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Wegovy vs Zepbound in Canada: how do they compare?

The two weekly injections approved in Canada for weight management: how they work, what the head-to-head trial found, what they cost and why no province covers either.

GLP Guidebook teamPublished 14 Oct 20268 min read16 sourcesWritten from published sources
What we checked16 sources, each one opened and linked to the sentence it supportsLast checked 14 Oct 2026 · Next review due 14 Apr 2027 · How we write

Written for Canada, from Canadian sources.

The short answer

Wegovy (semaglutide) and Zepbound (tirzepatide) are both approved in Canada for chronic weight management. In SURMOUNT-5, the head-to-head trial, people lost 20.2% of their weight on Zepbound and 13.7% on Wegovy over 72 weeks, and 44 in 100 felt sick on each. No province covers either for weight.

At a glance

WegovyZepbound
Medicine and makerSemaglutide, Novo Nordisk1Tirzepatide, Eli Lilly2
Approved in Canada forWeight management in adults and teens 12 and over; lowering heart-attack risk with heart disease and BMI 27 or more; a liver disease, MASH (conditional)1Weight management in adults; moderate to severe sleep apnea in adults with obesity2
Who, on the labelBMI 30 or more, or 27 or more with a weight-related condition1BMI 30 or more, or 27 to under 30 with a weight-related condition2
How it’s takenInjection under the skin once a week; a 4-dose FlexTouch pen, or a single-use pen1,3Injection under the skin once a week, from a 4-dose KwikPen2
Dose steps0.25 mg, then up every 4 weeks (0.5, 1, 1.7 mg) to 2.4 mg from week 1712.5 mg for 4 weeks, then 5 mg; up 2.5 mg at a time after at least 4 weeks; maintenance 5, 10 or 15 mg2
Weight change in the head-to-head trial (SURMOUNT-5, 72 weeks)−13.7% on 1.7 or 2.4 mg4,544 in 100 felt sick (nausea); 21 in 100 vomited−20.2% on 10 or 15 mg4,544 in 100 felt sick (nausea); 15 in 100 vomited
Most common side effectsNausea, vomiting, diarrhea, constipation and stomach pain: very common, more than 1 in 10 (EU Wegovy label)6Nausea and diarrhea, and in weight management vomiting and constipation: very common, more than 1 in 10 (EU Mounjaro label)7
Official price$388.64 a pen at every dose (maker’s price submitted to Canada’s Drug Agency): about $421 a month, $5,052 a year3$300 a pen at 2.5 or 5 mg, $420 at 7.5 or 10 mg, $540 at 12.5 or 15 mg (maker’s price submitted to Canada’s Drug Agency): about $325 to $585 a month, $3,900 to $7,020 a year8
Coverage in CanadaNo public plan for weight; Novo Nordisk stopped seeking public coverage in December 2025. Private plans set their own rules9No public plan lists it; Canada’s Drug Agency recommended limited coverage in 2026 if the price falls. Private plans set their own rules10,8

Side by side, not ranked. Prices: one pen holds 4 weekly doses; a year is 52 doses (13 pens); a month is a twelfth of a year; our arithmetic. Pharmacies add their own markup and fees. Checked 14 Oct 2026.

