How do the potential side effects of Semaglutide and Tirzepatide compare? – Healthcare Select - MWL

Potential Side Effects of Semaglutide

Semaglutide may cause a range of side effects, from mild to severe. The most common side effects include:

Nausea
Vomiting
Diarrhea
Abdominal pain
Constipation
Heartburn
Belching

These gastrointestinal side effects are most common when first starting Semaglutide and when the dose is increased. They often subside over time as the body adjusts to the medication.

It is important to be aware that Semaglutide may also affect mental health. Some individuals using semaglutide injection for weight loss have reported changes in their mental health, including suicidal thoughts. If you experience any unusual changes in mood or behavior, such as depression, thoughts of harming yourself, or withdrawing from friends and family, it is crucial to contact your healthcare provider immediately.

In some cases, Semaglutide may cause more serious side effects, such as:

Inflammation of the pancreas (pancreatitis)
Changes in vision
Low blood sugar (hypoglycemia)
Kidney problems
Severe stomach problems
Serious allergic reactions
Gallbladder problems
Thyroid tumors, including cancer

It is crucial to contact a healthcare professional immediately if you experience any of these serious side effects.

Potential Side Effects of Tirzepatide

Similar to Semaglutide, Tirzepatide can also cause a range of side effects. The most common side effects include:

Nausea
Vomiting
Diarrhea
Constipation
Stomach pain
Decreased appetite
Heartburn
Acid reflux
Stomach swelling
Burping and flatulence
Fatigue

These side effects are generally mild and often improve over time. Research indicates that the incidence of drug discontinuation due to adverse events was highest with the 15 mg dose of Tirzepatide (10%).

While Tirzepatide may not cause hypoglycemia on its own, it can increase the risk of low blood sugar when used with other medications that lower blood sugar, such as insulin or sulfonylureas.

If you experience any serious side effects while taking Tirzepatide, it is essential to seek medical attention immediately. Serious side effects of Tirzepatide can include:

Inflammation of the pancreas (pancreatitis)
Kidney damage
Severe stomach problems
Vision changes (diabetic retinopathy)
Gallbladder problems
Thyroid tumors
Serious allergic reactions

Comparing Side Effects: Semaglutide vs. Tirzepatide

While both medications share some common side effects, there are notable differences in their potential adverse event profiles. Both Semaglutide and Tirzepatide share similar side effects, particularly gastrointestinal issues like nausea, vomiting, and diarrhea. However, there are some key differences to consider:

Gastrointestinal Side Effects: While both medications can cause gastrointestinal side effects, some studies suggest that Tirzepatide may be associated with fewer of these side effects compared to Semaglutide. This may be due to Tirzepatide's dual-action mechanism, which may help to offset some of the gastrointestinal effects of GLP-1 receptor activation.
Hypoglycemia: Tirzepatide carries a higher risk of hypoglycemia compared to Semaglutide when used in conjunction with other diabetes medications. This is because Tirzepatide also activates GIP receptors, which can further increase insulin release.
Weight Loss: Studies suggest that Tirzepatide may lead to greater weight loss compared to Semaglutide. This may be due to its dual-action mechanism, which may result in more robust appetite suppression.
Cost-Effectiveness: One U.S. study utilizing a cost-needed-to-treat analysis has shown that tirzepatide may offer a better value for money when compared to semaglutide for weight reduction over 68 to 72 weeks.

It is important to note that individual responses to medications can vary, and some people may experience more or fewer side effects with one medication compared to the other.

Studies Comparing Side Effects

Several studies have compared the side effects of Semaglutide and Tirzepatide. One study found that the number of people who reported side effects was similar between the two medications, but serious side effects occurred more frequently in the Tirzepatide group (5.3% to 7% vs 2.8%). Another study found that Tirzepatide was more effective than Semaglutide in reducing blood sugar levels and promoting weight loss, but it was also associated with a higher risk of gastrointestinal side effects at higher doses17. In this study participants with an average A1C of 8.3% and an average weight of 207 lbs saw an A1C reduction of 2% to 2.3% with Mounjaro (tirzepatide) compared to a 1.9% reduction for participants in the semaglutide (Ozempic) 1 mg group. Mounjaro 5 mg, 10 mg or 15 mg also led to weight loss of 17 lb to 25 lb, on average, compared to 13 lb for semaglutide (Ozempic).

A meta-analysis of several studies found that Tirzepatide resulted in greater weight loss than Semaglutide (17.8% vs 12.4%), and the researchers suggested that Tirzepatide provides a better cost value. Evidence demonstrates that in the SURPASS trials, participants reported weight loss of 15%-22% of their body weight, depending on dosage, compared to 10%-15% seen with semaglutide in the STEP trials.

FDA Concerns and Warnings

The FDA has expressed concerns regarding compounded semaglutide and tirzepatide products, particularly regarding potential dosing errors and the use of salt forms. Compounded drugs are medications that are made by a pharmacist or physician by combining, mixing, or altering ingredients to create a medication tailored to the needs of an individual patient.

The FDA has received reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products. These errors can occur when patients measure and self-administer incorrect doses or when healthcare professionals miscalculate doses. Additionally, there have been reports of adverse events potentially linked to patients receiving compounded semaglutide or tirzepatide in doses exceeding those approved by the FDA.

Another concern is the use of salt forms of semaglutide in compounded products. Salt forms, such as semaglutide sodium and semaglutide acetate, have not been evaluated for safety or effectiveness. They are different active ingredients than the base form of semaglutide used in FDA-approved medications.

The FDA is also aware of counterfeit Ozempic (semaglutide) being marketed in the U.S. Counterfeit drugs may contain incorrect ingredients, insufficient or excessive amounts of the active ingredient, or other harmful substances.

To ensure patient safety, the FDA recommends that individuals only obtain semaglutide and tirzepatide with a prescription from a licensed healthcare provider and from state-licensed pharmacies or registered outsourcing facilities.

Warnings and Precautions

Both Semaglutide and Tirzepatide carry a boxed warning for an increased risk of thyroid tumors, including cancer. People with a family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) should not take either of these drugs.

Other precautions for both medications include:

History of pancreatitis
Kidney disease
Diabetic retinopathy
Gallbladder disease
Pregnancy (weight loss is not advised during pregnancy and may cause fetal harm)
Breastfeeding (there is no data on the safety of these medications during breastfeeding)
Increased risk of pulmonary aspiration during surgery or other procedures that use anesthesia or deep sedation

It is essential to discuss your medical history with your healthcare provider before starting either medication.

In addition to the above precautions, counseling may be necessary for some patients using Semaglutide or Tirzepatide. This may include counseling on preventing and managing side effects, adjusting diabetes medication dosages based on lifestyle changes, and contraception and pregnancy for diabetic patients.

Conclusion

Semaglutide and Tirzepatide are effective medications for managing type 2 diabetes and promoting weight loss. Both medications can cause side effects, but the type and severity of side effects can vary between individuals. Research indicates that Tirzepatide may be associated with fewer gastrointestinal side effects and greater weight loss, but it also carries a higher risk of hypoglycemia when used with other diabetes medications. Ultimately, the choice between Semaglutide and Tirzepatide should be individualized based on a patient's specific needs and risk tolerance, with careful consideration of the potential benefits and drawbacks of each medication. The decision should be made in consultation with a healthcare provider, taking into account individual health goals, medical history, and risk tolerance.