Oral semaglutide has led to more severe GI upset in all populations during trials [7, 18]
For a 10 mg vial reconstituted to 5 mg/mL, that is 2.0 mL
Tirzepatide can cause constipation, and dehydration makes it worse
Specifically, GLP-1s can increase the risk of hypoglycemia (low blood sugar) and SGLT-2s can raise the risk of a serious, life-threatening complication called diabetic ketoacidosis (DKA)
However, it may casue decreased of appetite, diarrhea, and itching in some people
Consider semaglutide if: You prioritize lower cost and established safety data You have a history of GI sensitivity and prefer gradual titration You want to start with the more affordable option (semaglutide at $299/month) You're seeking 15-18% weight loss with solid cardiovascular benefit Consider tirzepatide if: You have more aggressive weight loss goals (20%+ reduction) You have type 2 diabetes or significant cardiometabolic risk Cost is not a primary barrier You tolerate GI side effects well or are willing to manage them Many patients find success on either medication