Key takeaways

  • Wegovy (semaglutide) and Zepbound (tirzepatide) are both approved in Canada for chronic weight management, at a BMI of 30 or more, or 27 or more with a weight-related condition.1,2
  • In SURMOUNT-5, a 72-week head-to-head trial in 751 adults without diabetes, weight fell 20.2% on Zepbound and 13.7% on Wegovy; Eli Lilly funded it.4
  • Nausea affected 44 in 100 people on each medicine in SURMOUNT-5; vomiting affected 15 in 100 on Zepbound and 21 in 100 on Wegovy.5
  • A Wegovy pen costs $388.64 at every dose; Zepbound costs $300 to $540 a pen depending on the dose, each pen holding 4 weekly doses.3,8
  • No province covered either for weight on 14 October 2026; BC listed Wegovy as a non-benefit in December 2025.9,10
Before you go further
  • GLP‑1 medicines are prescription drugs in Canada. Nothing here is a reason to start, stop or switch one.11
  • We name brands and official prices as facts. We don’t recommend, rank or link to any brand, pharmacy, clinic or program.
  • Canadian law bans advertising any drug to the general public as a treatment, preventative or cure for obesity or diabetes.12 This page is information, not an ad, and nothing here is for sale.
  • Trial results are averages. Some people lose much less, and every benefit comes with risks: see our side effects guide.
On this page
  1. How do Wegovy and Zepbound differ?
  2. What did the head-to-head trial find?
  3. How do their side effects compare?
  4. How much do they cost, and who covers them?
  5. What else is each one approved for?
  6. Which one? What does a doctor weigh?
  7. Questions people ask
  8. How we researched this
  9. Sources

How do Wegovy and Zepbound differ?

They are different medicines. Wegovy is semaglutide, which acts on the GLP‑1 receptor; Zepbound is tirzepatide, which acts on both the GIP and GLP‑1 receptors.1,2

GLP‑1 and GIP are gut hormones released after eating. GLP‑1 receptors sit in brain areas that regulate appetite.1 Both medicines are weekly injections that start low and rise every 4 weeks, to limit stomach side effects.1,2

Each has a sister brand for type 2 diabetes: Ozempic for semaglutide, Mounjaro for tirzepatide.13,14 See Wegovy vs Ozempic and Zepbound vs Mounjaro.

What did the head-to-head trial find?

SURMOUNT-5 gave 751 adults with obesity and no diabetes the highest dose each person could tolerate, for 72 weeks. Weight fell 20.2% on Zepbound and 13.7% on Wegovy.4

People were put into the two groups at random, so the groups started alike, and the gap between them reflects the medicine.4

  • Weight. For someone starting at 90 kg (198 lb), 20.2% is about 18 kg (40 lb) and 13.7% about 12 kg (27 lb).4
  • Waist. It shrank by 18.4 cm (7.2 in) on Zepbound and 13.0 cm (5.1 in) on Wegovy.4
  • Who paid. Eli Lilly, Zepbound’s maker. The trial was open-label, so people knew which medicine they took.4

These are averages: some people lose much more, some very little. The trial didn’t include people with type 2 diabetes.4

RisksThe risks, in brief
  • Stomach effects are very common (more than 1 in 10 people) on the EU Wegovy and Mounjaro labels; in Europe, Mounjaro is the tirzepatide brand used for weight. In SURMOUNT-5, 44 in 100 people felt sick (nausea) on each medicine.6,7,5
  • Gallbladder. Gallstones are common (up to 1 in 10) on the EU Wegovy label and uncommon (up to 1 in 100) on the EU Mounjaro label.6,7
  • Pancreatitis (an inflamed pancreas) is uncommon (up to 1 in 100) on both EU labels: severe stomach pain that won’t go away, sometimes spreading to the back.6,7
  • Thyroid, pregnancy and the pill. Neither is for anyone with a personal or family history of medullary thyroid cancer or MEN 2. Tirzepatide can make the contraceptive pill less reliable for 4 weeks after starting and after each dose increase.1,2,14
Full detail in our side effects guide →
Get help now: call 911 or go to the nearest emergency department for severe stomach pain that won’t go away, with or without vomiting. It can be pancreatitis. Not sure? Call 811 to speak to a nurse in most provinces (Info-Santé 811 in Quebec).15

How do their side effects compare?

