Switching between semaglutide and tirzepatide in obesity Management: an expert-consensus framework for approximate clinical Efficacy-matched switching doses
Related Experiment Video
Updated: Oct 30, 2026

Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Eyal Schwartzberg1,2, Erez Berman1,3, Segev Shani4
1School of Pharmacy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Introduction:
Currently, there are no available guidelines for switching from semaglutide to tirzepatide, since the mechanisms of action and pharmacokinetics differ, thus posing a challenge for continuous treatment of obesity.
Areas Covered:
A narrative review of PubMed, Embase, and ClinicalTrials.gov (to May 2026) evaluated trials and cohorts comparing semaglutide (0.25-7.2 mg) and tirzepatide (2.5-15 mg). We synthesized indirect treatment comparisons to outline dose-response relationships and develop approximate Efficacy-matched switching doses bands.
Expert Opinion:
Estimation of clinical Efficacy-matched switching doses is more practical than mandatory lowest-dose initiation, which naturally risks a 'therapeutic gap' and subsequent weight regain. Until prospective switching trials validate exact conversions, clinicians should utilize the proposed equivalence bands and the 5-step clinical decision algorithm to guide seamless transitions, titrating doses every 4-8 weeks based on individual tolerability and metabolic outcomes.
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