Semaglutide vs Tirzepatide at Ondra Health: Which Is Right for You?
Both are weekly injectables available through Ondra Health. They work through different mechanisms, carry different side effect profiles, and are priced differently. This is an educational overview to help you have a more informed conversation with your provider — not a promise of what either medication will do for you.
Key takeaways
Tirzepatide activates both GLP-1 and GIP receptors. Semaglutide activates GLP-1 only. These are different mechanisms — not interchangeable drugs.
Clinical trials of the FDA-approved brand-name versions showed different average outcomes. Those figures apply to Wegovy and Zepbound — not to compounded semaglutide or tirzepatide, which have not been studied in equivalent trials.
At Ondra Health, compounded semaglutide is $113–$149 per month and compounded tirzepatide is $183–$219 per month, depending on the selected billing plan. Both are flat-priced across all available dose levels.
The right choice depends on your individual clinical profile. Your provider at Wasef Health, PC makes the prescribing decision — not you, and not this article.
How they work differently
Semaglutide is a GLP-1 receptor agonist. It mimics glucagon-like peptide-1, a gut hormone that slows gastric emptying, reduces appetite, and stimulates insulin release. It is the active ingredient in the brand-name products Wegovy, for weight management, and Ozempic, for type 2 diabetes.
Tirzepatide is a dual GLP-1 and GIP receptor agonist — the only approved medication in its class that activates both pathways. The GIP component adds insulin sensitization through adipose tissue signaling. It is the active ingredient in Zepbound, for weight management, and Mounjaro, for type 2 diabetes.
The compounded versions available through Ondra Health are prepared by state-licensed compounding pharmacies based on individual prescriptions. Compounded medications are not FDA-approved and are not therapeutically equivalent to brand-name products. No clinical trials have evaluated the specific compounded formulations dispensed through Ondra's pharmacy partners.
What the clinical trial data shows — brand-name products only
The following trial data applies exclusively to FDA-approved brand-name semaglutide, Wegovy, and tirzepatide, Zepbound. It does not describe expected outcomes from compounded versions. It is presented here as background on the clinical science behind each drug class.
STEP 1 trial — FDA-approved semaglutide (Wegovy), NEJM 2021
1,961 adults with obesity or overweight · 68 weeks · 2.4 mg weekly semaglutide
Mean weight loss: −14.9% vs −2.4% placebo
86.4% achieved ≥5% weight loss · 69.1% achieved ≥10%
Wilding et al., NEJM 2021 — DOI: 10.1056/NEJMoa2032183
SURMOUNT-1 trial — FDA-approved tirzepatide (Zepbound), NEJM 2022
2,539 adults with obesity or overweight · 72 weeks · Up to 15 mg weekly tirzepatide
Mean weight loss: −20.9% at 15 mg · −19.5% at 10 mg · −15.0% at 5 mg · vs −3.1% placebo
Jastreboff et al., NEJM 2022 — DOI: 10.1056/NEJMoa2206038
SURMOUNT-5 head-to-head trial — FDA-approved products only
The first direct comparison trial studied FDA-approved tirzepatide against FDA-approved semaglutide over 72 weeks. Tirzepatide showed approximately 20% mean weight loss versus approximately 14% for semaglutide in that trial. This data does not apply to compounded versions of either medication. Individual results vary significantly, even within FDA-approved trials.
Important — what this data does not tell you
These figures are group averages from controlled trials of FDA-approved products. Compounded semaglutide and tirzepatide have not been studied in equivalent trials. Compounded medications are not FDA-approved and are not therapeutically equivalent to brand-name products. Your individual outcome on any version of these medications depends on your dose, adherence, lifestyle, and biology. These numbers should not be treated as predictions of what will happen to you.
Side effect profiles — what is similar and what differs
Both semaglutide and tirzepatide work through GLP-1 receptors in the gut, so the majority of side effects overlap. Nausea, constipation, diarrhea, fatigue, and injection-site reactions are among the commonly reported side effects and may improve as the body adjusts to treatment.
Shared across both medications
Both medications have similar gastrointestinal side effects. A personal or family history of medullary thyroid carcinoma or MEN2 syndrome may make treatment inappropriate. Both should be discontinued before attempting conception according to provider guidance. Both are once-weekly subcutaneous injections, and provider supervision is recommended throughout dose titration.
Possible differences
In head-to-head trial data, nausea appeared somewhat more common with semaglutide. Tirzepatide's added GIP receptor activity may produce different side-effect timing for some patients. Individual tolerance varies considerably, and some patients may tolerate one medication better than the other for reasons that are not always predictable at the outset.
Pricing and pharmacy availability at Ondra Health
Both medications are flat-priced across all available dose levels, so your plan price does not increase as your prescribed dose changes. Every plan includes your provider consultation, medication, supplies, and free shipping, with no separate membership fee.
Compounded semaglutide
Monthly plan: $149 per month
Quarterly plan: $339 every 3 months, equivalent to $113 per month
Dispensed by Hallandale, Boudreaux's, and Vials RX. Some state restrictions apply depending on the pharmacy.
Compounded tirzepatide
Monthly plan: $219 per month
Quarterly plan: $549 every 3 months, equivalent to $183 per month
Availability varies by state.
See the full breakdown at semaglutide options and tirzepatide options, or check your state at ondra.health/service-areas.
How to decide
This article is not the right place to make that decision — and neither is a comparison chart. The right medication depends on your medical history, current medications, relevant comorbidities, cost sensitivity, state availability, and clinical goals. Neither medication is universally better for everyone.
Your provider at Wasef Health, PC reviews your individual intake and determines which medication, if either, is clinically appropriate for you. If you have questions about which to choose, bring them up during your intake or through secure messaging after approval. That conversation is exactly what your provider is there for.
You can also use our state availability finder to confirm which medications and pharmacies are available in your state before starting your intake.
† This article is for educational purposes only and does not constitute medical advice. All clinical trial data for STEP 1, SURMOUNT-1, and SURMOUNT-5 reflects studies of FDA-approved brand-name products — Wegovy® and Ozempic® (semaglutide, Novo Nordisk) and Zepbound® and Mounjaro® (tirzepatide, Eli Lilly) — and does not apply to the compounded versions available through Ondra Health. Compounded semaglutide and tirzepatide are not FDA-approved, have not been studied in equivalent clinical trials, are not reviewed by the FDA for safety, effectiveness, or manufacturing quality, and are not therapeutically equivalent to brand-name products. Individual results vary. All prescribing decisions are made solely by licensed providers at Wasef Health, PC based on individual clinical evaluation. Ondra Health is not affiliated with Novo Nordisk or Eli Lilly.