Mostly alike. In SURMOUNT-5, 44 in 100 people felt sick on each medicine, and stomach effects came mainly while the dose was going up.4,5

  • Vomiting: 15 in 100 on Zepbound, against 21 in 100 on Wegovy.5
  • Diarrhea: about 23 in 100 on each (88 people in each group).5
  • Constipation: 27 in 100 on Zepbound, against 28 in 100.5
  • Serious adverse events: 5 in 100 on Zepbound, against 3 in 100 on Wegovy.5

Against a dummy injection, the Canadian monographs report nausea in 44 in 100 on Wegovy 2.4 mg (against 16 in 100), and 28 in 100 on Zepbound 15 mg (against 9 in 100).1,2 Those were separate trials, so those two numbers can’t be compared directly.

How much do they cost, and who covers them?

Canada’s Drug Agency used $388.64 for a Wegovy pen at any dose, and $300 to $540 for a Zepbound pen, depending on the dose. Each pen holds 4 weekly doses.3,8

Over a year of 13 pens, that is about $5,052 for Wegovy. Zepbound comes to $3,900 held at 5 mg, $5,460 at 10 mg and $7,020 at 15 mg, by our arithmetic.3,8

No province covers either for weight. Novo Nordisk told the national price-negotiating body in 2025 it would stop seeking public coverage of Wegovy.9 For Zepbound, Canada’s Drug Agency recommended in June 2026 that plans cover it only for adults with a BMI of 27 or more and prediabetes, and only at a lower price.8 The background is in why no province covers Wegovy or Zepbound.

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What else is each one approved for?

Wegovy is also approved for teens 12 and over, to lower heart-attack risk in adults with heart disease, and for a liver disease, MASH. Zepbound is also approved for sleep apnea.1,2

  • Heart: Wegovy, to reduce the risk of a non-fatal heart attack in adults with heart disease and a BMI of 27 or more.1
  • Liver: Wegovy, for MASH with moderate to advanced scarring, under a conditional approval pending more trials.1
  • Sleep apnea: Zepbound, for moderate to severe obstructive sleep apnea in adults with obesity.2
  • Teens: Wegovy is approved from age 12; Zepbound’s weight use is for adults.1,2

More in Wegovy for the heart and liver, and Zepbound for sleep apnea.

Which one? What does a doctor weigh?

We don’t recommend either. These are the points a doctor and patient usually talk through, from the Canadian labels, the trial and the plans.

  • Other conditions. Heart disease, MASH or sleep apnea each match one label.1,2
  • Weight goals. SURMOUNT-5 is the head-to-head evidence, and it ran 72 weeks in adults without diabetes.4
  • Cost and coverage. Which one, if either, your private plan pays for.8,9
  • Contraception and pregnancy. Tirzepatide can make the pill less reliable, and its Canadian monograph rules it out in pregnancy; Wegovy should stop at least 2 months before a planned pregnancy.14,1
  • Age. Only Wegovy is approved for teens.1

Our guide to your options sets medicines beside lifestyle care and surgery.

Questions people ask

Do people lose more weight on Zepbound than on Wegovy?

In SURMOUNT-5, the head-to-head trial, average weight loss was 20.2% on Zepbound and 13.7% on Wegovy over 72 weeks, in adults without diabetes. Nausea was similar (44 in 100 on each), and serious adverse events were 5 in 100 on Zepbound, against 3 in 100 on Wegovy.4,5

Is Zepbound available in Canada?

Yes. Health Canada approved Zepbound for weight management, and it is marketed as a 4-dose KwikPen.2,11

Can I switch from Wegovy to Zepbound?

Only your prescriber can decide that. Zepbound’s Canadian monograph starts at 2.5 mg and says not to use it with any other GLP‑1 medicine; we found no Canadian conversion table.2

Does any province cover Wegovy or Zepbound for weight loss?

No, as of 14 October 2026. Canada’s Drug Agency recommended limited coverage of Zepbound in 2026, conditional on a lower price.9,8

Is there a generic Wegovy or Zepbound?

