Liraglutide vs tirzepatide

Liraglutide (Victoza, Saxenda) acts on the GLP-1 receptor, and tirzepatide (Mounjaro, Zepbound) acts on both the GIP and GLP-1 receptors. Both are approved in the US and EU for type 2 diabetes and weight management, and both have many studies in people. This page compares their results.

Best randomized result by outcome

For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.

Best randomized result by outcome for Liraglutide, Tirzepatide
Outcome	Liraglutide	Tirzepatide
Body weightMetabolic and weightCompared as: difference from placebo, in %	−8.03% mean difference Dose studied: 3.0 mg once daily24 weeksn = 572023	−19.4% Difference Dose studied: maximum tolerated dose (10 or 15 mg)52 weeksn = 6702024
Glycemic controlMetabolic and weightCompared as: difference from placebo, in %	−1.09% HbA1c difference Dose studied: 1.8 mg once daily26 weeksn = 3442009	−0.4% HbA1c mean difference Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026
Heart functionCardiovascularCompared as: value in the arm that got the peptide, in ml	−11.5 mL Cardiac adipose tissue change Placebo: −0.01 mL Dose studied: 1.8 mg/d26 weeksn = 512021	−45 mL Paracardiac adipose tissue change Dose studied: 2.5 mg weekly, increasing to a maximum of 15 mg weekly52 weeksn = 1062025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg	4 mm Hg Diastolic nocturnal blood pressure difference Dose studied: 1.8 mg once daily24 weeksn = 1002017	−4.2 mm Hg Net diastolic blood pressure reduction · Shown as a change. The study reports a net diastolic blood pressure reduction of this size. 72 weeksn not reported2024
Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in %	−40.2% UACR change Dose studied: 1.2-1.8 mg/d26 weeks (after 6 weeks of titration)n = 392019	−19.3% UACR percent change · tirzepatide 5 mg Dose studied: 5 mgweek 40/42n not reported2025
SleepSleepCompared as: value in the arm that got the peptide, in events/h	−12 events/h Mean difference in AHI 24 weeksn not reported2024	−34.1 to −27.7 events/h AHI change Dose studied: 10 mg or 15 mg (maximum tolerated dose)52 weeksn not reported2026
Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in %	35.7% GI adverse events Placebo: 17.5% Dose studied: 1.8 mg once daily26 weeksn = 2792016	42.5% GI adverse events Dose studied: up to 15 mg weeklymedian 46.9 monthsn = 13,1652026
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %	1% Severe hypoglycemia 5.0 years (mean follow-up)n = 5,0472022	0.6% Hypoglycemia · tirzepatide 5 mg Dose studied: 5 mg once weekly40 weeksn not reported2021

Body weightMetabolic and weightCompared as: difference from placebo, in %
- Liraglutide
  −8.03%
  mean difference
  Dose studied: 3.0 mg once daily24 weeksn = 572023
- Tirzepatide
  −19.4%
  Difference
  Dose studied: maximum tolerated dose (10 or 15 mg)52 weeksn = 6702024
Glycemic controlMetabolic and weightCompared as: difference from placebo, in %
- Liraglutide
  −1.09%
  HbA1c difference
  Dose studied: 1.8 mg once daily26 weeksn = 3442009
- Tirzepatide
  −0.4%
  HbA1c mean difference
  Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026
Heart functionCardiovascularCompared as: value in the arm that got the peptide, in ml
- Liraglutide
  −11.5 mL
  Cardiac adipose tissue change
  Placebo: −0.01 mL
  Dose studied: 1.8 mg/d26 weeksn = 512021
- Tirzepatide
  −45 mL
  Paracardiac adipose tissue change
  Dose studied: 2.5 mg weekly, increasing to a maximum of 15 mg weekly52 weeksn = 1062025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg
- Liraglutide
  4 mm Hg
  Diastolic nocturnal blood pressure difference
  Dose studied: 1.8 mg once daily24 weeksn = 1002017
- Tirzepatide
  −4.2 mm Hg
  Net diastolic blood pressure reduction · Shown as a change. The study reports a net diastolic blood pressure reduction of this size.
  72 weeksn not reported2024
Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in %
- Liraglutide
  −40.2%
  UACR change
  Dose studied: 1.2-1.8 mg/d26 weeks (after 6 weeks of titration)n = 392019
- Tirzepatide
  −19.3%
  UACR percent change · tirzepatide 5 mg
  Dose studied: 5 mgweek 40/42n not reported2025
SleepSleepCompared as: value in the arm that got the peptide, in events/h
- Liraglutide
  −12 events/h
  Mean difference in AHI
  24 weeksn not reported2024
- Tirzepatide
  −34.1 to −27.7 events/h
  AHI change
  Dose studied: 10 mg or 15 mg (maximum tolerated dose)52 weeksn not reported2026
Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in %
- Liraglutide
  35.7%
  GI adverse events
  Placebo: 17.5%
  Dose studied: 1.8 mg once daily26 weeksn = 2792016
- Tirzepatide
  42.5%
  GI adverse events
  Dose studied: up to 15 mg weeklymedian 46.9 monthsn = 13,1652026
Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Liraglutide
  1%
  Severe hypoglycemia
  5.0 years (mean follow-up)n = 5,0472022
- Tirzepatide
  0.6%
  Hypoglycemia · tirzepatide 5 mg
  Dose studied: 5 mg once weekly40 weeksn not reported2021

