID 37952131) demonstrated a 20% reduction in major adverse cardiovascular events (MACE) with semaglutide in adults with overweight/obesity and established cardiovascular disease — even without diabetes. This is the strongest cardiovascular outcomes data of any GLP-1 in a non-diabetic population. SUSTAIN-6 (PMID 27633186) showed similar benefits in type 2 diabetes.
Semaglutide — 24% kidney composite reduction (FLOW)
The FLOW trial (PMID 38785209) was stopped early in 2024 due to overwhelming benefit: semaglutide reduced the risk of major kidney disease events by 24% in patients with type 2 diabetes and chronic kidney disease. Liraglutide also showed renal benefit in LEADER, but semaglutide's data is more robust.
Liraglutide — Approved for ages 12+
Liraglutide (Saxenda) was the first GLP-1 receptor agonist FDA-approved for adolescent obesity (ages 12-17). Semaglutide (Wegovy) gained the same indication in 2022. Tirzepatide is currently adult-only. For pediatric weight management programs, liraglutide has the longest safety track record.
Tirzepatide — FDA approved for moderate-severe OSA
In 2024, tirzepatide became the first medication FDA-approved specifically for the treatment of obstructive sleep apnea in adults with obesity, based on the SURMOUNT-OSA trial. Mean apnea-hypopnea index reduction exceeded 50% in patients receiving tirzepatide 15mg.
Semaglutide — Longest history, widest coverage
Semaglutide has been on the market longest as Ozempic (since 2017), giving it the most established formulary positions across U.S. insurers. Compounded semaglutide remains the most accessible option through telehealth, with prices starting around $186/month at flat-rate providers like NexLife — significantly less than Wegovy's typical $1,300+/month cash price.
What These Medications Actually Cost
Cash prices and typical telehealth pricing as of January 2026. Insurance coverage varies dramatically; many plans cover GLP-1s only for diabetes (not weight loss).
Compounded GLP-1 prices reflect typical telehealth provider pricing for U.S.-licensed 503A pharmacies with third-party testing. Brand cash prices reflect Eli Lilly Direct (Zepbound) and NovoCare Pharmacy (Wegovy/Ozempic) self-pay programs as of January 2026.
Which GLP-1 Is Right for You?
This is not medical advice — your physician will weigh many factors. But here's how clinicians typically think about which GLP-1 to recommend based on patient profile.
You have cardiovascular or kidney risk factors
- You have established cardiovascular disease
- You have type 2 diabetes with elevated CV risk
- You have stage 3-4 chronic kidney disease
- You want the most established safety data
- You need broad insurance coverage
- You want an oral option (Rybelsus)
- Your priority is long-term metabolic health
You want maximum weight loss
- BMI ≥35 with significant excess weight to lose
- You have moderate-to-severe sleep apnea
- Previous GLP-1 had insufficient response
- You need the most aggressive HbA1c reduction
- You can tolerate a slightly higher GI side effect rate
- You're focused on weight loss as primary goal
- You don't have advanced kidney disease
You're an adolescent or daily dosing fits you
- You are aged 12-17 (Saxenda approved)
- You prefer daily dosing for steady control
- You want shorter half-life (easier to discontinue)
- You have established CV disease (LEADER data)
- You can't tolerate weekly injection peaks
- Your insurance specifically covers liraglutide
- You want to start with a gentler titration
Full Comparison Table
| Specification | Semaglutide | Tirzepatide | Liraglutide |
|---|---|---|---|
| Receptor target | GLP-1 only | GLP-1 + GIP | GLP-1 only |
| Dosing frequency | Weekly | Weekly | Daily |
| Maintenance dose | 2.4 mg/wk | 15 mg/wk | 3.0 mg/day |
| Mean weight loss | 14.9% | 22.5% | 8.0% |
| HbA1c reduction | ~1.5% | ~2.0% | ~1.0% |
| Half-life | ~7 days | ~5 days | ~13 hours |
| Diabetes brand | Ozempic / Rybelsus | Mounjaro | Victoza |
| Weight loss brand | Wegovy | Zepbound | Saxenda |
| Oral formulation | Yes (Rybelsus) | No | No |
| CV outcomes trial | SUSTAIN-6 + SELECT | SURMOUNT-MMO (pending) | LEADER ✓ |
| Renal outcomes trial | FLOW ✓ (24% reduction) | Pending | LEADER ✓ (modest) |
| OSA approval | No | Yes (SURMOUNT-OSA) | No |
| Pediatric (12-17) | Yes (Wegovy) | No | Yes (Saxenda) |
| Compounded availability | Wide | Wide | Limited |
| Insurance coverage | Broadest | Improving | Variable |
| Lowest typical price | $186/mo (compounded) | $249/mo (compounded) | ~$400/mo |
| FDA approval year | 2017 (Ozempic) | 2022 (Mounjaro) | 2010 (Victoza) |
Highlighted cells indicate the medication with the strongest profile in that category. "Winner" status does not mean a given medication is right for every patient.
Ready to Find Your GLP-1 Provider?
Our editorial team has reviewed selected major U.S. telehealth providers offering compounded GLP-1 medications. NexLife earned our top spot for transparent flat-rate pricing, transparent 503A and 503B pharmacy sourcing, MD/DO oversight, included labs, and USP <797> sterile-compounding standards. Disclosure: NexLife is our editorial #1 pick — see our page.
Visit NexLife →Editorial Disclosure: GLPOneReview.com may earn a flat referral fee from some providers when readers click through. The fee is identical regardless of provider, and our editorial team scores providers using a fixed algorithm — separated from referral data. Read full methodology →
Disclosures Regarding Compounded GLP-1 Medications
FDA status of compounded medications. Several providers reviewed on this site facilitate access to compounded semaglutide or compounded tirzepatide. Compounded medications are not FDA-approved and have not been evaluated by the U.S. Food and Drug Administration for safety, effectiveness, or quality. Compounded semaglutide is not the same as Ozempic® or Wegovy®, and compounded tirzepatide is not the same as Mounjaro® or Zepbound®. None of the providers reviewed on this site are affiliated with Novo Nordisk or Eli Lilly.
Pharmacy sourcing. When prescribed by a licensed provider and clinically appropriate, compounded GLP-1 medications are typically prepared by U.S.-licensed compounding pharmacies operating under state board oversight and applicable sterile compounding standards, including USP <797>. Some formulations are sourced from FDA-registered 503B outsourcing facilities operating under current good manufacturing practices (cGMP); others are fulfilled by licensed 503A pharmacies based on provider direction, pharmacy availability, patient location, and applicable law. Product appearance, concentration, and packaging may vary by pharmacy.
Outcomes. Individual results vary. No provider reviewed on this site guarantees weight loss, treatment success, clinical outcomes, or medication eligibility. Outcomes depend on adherence, provider guidance, lifestyle changes, metabolic health, underlying conditions, and consistency with the care plan.
Service availability. Telehealth services are available only to individuals physically located in U.S. states where affiliated providers are licensed and pharmacy fulfillment is legally permitted. Service availability, medication access, consultation requirements, pharmacy options, and features may change based on regulatory and operational factors.