Sevmia, a generic of Wegovy, was approved in June 2026 but not yet sold on 14 October 2026. Data protection on tirzepatide runs to November 2030.11,16

How we researched this

We compared the Canadian product monographs for Wegovy (2 October 2026) and Zepbound (11 June 2026), the SURMOUNT-5 paper and its posted results on ClinicalTrials.gov, the EU package leaflets for frequency bands, and Health Canada’s Drug Product Database on 14 October 2026.

Prices are the makers’ prices submitted to Canada’s Drug Agency. Coverage is from BC’s Wegovy decision, Ontario’s formulary and the agency’s 2026 Zepbound recommendation.

Before you move on

  • Check which brand is on your prescription, and what it’s approved for.
  • Ask what your private plan covers, and its criteria.
  • Never use two GLP‑1 medicines together.
  • Ask about contraception if you take the pill.
  • Know the warning signs in the risks box.
Cost calculatorCould it be an option?Side effects and risks

More from the Canada blog

CACanadaHow much do Ozempic, Wegovy, Mounjaro and Zepbound cost in Canada?CACanadaDoes private insurance cover Ozempic, Wegovy or Zepbound in Canada?CACanadaWegovy for the heart and liver, and Zepbound for sleep apnea: what’s approved in Canada?
About GLP Guidebook

The monthly Canada update

An independent guide to GLP‑1 medicines. We don’t sell medicines, take drug-company money, earn commissions or link to any provider. Once a month: Health Canada approvals, recalls, provincial coverage changes and official prices. How we write