Outcomes with a randomized result for one peptide only (4 outcomes)

The other peptides have no randomized result on the same measure, so these results cannot be set side by side.

Outcomes with a randomized result for one peptide only: Liraglutide, Tirzepatide
Outcome	Liraglutide	Tirzepatide
Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in %	No comparable result 74 randomized-trial results measure it in another way or another unit.	23.7% event rate Dose studied: up to 15 mg weeklymedian 46.9 monthsn = 13,1652026
Metabolic pathways and metabolomicsGastrointestinalCompared as: value in the arm that got the peptide, in mg/dl	No comparable result 5 randomized-trial results measure it in another way or another unit.	−0.69 mg/dL SUA change · tirzepatide 5 mg Placebo: −0.18 mg/dL Dose studied: 5 mg72 weeksn = 2,5392026
Quality of lifeWhole bodyCompared as: difference from placebo, in points	3.4 points IWQOL-Lite estimated treatment difference Dose studied: 3.0 mg3 yearsn = 2,2102018	No comparable result 38 randomized-trial results measure it in another way or another unit.
Body compositionMetabolic and weightCompared as: difference from placebo, in %	−0.24% Treatment difference Dose studied: 3.0 mg target dose, once daily40 weeksn = 1282024	No comparable result 12 randomized-trial results measure it in another way or another unit.

Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in %
- Liraglutide
  No comparable result
  74 randomized-trial results measure it in another way or another unit.
- Tirzepatide
  23.7%
  event rate
  Dose studied: up to 15 mg weeklymedian 46.9 monthsn = 13,1652026
Metabolic pathways and metabolomicsGastrointestinalCompared as: value in the arm that got the peptide, in mg/dl
- Liraglutide
  No comparable result
  5 randomized-trial results measure it in another way or another unit.
- Tirzepatide
  −0.69 mg/dL
  SUA change · tirzepatide 5 mg
  Placebo: −0.18 mg/dL
  Dose studied: 5 mg72 weeksn = 2,5392026
Quality of lifeWhole bodyCompared as: difference from placebo, in points
- Liraglutide
  3.4 points
  IWQOL-Lite estimated treatment difference
  Dose studied: 3.0 mg3 yearsn = 2,2102018
- Tirzepatide
  No comparable result
  38 randomized-trial results measure it in another way or another unit.
Body compositionMetabolic and weightCompared as: difference from placebo, in %
- Liraglutide
  −0.24%
  Treatment difference
  Dose studied: 3.0 mg target dose, once daily40 weeksn = 1282024
- Tirzepatide
  No comparable result
  12 randomized-trial results measure it in another way or another unit.

