| Obesity
Zepbound vs Xenical
Side-by-side clinical, coverage, and cost comparison for obesity.Deep comparison between: Zepbound vs Xenical with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXenical has a higher rate of injection site reactions vs Zepbound based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xenical but not Zepbound, including UnitedHealthcare
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Category
Zepbound
Xenical
At A Glance
SC injection
Once weekly
GIP/GLP-1 receptor agonist
Oral
Three times daily
Gastrointestinal lipase inhibitor
Indications
- Obesity
- Sleep Apnea, Obstructive
- Obesity
Dosing
Obesity Starting dose 2.5 mg SC once weekly for 4 weeks, escalating in 2.5 mg increments every 4 weeks; maintenance 5 mg, 10 mg, or 15 mg SC once weekly.
Sleep Apnea, Obstructive Starting dose 2.5 mg SC once weekly for 4 weeks, escalating in 2.5 mg increments every 4 weeks; maintenance 10 mg or 15 mg SC once weekly.
Obesity One 120-mg capsule three times a day with each main meal containing fat (during or up to 1 hour after the meal); distribute daily fat, carbohydrate, and protein over three main meals.
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to tirzepatide or any excipient in ZEPBOUND
- Pregnancy
- Chronic malabsorption syndrome
- Cholestasis
- Known hypersensitivity to XENICAL or to any component of this product
Adverse Reactions
Most common (>=2%) Nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, hypersensitivity reactions, eructation, hair loss, gastroesophageal reflux disease, flatulence, abdominal distension, dizziness
Serious Risk of thyroid C-cell tumors, severe gastrointestinal reactions, acute kidney injury, acute gallbladder disease, acute pancreatitis, hypersensitivity reactions including anaphylaxis and angioedema, hypoglycemia, diabetic retinopathy complications, pulmonary aspiration
Postmarketing Acute pancreatitis, hemorrhagic and necrotizing pancreatitis, ileus, intestinal obstruction, severe constipation including fecal impaction, anaphylaxis, angioedema, pulmonary aspiration, acute renal failure or worsening of chronic renal failure
Most common (>=5%) Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, fecal incontinence
Postmarketing Hepatitis, hepatic failure, hypersensitivity reactions (pruritus, rash, urticaria, angioedema, bronchospasm, anaphylaxis), bullous eruption, leukocytoclastic vasculitis, acute oxalate nephropathy, pancreatitis, lower gastrointestinal bleeding
Pharmacology
Tirzepatide is a dual GIP receptor and GLP-1 receptor agonist that selectively binds and activates both receptors, reducing body weight by decreasing caloric intake and affecting appetite regulation, stimulating glucose-dependent insulin secretion, reducing glucagon secretion, and delaying gastric emptying.
Orlistat is a reversible inhibitor of gastrointestinal lipases that forms a covalent bond with the active serine residue site of gastric and pancreatic lipases, preventing hydrolysis of dietary triglycerides into absorbable free fatty acids and monoglycerides, resulting in a caloric deficit that may have a positive effect on weight control.
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Most Common Insurance
Anthem BCBS
Zepbound
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Xenical
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (4/12) · Qty limit (9/12)
UnitedHealthcare
Zepbound
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (1/8)
Xenical
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Zepbound
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (0/3)
Xenical
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$25/fillfill
Zepbound Savings Card - Covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
No savings programs available for Xenical.
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ZepboundView full Zepbound profile
XenicalView full Xenical profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.