Switching between GLP-1 receptor agonists (GLP-1 RAs) for weight loss

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There is limited guidance available for switching between GLP-1 RAs when used for weight loss. Much of the information comes from studies in people with diabetes and from authors’ opinions based on clinical experience.

How to Switch

  1. Start with an equivalent dose of the new GLP-1 RA, or one dose lower. A conservative approach is generally recommended to help reduce the risk of gastrointestinal adverse reactions during the transition.
  2. Give the first dose of the new GLP‐1 RA at the time when the next dose of the previous GLP‐1 RA was due.
  3. Titrate the dose based on tolerability (e.g. gastrointestinal adverse reactions, or glycaemic response in patients with diabetes) and efficacy (weight loss).
  4. If the patient is switching due to gastrointestinal adverse reactions: wait for the symptoms to resolve before starting the new GLP-1 RA, start at the lowest possible dose, and consider a slower titration.

Dose Comparisons

GLP-1 RA

Brand name

Frequency

Approximate Equivalent Doses

Dulaglutide

Trulicity®

Weekly

 

0.75 mg

1.5-3 mg

4.5 mg

 

 

 

Liraglutide

Saxenda®

Victoza®

Daily

0.6 mg

1.2 mg

1.8 mg

2.4 mg

3 mg

 

 

Semaglutide

Ozempic®

Wegovy®

Weekly

 

0.25 mg

0.5 mg

1 mg

2 mg

 

 

1.7-2.4 mg

Tirzepatide

 

Mounjaro®

Weekly

2.5 mg

5 mg

7.5 mg

10-15 mg

Overall weight loss effect appears greatest with tirzepatide, followed by semaglutide, liraglutide, then dulaglutide, based on available comparative data.

 

References

  1. Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes. JAMA. 2022 Jan 11;327(2):138–50.
  2. Whitley HP, Trujillo JM, Neumiller JJ. Special Report: Potential Strategies for Addressing GLP-1 and Dual GLP-1/GIP Receptor Agonist Shortages. Clin Diabetes Publ Am Diabetes Assoc. 2023;41(3):467–73.
  3. Almandoz JP, Lingvay I, Morales J, Campos C. Switching Between Glucagon-Like Peptide-1 Receptor Agonists: Rationale and Practical Guidance. Clin Diabetes Publ Am Diabetes Assoc. 2020 Oct;38(4):390–402.
  4. VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives. Semaglutide (WEGOVY) Subcutaneous Injection Conversion Guidance for Weight Management February 2023. 2023 Feb [cited 2026 Mar 13]; Available from: https://www.va.gov/formularyadvisor/DOC_PDF/CRE_Semaglutide_WEGOVY_Conversion_Guidance_Rev_Feb_2023.pdf
  5. Wisconsin Academy of Family Physicians. Updates to the GLP1-RA Dose Comparisons Chart [Internet]. [cited 2026 Mar 13]. Available from: https://www.wafp.org/assets/files/pdfs/GLP%20equivalent%20Doses%20UPDATED%20chart.pdf