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Liraglutide, Tirzepatide
Peptide	Synthetic analog Liraglutide	Synthetic analog Tirzepatide
Identity
Kind	Synthetic analog	Synthetic analog
Area	Weight and metabolic	Weight and metabolic
Evidence
Amount of evidence	4,766	2,165
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	805 (793 in people)	462 (462 in people)
Status
Approval
Sport (WADA)
Registered trials	469 · 30 active49 more mention it but do not test it	254 · 162 active47 more mention it but do not test it

Shared outcomes

Glycemic control1481
Body weight1355
Adverse events717
Gastrointestinal adverse events364
Cardiovascular events288
Heart function263
Lipids222
Liver fat and liver function189
Blood pressure171
Inflammation markers158
Kidney function144
Appetite and food intake132

Approval and sport status

From the regulatory data of each peptide.

Liraglutide
The EMA label for Victoza says: “Adults, adolescents and children 10 years and older with insufficiently controlled type 2 diabetes, as an adjunct to diet and exercise”
Tirzepatide
The FDA label for Mounjaro says: “Adjunct to diet and exercise for glycemic control in adults and pediatric patients 10 years and older with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes at high risk for these events”

Amount of evidence by outcome

Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.

Study results per shared outcome group and evidence class
Outcome group	Liraglutide	Tirzepatide
Glycemic controlNervous system and cognition	1,1171067491	36435581
Body weightMusculoskeletal	83481717	521501182
Adverse eventsWhole body	50449311	213213
Gastrointestinal adverse eventsGastrointestinal	185185	179179
Cardiovascular eventsCardiovascular	13313111	1551523
Heart functionCardiovascular	214198142	49427
LipidsMetabolic and weight	14313733	79763
Liver fat and liver functionMetabolic and weight	1361279	5353
Blood pressureCardiovascular	1201182	5151
Inflammation markersRespiratory	117100152	41347
Kidney functionWhole body	1049932	40391
Appetite and food intakeNervous system and cognition	1129517	20191

Sequence alignment

Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.

Against Glucagon-like peptide 1 (7-37)Liraglutide

Liraglutide differs from Glucagon-like peptide 1 (7-37) at 1 position and carries 1 added group.

Top row: Glucagon-like peptide 1 (7-37) (parent, numbered from 7)
Bottom row: Liraglutide

HAEGTFTSDV

SSYLEGQAA

EFIAWLVGR

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 26: Lys carries an added group: lipidation.
2Position 34: Lys is replaced by Arg.

Against Gastric inhibitory polypeptide (GIP)Tirzepatide

Tirzepatide differs from Gastric inhibitory polypeptide (GIP) at 11 positions and in 1 end segment.

Top row: Gastric inhibitory polypeptide (GIP) (parent)
Bottom row: Tirzepatide

YEGTFSDY

SIDKIQ

FVWLA

PSSGAPPPS

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end
Replaced segment
Parent context

What is different

1Position 2: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
2Position 7: Ile is replaced by Thr.
3Position 13: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
4Position 14: Met is replaced by Leu.
5Position 18: His is replaced by Ala.
6Position 20: Gln is replaced by Lys.
7Position 21: Asp is replaced by Ala.
8Position 24: Asn is replaced by Gln.
9Position 27: Leu is replaced by Ile.
10Position 29: Gln is replaced by Gly.
11Position 30: Lys is replaced by Gly.
12Positions 31 to 39: the end of the peptide is a different stretch of amino acids, not a set of single swaps.

Trials side by side

Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.

Liraglutide469 registered trials

Top 3 of 469 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT01179048

Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results

Novo Nordisk A/S9,341 participants31 Aug 2010 to 17 Dec 2015

Diabetes · Diabetes Mellitus, Type 2

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT01794143

A Comparative Effectiveness Study of Major Glycemia-lowering Medications for Treatment of Type 2 Diabetes

GRADE Study Group7,850 participantsMay 2013 to 30 Apr 2021

Type 2 Diabetes · Comparative Effectiveness of Glycemia-lowering Medications

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT01272219

Effect of Liraglutide on Body Weight in Non-diabetic Obese Subjects or Overweight Subjects With Co-morbidities: SCALE™ - Obesity and Pre-diabetes

Novo Nordisk A/S3,731 participants1 Jun 2011 to 2 Mar 2015

Metabolism and Nutrition Disorder · Obesity

Trial page ClinicalTrials.gov

49 more mention it but do not test it. They only measure it or name it in their text.

Tirzepatide254 registered trials

Top 3 of 254 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT04255433