5 Wegovy Alternatives to Consider for Weight Loss - GoodRx (2024)

Wegovy (semaglutide) belongs to a growing group of medications called glucagon-like peptide-1 (GLP-1) agonists. It’s given as a once-weekly injection for weight loss. Because it works well to help people lose weight, Wegovy is often difficult to find due to shortages.

So, what are your options if you can’t fill your Wegovy prescription? Below, we cover five injectable and oral Wegovy alternatives your prescriber may consider for you.

1. Zepbound

Compared with the other Wegovy alternatives, Zepbound (tirzepatide) has a few similarities with Wegovy. It’s also a once-weekly injection, and it works in a similar but slightly different way. Wegovy mimics GLP-1, a gut hormone involved in digestion and appetite. But Zepbound also mimics a second hormone called glucose-dependent insulinotropic polypeptide (GIP).

Because of how it works, Zepbound may result in greater weight loss compared with Wegovy. The two medications are being studied in a head-to-head trial to confirm if this is true. However, Wegovy is also approved to lower the risk of serious cardiovascular problems in certain people. Zepbound isn’t approved for this yet, but it could be in the future.

Zepbound and Wegovy are both approved for adults. Wegovy is also approved for adolescents ages 12 and older. So, adolescents looking for a Wegovy alternative may need to consider a different option than Zepbound for now.

As with Wegovy, the demand for Zepbound is high. As of May 2024, most Zepbound doses have limited availability through June 2024. Tirzepatide, the main ingredient in Zepbound, is also sold under the brand name Mounjaro for Type 2 diabetes. Most Mounjaro doses also have limited availability.

2. Saxenda

Saxenda (liraglutide) is another injectable GLP-1 agonist medication. It works the same way as Wegovy, but Saxenda needs to be injected every day. And it doesn’t have the same cardiovascular risk reduction approval. But like Wegovy, Saxenda is also approved for adults and adolescents ages 12 and older.

If you switch from Wegovy to Saxenda, keep in mind that the injection pens work differently. Wegovy comes in a single-use injection pen, while Saxenda comes in a multidose pen. That means you’ll use the Saxenda pen for multiple doses, instead of throwing it away after you use it.

With Saxenda, you may not lose as much weight as you might with Wegovy. In a study comparing the two medications, people receiving Saxenda lost about 6% of their starting body weight, while people receiving Wegovy lost close to 16%.

Saxenda and Wegovy are made by the same manufacturer. Similarly, Saxenda is also in short supply.

3. Contrave

If you’re looking for an oral weight-loss option, your prescriber may consider Contrave. It’s an oral pill that contains two medications — naltrexone and bupropion — that work together to reduce hunger and manage cravings. Because of how it works, Contrave can be a good option if you experience emotional eating.

After the first week, you’ll take Contrave twice a day. The amount of weight loss people see with Contrave is usually 5% to 8% of their starting body weight. As with Wegovy, you may experience side effects such as nausea and vomiting, constipation, and diarrhea. But dry mouth, trouble sleeping, and higher blood pressure are also possible with Contrave.

Contrave may not be safe for certain people, including those with unmanaged high blood pressure and seizure disorders. Contrave can also interact with other medications, such as opioid medications used for pain. Review your full medication list and health history with your healthcare team before starting Contrave.

4. Qsymia

Another oral option is Qsymia (phentermine / topiramate ER). Qsymia is also a combination tablet. Each tablet contains phentermine (a stimulant) and topiramate (a seizure medication). Both of these medications lower your appetite to help you lose weight.

Qsymia is taken once a day in the morning. As with Wegovy, you’ll typically start at a low dose and work your way up. Depending on which dose they take long term, most people lose 5% to 10% of their body weight with Qsymia. This is similar to the potential weight loss with Contrave but less than with Wegovy.

Qsymia also has different side effects, risks, and interactions to consider. Common side effects include dry mouth, constipation, and feelings of numbness and tingling. You should typically avoid Qsymia if you have certain health conditions, including glaucoma or hyperthyroidism.

Qsymia is the only weight-loss medication with a special risk management program. This is because it can harm a growing fetus. If you’re able to get pregnant, you need a negative pregnancy test before starting Qsymia. Monthly pregnancy tests and the use of effective birth control are also required to manage this risk.

5. Xenical

Xenical (orlistat) is an oral capsule that’s taken for weight loss. Xenical requires a prescription. But its active ingredient is also available over the counter (OTC) at a lower dose (sold as Alli).

Xenical helps people lose weight by blocking the body’s ability to absorb fat when you eat. Because of this, it should be taken with meals that contain fat. Unfortunately, this also results in unpleasant side effects — such as loose, oily, or fatty stools; gas; and oily spotting on underwear.

One study found that after taking Xenical for one year, people lost an average of 8.5% of their starting body weight. Again, this is similar to the potential weight loss with other oral options but less than with Wegovy.

Since Xenical blocks fat absorption, it can interfere with your ability to absorb certain vitamins from your food. So, your prescriber may recommend adding a multivitamin. Xenical can also interact with other medications that you take by mouth, such as thyroid pills. In this case, you may need to take your other medications at a different time from when you take Xenical.

When will the Wegovy shortage be resolved?

The short answer: It’s not clear. Wegovy’s manufacturer has been working to boost production to keep up with demand. This is not an easy task, since it’s estimated that at least 25,000 people start taking Wegovy every week in the U.S.

Lower Wegovy doses may be more difficult to find since the manufacturer isn’t shipping as many. This is to manage the number of new people starting Wegovy — who typically take lower doses — ensuring that others who’ve already been taking it can continue treatment.

Given the popularity of medications such as Wegovy, it may be difficult to find alternatives that aren’t also in short supply. If your pharmacy doesn’t have your dose in stock, try calling around to other pharmacies in your area. If you’re not having any luck, your prescriber can work with you to come up with the best course of action.