What is the difference between semaglutide, from Ozivy, and tirzepatide Credit: Disclosure What is the difference between semaglutide and tirzepatide? And what is Ozivy, the national option that arrived in pharmacies? Brazil has just gained a new treatment option based on semaglutide. Ozivy, produced by EMS, has arrived in pharmacies and is now part of the group of semaglutide-based treatments available in the country for patients with type 2 diabetes. For those who already know Ozempic, the arrival of a national version raises a series of doubts, and one of the main ones is knowing the difference between semaglutide and tirzepatide. The answer matters both for those who have diabetes and for those undergoing treatment for obesity, two conditions that, in Brazil, are growing together at an accelerated pace. Finding these and other health products at Drogal is one of the ways to have access to a network of pharmacists prepared to guide you in this type of doubt. What is the difference between semaglutide and tirzepatide: the mechanism that explains everything The main difference between tirzepatide and semaglutide is in the mechanism of action. Semaglutide acts on a single hormone, GLP-1. Tirzepatide acts on two: GLP-1 and GIP. This double action tends to generate greater weight loss. In practice, both medications imitate the hormones that the body naturally produces after meals. These hormones stimulate the release of insulin, reduce appetite and delay gastric emptying, which contributes to glucose control and the feeling of satiety. Semaglutide does this by activating a receptor. Tirzepatide does this by activating two, which amplifies the effects. In relation to weight loss, tirzepatide is usually more advantageous. In the SURMOUNT-5 study, the first to compare the two directly, tirzepatide resulted in an average loss of 20.2% of body weight in 72 weeks, compared to 13.7% for semaglutide. Still, the choice does not depend only on effectiveness: tolerance, cost and medical indications also weigh in when making a decision. Semaglutide continues to be a viable alternative for patients looking for a consolidated therapeutic option, with a broad clinical history of use. The side effects of both are similar: nausea, diarrhea, vomiting and constipation, more common at the beginning of treatment and generally controlled by gradually adjusting the dose. What is Ozivy? Ozivy was the first synthetic analogue of semaglutide to receive marketing authorization in Brazil, using the same active ingredient as Ozempic. The semaglutide in Ozivy is obtained by chemical synthesis, a process different from that used in traditional biological medicines. The technology allows the molecule to be reproduced with a high degree of purity and quality control. A practical difference that deserves attention: Ozivy needs to remain refrigerated between 2°C and 8°C before and after starting use. The reference medicine can remain out of the refrigerator for up to six weeks, as long as it is kept at a temperature below 30°C after the first use. Anvisa classified Ozivy as a new medicine. It is, therefore, not a biosimilar or generic, nor is it interchangeable with Ozempic. This means that, when going to the pharmacy with a prescription for a reference medicine, the pharmacist cannot automatically make the change. The recommendation is up to the doctor. Diabetes and obesity in Brazil: two problems that go hand in hand To understand why these medications have gained so much attention, it is worth looking at the numbers. Data from the Ministry of Health inform that the number of Brazilian adults with diabetes increased by 135% between 2006 and 2024, going from 5.5% to 12.9%. In the same period, obesity grew 118% and overweight increased 47%. It is estimated that more than 16 million Brazilians live with diabetes, the majority of which is type 2, a form of the disease associated with genetic factors combined with weight gain, poor diet and physical inactivity. The connection between the two conditions is no coincidence. The prevalence of obesity in diabetic patients is three times higher than that observed in the general Brazilian population. In other words, those who have diabetes are much more likely to also have obesity, and vice versa. The two problems feed each other, which means that treatments capable of acting on both fronts at the same time are increasingly studied and sought after. For those undergoing treatment and need additional support for the process, from sports supplements to intestinal regulators to deal with possible gastrointestinal side effects, Drogal has a complete line available in stores and on the website. What to know before seeking any of these treatments Semaglutide and tirzepatide are licensed medications, controlled for use, and require a prescription. None of them should be started on your own. Treatment starts with low doses so that the body adapts. Abrupt increases or starting a maintenance dose can cause nausea, severe vomiting and dehydration. The decision must consider safety, cost, availability, medical history and patient preference. For those who have diabetes or obesity, follow-up with an endocrinologist remains the safest way to assess which option makes the most sense for each case. See the main differences between weight loss pens and how they act on the body Eliane Messias Rodrigues, responsible pharmacist for Drogal. CRF/SP 43,895