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Sources

  1. Novo Nordisk Canada. Wegovy (semaglutide injection) Product Monograph, 2 October 2026 (indications; dose escalation 0.25, 0.5, 1, 1.7 mg every 4 weeks to 2.4 mg; reassess after 12 weeks on the maintenance dose; STEP 1–3 results; Table 4: nausea 44% vs 16% on placebo; perioperative aspiration warning). PDF
  2. Eli Lilly Canada. Zepbound (tirzepatide injection) Product Monograph, 11 June 2026 (indications; 2.5 mg start, maintenance 5, 10 or 15 mg; “The ZEPBOUND multi-dose KwikPen contains 4 doses”; SURMOUNT-1 results; Table 2: nausea 28.0% on 15 mg vs 8.5% on placebo; not to be combined with other tirzepatide or GLP‑1 products; aspiration warning). PDF
  3. Canada’s Drug Agency (CDA-AMC). Semaglutide (Wegovy) SR0841, pharmacoeconomic review: submitted price “$388.64 per multiuse, prefilled, single-dose pen, regardless of strength … each pen contains 4 doses”; annual cost of Wegovy $5,066, of Ozempic for type 2 diabetes $2,844 to $5,688. 2025. Link
  4. Aronne LJ, Horn DB, le Roux CW, et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025;393:26–36. Open-label, 72 weeks, 751 adults without diabetes; −20.2% vs −13.7%; waist −18.4 cm vs −13.0 cm; funded by Eli Lilly. doi:10.1056/NEJMoa2416394, PMID 40353578. PubMed
  5. ClinicalTrials.gov. NCT05822830 (SURMOUNT-5), posted results, adverse events: nausea 163 of 374 on tirzepatide and 167 of 376 on semaglutide; vomiting 56 and 80; diarrhea 88 and 88; constipation 101 and 107; serious adverse events 18 and 13. Checked 14 October 2026. Link
  6. European Medicines Agency. Wegovy: EPAR product information (package leaflet section 4: nausea, vomiting, diarrhea, constipation and stomach pain “very common (may affect more than 1 in 10 people)”; gallstones “common”; acute pancreatitis “uncommon”). PDF
  7. European Medicines Agency. Mounjaro: EPAR product information (package leaflet section 4: nausea and diarrhea “very common (may affect more than 1 in 10 people)”; vomiting and constipation very common in people treated for weight management; acute pancreatitis and gallstones “uncommon (may affect up to 1 in 100 people)”). PDF
  8. Canada’s Drug Agency (CDA-AMC). Tirzepatide (Zepbound) reimbursement recommendation SR0920, committee meeting 24 June 2026: “Reimburse with conditions” only for adults with a BMI of 27 or more and prediabetes, if the cost is reduced; submitted price $300.00 per 2.5 or 5 mg pen, $420.00 per 7.5 or 10 mg pen and $540.00 per 12.5 or 15 mg pen (“12 mg” in the source), annual cost $3,913 to $7,044. Link
  9. BC PharmaCare. Drug coverage decision: semaglutide (Wegovy), “Non-benefit”, 18 December 2025 (the pan-Canadian Pharmaceutical Alliance concluded negotiations without agreement on 1 December 2025; Novo Nordisk “would no longer be seeking public coverage of Wegovy in Canada”). PDF
  10. Ontario Ministry of Health. Ontario Drug Benefit Formulary search (Ozempic $227.94 a pen, with the plan paying $78.141; Apo-Semaglutide and Dr. Reddy’s semaglutide $78.141 a pen; Sevmia $325.048 a pen and Wegovy with no price, both “Off-Formulary Interchangeable”; Rybelsus $7.5303 a tablet at every strength; no tirzepatide). Checked 14 October 2026. Link
  11. Health Canada. Drug Product Database: product records, schedule, route and status for every semaglutide, tirzepatide, liraglutide and dulaglutide product (all on the “Prescription” schedule; all subcutaneous injections or oral tablets; for example Sevmia “Approved”, not marketed; first generic semaglutide marketed 6 May 2026). Searched 14 October 2026. Link
  12. Food and Drugs Act (R.S.C., 1985, c. F-27), section 3(1): “No person shall advertise any food, drug, cosmetic or device to the general public as a treatment, preventative or cure for any of the diseases … referred to in Schedule A.1”; Schedule A.1 lists diabetes and obesity. Justice Laws Website. Checked 14 October 2026. Link
  13. Novo Nordisk Canada. Ozempic (semaglutide injection) Product Monograph, 13 July 2026 (type 2 diabetes indications, including reducing the risk of major heart and blood-vessel events in adults with type 2 diabetes and heart or chronic kidney disease, and of kidney decline in type 2 diabetes with chronic kidney disease; GLP‑1 receptor agonist; 0.25 mg for 4 weeks, then 0.5 mg, then 1 mg and 2 mg if needed, maximum 2 mg; SUSTAIN 2 and SUSTAIN 9 results; Table 2 adverse reactions: nausea 17.0% on 0.5 mg and 19.9% on 1 mg vs 6.3% on comparators; once weekly “at any time of the day, with or without meals”; missed dose within 5 days; stop at least 2 months before a planned pregnancy; perioperative aspiration warning). PDF
  14. Eli Lilly Canada. Mounjaro (tirzepatide injection) Product Monograph, 23 June 2026 (type 2 diabetes in adults and ages 10 to under 18; “a GIP and a GLP-1 receptor agonist”; dose steps; oral hormonal contraceptives: switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase; SURPASS-2 Table 10; Table 2 adverse reactions: nausea 12.2%, 15.4% and 18.3% on 5, 10 and 15 mg vs 4.3% on placebo; aspiration warning). PDF
  15. Heart and Stroke Foundation of Canada. Medical services by phone (811 in most provinces and Yukon; Info-Santé 811 in Quebec). Checked 12 October 2026. Link
  16. Health Canada. Register of Innovative Drugs, 24 January 2025 edition (semaglutide data protection ended 4 January 2026; tirzepatide data protection ends 24 November 2030). PDF

Last checked 14 Oct 2026 · Next review due 14 Apr 2027 · Report an error

How this page was made. Written by the GLP Guidebook team from the sources above. Prices are official list, formulary or maker-submitted prices, never a pharmacy, clinic, savings-card or coupon price. Figures marked as our arithmetic are worked out from those sources. It’s general information, not medical advice, and not an advertisement for any medicine. Talk to your family doctor, nurse practitioner or pharmacist before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand or provider. How we write