is there a semaglutide to tirzepatide dose conversion?

updated

no FDA label converts one drug into the other. what exists are published estimates and two small studies, and a switch stays the prescriber's decision.

verdict: no label conversion; published estimates are not a validated chart (expert estimates and small studies / no label guidance)

quick answer

not on any FDA label for either drug. the Zepbound, Mounjaro, Wegovy, Ozempic and semaglutide tablet labels cited here give no semaglutide to tirzepatide conversion, so a switch is the prescriber's decision. published sources do exist: a 2023 shortage report suggested comparative doses for type 2 diabetes based on glucose lowering, a 2024 Lilly-authored model simulated the switch, and two small 2025 studies followed 15 and 11 people with type 2 diabetes for three months after switching.

the evidence

published comparisons do exist. (supported)

Whitley, Trujillo and Neumiller (Clinical Diabetes, 2023) suggested comparative doses of GLP-1 drugs during shortages, based on glucose-lowering effect in type 2 diabetes; a 2024 erratum corrected one liraglutide entry. Urva and colleagues (2024), three of them from Eli Lilly, simulated switching from semaglutide or dulaglutide to tirzepatide with models built from type 2 diabetes trials. two 2025 studies, one retrospective and one prospective observational, followed 15 and 11 people with type 2 diabetes for three months after the switch.

none of it is a label conversion. (gap)

the Zepbound label does not mention semaglutide. its recommended starting dosage, 'for all indications', is '2.5 mg injected subcutaneously once weekly', and the label adds that 'the 2.5 mg dosage is for treatment initiation and is not approved as a maintenance dosage.' the switching sections in the semaglutide labels stay within semaglutide, and the tablet label says its own two tablet brands are not substitutable milligram for milligram.

comparison is not prescribing. (risk)

these sources report estimates and group averages in type 2 diabetes. this page does not recommend switching products or choosing a dose.

bottom line

a published comparison describes averages in type 2 diabetes; the dose a person gets is set by the prescriber, starting from the label.

scores

  • randomized human conversion evidence: 0 · none among the published switching sources: the two human studies were retrospective (15 people) and observational (11 people)
  • mechanism overlap: 50 · labels: semaglutide activates the GLP-1 receptor; tirzepatide activates both the GIP and GLP-1 receptors
  • conversion-chart gap: 100 · published tables are expert estimates of glucose lowering in type 2 diabetes, and the Lilly analysis is a simulation
  • label guidance: 0 · none of the five labels cited converts one drug into the other; the semaglutide tablet label says its two tablet brands are not substitutable milligram for milligram

sources

  1. Zepbound US prescribing information, revised August 2026. Current Zepbound label.
  2. Mounjaro US prescribing information, revised August 2026. Current Mounjaro label.
  3. Wegovy US prescribing information, revised June 2026. Current Wegovy injection and tablet label, including Wegovy HD and the MASH indication.
  4. Ozempic injection US prescribing information, revised October 2025. Current Ozempic injection label.
  5. Rybelsus and Ozempic tablets US prescribing information, revised January 2026. Current oral semaglutide product label.
  6. Whitley HP, Trujillo JM, Neumiller JJ. Clin Diabetes 2023. Special report on GLP-1 and GIP/GLP-1 receptor agonist shortages, with a suggested comparative-dose table for type 2 diabetes.
  7. Urva S et al. Curr Med Res Opin 2024. Model-based simulation of switching from semaglutide or dulaglutide to tirzepatide in type 2 diabetes.
  8. Kurinami N et al. Endocrinol Metab (Seoul) 2025. Tirzepatide after switching from semaglutide in type 2 diabetes.
  9. Fukaishi T, Ishibashi F. JMA J 2025. Quality of life after switching from oral semaglutide to tirzepatide in type 2 diabetes.

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claim checks

reptides grades the research record and cites the literature behind every call. research reference only; not medical advice.