GLP-1 Medications: Which Brand Is Which, and How to Ease Side Effects

GLP-1 medications are now FDA approved for much more than diabetes. Depending on the brand, they treat type 2 diabetes, obesity, heart risk, sleep apnea, kidney disease in diabetes, or a serious form of fatty liver disease.

The brand matters because each one carries its own approval. Wegovy and Ozempic both contain semaglutide and both now come as a shot or a pill, but they are approved for different uses and the manufacturer states they are not interchangeable.

What each brand is approved for

Wegovy pen (semaglutide), a shot once a week. Approved for weight management, for lowering the risk of heart attack and stroke in people with heart disease, and for MASH, a type of fatty liver disease.

Wegovy pill (semaglutide), once a day. Approved for weight management and for lowering the risk of heart attack and stroke.

Ozempic pen (semaglutide), a shot once a week. Approved for type 2 diabetes, for lowering heart risk in type 2 diabetes, and for lowering kidney risks in type 2 diabetes with kidney disease.

Ozempic pill, formerly Rybelsus (semaglutide), once a day. Approved for type 2 diabetes and for lowering heart risk in high-risk adults with type 2 diabetes.

Zepbound (tirzepatide), a shot once a week. Approved for weight management and for moderate to severe sleep apnea in adults with obesity.

Mounjaro (tirzepatide), a shot once a week. Approved for type 2 diabetes.

Foundayo (orforglipron), once a day. Approved for weight management.

The pills are not taken the same way. The Wegovy pill is taken first thing in the morning on an empty stomach with a small sip of water, and you wait 30 minutes before food, drinks, or other medicines. Foundayo can be taken any time of day, with or without food or water.

How much weight people lose

These are averages from the main published trial for each medicine. They count everyone who started the medicine, including people who stopped it, so people who stayed on it lost more. All of these trials enrolled adults without diabetes, and none compared the medicines head to head.

Foundayo 5.5, 9, or 17.2 mg: 7.5%, 8.4%, or 11.2% over 72 weeks, compared with 2.1% on placebo. The trial used 6, 12, and 36 mg doses, which Lilly reports match the tablets sold now.

Wegovy pill 25 mg: 13.6% over 64 weeks, compared with 2.2% on placebo.

Wegovy pen 2.4 mg: 14.9% over 68 weeks, compared with 2.4% on placebo.

Wegovy HD pen 7.2 mg: 18.7% over 72 weeks, compared with 3.9% on placebo.

Zepbound 5, 10, or 15 mg: 15.0%, 19.5%, or 20.9% over 72 weeks, compared with 3.1% on placebo.

The benefit is not only weight

Semaglutide lowered heart risk in a large trial called SELECT. In adults who already had heart disease and carried extra weight but did not have diabetes, the weekly shot cut the combined risk of heart attack, stroke, and death from heart disease by 20% compared with placebo. That trial did not study people without heart disease, so we do not know yet whether the same benefit holds for them.

Side effects

Nausea and bloating are the side effects most people notice. The medication slows how quickly your stomach empties. That is part of how it works, and it is also why a normal-sized meal can suddenly feel like too much.

Side effects are a real reason people stop. In SELECT, 16.6% of people on semaglutide stopped because of side effects, compared with 8.2% on placebo.

How to ease side effects

• Eat smaller portions than you think you need. Eat slowly, and stop before or as soon as you feel full, even if there is food left.

• High-fat foods sit in the stomach the longest, so they cause the most trouble. Keep them to a minimum, especially in the first days after a dose.

• Staying upright after you eat keeps reflux from adding to the nausea. Do not lie down right after a meal.

• Dehydration makes nausea worse, and nausea makes you drink less, so it builds on itself. Sip fluids through the day instead of drinking a lot at once.

• Call our office if you cannot keep fluids down for a full day, if you are vomiting repeatedly, or if you have severe stomach pain that goes through to your back.

Getting the right medicine for you

The right GLP-1 depends on your other health conditions, how you tolerate the medicine, and what your insurance covers. At Precision Diabetes & Endocrinology, I choose the medication with you, adjust the dose based on how you are doing, and stay in touch between visits as side effects come up. To schedule a visit, contact the office.

Allison Johns, MD

Sources

• • Wegovy (semaglutide) injection and tablets, Prescribing Information. Novo Nordisk

  • Ozempic (semaglutide) injection, Prescribing Information. Novo Nordisk

  • Rybelsus and Ozempic (semaglutide) tablets, Prescribing Information. Novo Nordisk

  • Zepbound (tirzepatide) injection, Prescribing Information. FDA

  • Mounjaro (tirzepatide) injection, Prescribing Information. FDA

  • Foundayo (orforglipron) tablets, Prescribing Information. Eli Lilly

  • Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT). N Engl J Med 2023

  • Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med 2021

  • Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med 2022

  • Wharton S et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). N Engl J Med 2025

  • Wharton S et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). N Engl J Med 2025

  • Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP). Lancet Diabetes Endocrinol 2025