By You can switch from Wegovy to Zepbound, or from Zepbound to Wegovy, with a new prescription from your doctor. The two are different medicines, semaglutide and tirzepatide, so there is no exact dose-for-dose conversion, and you should never take both at once. In the one head-to-head trial, people on Zepbound lost more weight on average than people on Wegovy.
Gentle Health’s doctor prescribes both, in all 41 jurisdictions where our physician is licensed, for the same $28/month of doctor’s care, so switching with us does not change what you pay us. Here is why people switch, what the evidence shows, and how a switch works.
Why people switch
- Not enough response. Weight loss has slowed or stopped at a dose they can tolerate.
- Side effects. Nausea or other digestive effects that do not settle. Both medicines can cause them, but individual tolerance can differ.
- Cost. Self-pay prices differ by dose: Wegovy is $349 a month at every strength through 2.4 mg, while Zepbound ranges from $299 to $449 per four weeks.
- Insurance. A plan may cover one and not the other, or change which one it prefers.
- Supply or form. A preference for Zepbound’s vial or KwikPen over the Wegovy pen, or the reverse.
What the head-to-head trial found
In SURMOUNT-5, adults with obesity and without diabetes took either tirzepatide (the medicine in Zepbound) at the highest dose they tolerated, 10 mg or 15 mg, or semaglutide (the medicine in Wegovy) at 1.7 mg or 2.4 mg, for 72 weeks. Average weight change was −20.2% with tirzepatide and −13.7% with semaglutide (Aronne et al., NEJM 2025). The most common side effects in both groups were digestive.
That is an average across hundreds of people. It does not mean everyone does better on Zepbound, and some people tolerate Wegovy better or do well on it. Wegovy also carries an approval Zepbound does not: lowering the risk of heart attack, stroke and cardiovascular death in adults with established heart disease and obesity or overweight. Zepbound is approved for moderate to severe obstructive sleep apnea in adults with obesity.
How dosing works when you switch
Neither label gives a conversion table between the two medicines. Each label has its own starting dose and schedule:
- Zepbound starts at 2.5 mg once a week and increases in 2.5 mg steps no sooner than every four weeks; the maintenance doses for weight are 5 mg, 10 mg or 15 mg (Zepbound prescribing information).
- Wegovy starts at 0.25 mg once a week and steps up every four weeks through 0.5 mg, 1 mg and 1.7 mg to the usual maintenance dose of 2.4 mg (Wegovy prescribing information).
The doctor decides which dose to start the new medicine at and when to take the first one, based on how you tolerated the old one, your current dose and how long it has been since your last injection. Three rules apply whichever way you switch:
- Don’t take both. Both labels say not to combine them with another GLP-1 medicine. Stop the old medicine when the doctor tells you to, and don’t use leftover pens alongside the new one.
- Expect some side effects again. Digestive effects are most common while a dose is going up, and starting a new medicine can bring them back for a while.
- Birth-control pills. The Zepbound label advises switching to another method or adding a barrier method for four weeks after starting and after each dose increase.
Message the doctor about how the first weeks go. A switch is a new start, and the dose steps follow the new medicine’s schedule.
What each costs self-pay
| Wegovy pen (NovoCare Pharmacy) | Zepbound vial or KwikPen (LillyDirect) | |
|---|---|---|
| Starting doses | $199 for an eligible new patient’s first two fills of 0.25 mg or 0.5 mg; then $349 | $299 at 2.5 mg |
| Next dose | $349 | $399 at 5 mg |
| Maintenance doses | $349 at 1.7 mg or 2.4 mg; $399 for Wegovy HD 7.2 mg | $449 at 7.5 mg to 15 mg if refilled within 45 days, otherwise $499 to $699 |
Prices as of October 19–23, 2026, from NovoCare and LillyDirect. One fill of either is a 28-day supply.
Two cost details matter when switching. NovoCare’s $199 new-patient price applies only to people who have never filled a Wegovy injection prescription through NovoCare, so someone switching to Wegovy for the first time may qualify. And Zepbound’s $449 price at the higher doses depends on refilling within 45 days.
How a switch works with Gentle Health
- Message the doctor about why you want to switch: response, side effects, cost or coverage.
- The doctor reviews your history and decides whether the other medicine is right for you, at what dose, and when to start.
- The new prescription goes to the other pharmacy: LillyDirect for Zepbound, NovoCare Pharmacy for Wegovy. You set up checkout there; the old pharmacy’s prescription simply isn’t refilled.
- Your care fee doesn’t change. It stays $28/month, with messaging and video visits included, no minimum, and cancellation any time.
If you are not yet a patient, you start with the online intake and tell the doctor what you take now. A prescription is never guaranteed. How each pharmacy works is in how LillyDirect works and how NovoCare Pharmacy works. Gentle Health is not affiliated with Eli Lilly or Novo Nordisk.
Frequently asked questions
Can I switch from Wegovy to Zepbound? Yes, with a new prescription. The doctor decides the starting dose and when to take the first injection. Don’t take both.
Do I have to start Zepbound at 2.5 mg if I was on Wegovy? The label starts everyone at 2.5 mg, and there is no official conversion from a Wegovy dose. Your doctor decides whether to start there based on your history and how you tolerated Wegovy.
Is Zepbound more effective than Wegovy? In the head-to-head SURMOUNT-5 trial, average weight loss over 72 weeks was 20.2% with tirzepatide and 13.7% with semaglutide. Individual results vary.
Will switching cost more? It depends on the dose. Self-pay, Wegovy is $349 a month at strengths through 2.4 mg; Zepbound is $299 to $449 per four weeks if refilled on time. At Gentle Health the doctor’s care is $28/month for either.
Can I switch back later? Yes, with another new prescription and the doctor’s review.
Dr. James Simmons, MD