Table of Contents
Introduction
Tirzepatide is a new kind of medicine that is getting a lot of attention. It helps people with type 2 diabetes manage their blood sugar. It may also help with weight loss. Doctors and scientists are excited about it because it works in a different way than older drugs. Right now, tirzepatide is only available as an injection. But a new form, a pill you can swallow, is being studied. People are starting to ask: will the pill work as well as the shot? Which one is better? Should I swallow it or stick myself with a needle?
This article will look at those questions and more. It will compare tirzepatide pills and shots in a clear and simple way. Many people are searching online to find out if oral tirzepatide is just as good as the injection. They want to know about side effects, how to take each form, and which one may work better for them. This article will answer the most common questions people are asking on search engines like Google.
Tirzepatide is part of a class of medicines called GLP-1 receptor agonists. But it is a little different. It is also a GIP receptor agonist. These are hormones made by your body that help control blood sugar and hunger. When tirzepatide copies these hormones, it helps your body respond better after eating. It tells your pancreas to make more insulin. It slows down how fast food moves through your stomach. And it can help you feel full, so you may eat less. All of these effects can lead to better blood sugar control and weight loss.
Right now, if you want to take tirzepatide, you need to inject it under your skin. This is called a subcutaneous injection. Many people do not like shots. Some may be scared of needles. Others may find it hard to use the pen or remember to take it every week. This is why drug companies are working to make an oral version. Taking a pill could be much easier for some people. It could help more people stick to their treatment plan.
But making a pill version of tirzepatide is not easy. The stomach is a harsh place for drugs. Enzymes and acids can break down medicine before it gets into the bloodstream. That means the pill version must be made in a special way so your body can absorb it. Scientists are working on this problem. Some early studies suggest oral tirzepatide can work, but more research is needed.
This article will explore the differences between the injection and the pill. It will look at how well each one works, how often you have to take them, and what side effects they might cause. It will also look at safety, how your body absorbs each one, and how long each has been studied. Finally, it will talk about what patients may prefer and what insurance may cover in the future.
No opinions or personal stories will be shared. Instead, this article will use facts from clinical studies and public information. The goal is to help people understand their choices. This is especially important as new forms of medicines like tirzepatide come to market.
If you are someone living with type 2 diabetes, or if you are trying to lose weight under a doctor’s care, this information may help you ask better questions at your next appointment. Choosing between a shot and a pill may seem like a small thing, but it can have a big impact on your health routine. This article will guide you through the key facts, so you can feel more informed about the battle of the dose—swallow or stick?
What is Tirzepatide and How Does It Work?
Tirzepatide is a medicine used to help people with type 2 diabetes lower their blood sugar. It is also being studied for weight loss and other health problems linked to obesity. What makes tirzepatide different from other diabetes drugs is that it works in two ways, not just one.
Tirzepatide is called a “dual GIP/GLP-1 receptor agonist.” That means it acts like two hormones your body makes naturally: GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1). These are called “incretin hormones.” They help your body control blood sugar, especially after eating.
Let’s break down how these two hormones work and what tirzepatide does.
- Helps the Body Release Insulin
After you eat, your blood sugar rises. The body needs insulin to move that sugar from the blood into the cells, where it can be used for energy. Tirzepatide helps your pancreas make more insulin—but only when your blood sugar is high. This is important because it means tirzepatide lowers blood sugar without causing too many low blood sugar events, also called hypoglycemia.
This effect comes mostly from its action on GLP-1 receptors, but GIP may also help increase insulin when needed.
- Lowers Glucagon Levels
Glucagon is another hormone made by the pancreas. It has the opposite job of insulin. When your blood sugar is too low, glucagon helps raise it by telling the liver to release stored sugar.
In people with type 2 diabetes, glucagon levels can be too high at the wrong times. This adds to high blood sugar problems. Tirzepatide lowers glucagon levels when they are not needed, which helps keep blood sugar in a better range.
- Slows Down Stomach Emptying
Tirzepatide slows down how fast food leaves the stomach. This helps prevent sharp rises in blood sugar after meals. This action also makes people feel full longer after eating, which may lead to eating less and losing weight.
This slowing of stomach emptying is mostly from GLP-1 activity, but GIP might help too. However, this effect may become weaker over time as the body gets used to the medicine.
- Reduces Appetite and Food Cravings
Another way tirzepatide helps with weight loss is by working on parts of the brain that control hunger and cravings. People taking tirzepatide often say they feel less hungry and are less likely to snack or overeat.
Tirzepatide affects appetite centers in the brain by acting on GLP-1 and GIP receptors there. This may lead to a lower daily calorie intake, which helps with weight loss over time.
- GIP and GLP-1 Together May Offer Better Results
GLP-1 medicines like semaglutide (Ozempic, Wegovy) already help with blood sugar and weight loss. But tirzepatide may go further by also targeting GIP. Some studies suggest that the GIP part may add extra benefits, such as better fat burning and fewer stomach side effects.
In early trials, people taking tirzepatide had more weight loss and better blood sugar control than people taking GLP-1 drugs alone. Scientists believe this is because the two hormone actions work together in a stronger way.
Approved Use and Future Possibilities
Right now, tirzepatide is approved for adults with type 2 diabetes under the brand name Mounjaro. It is given as a once-weekly injection. It is also being tested in people who are overweight or obese, even if they do not have diabetes.
Researchers are also looking at other possible uses. These include preventing diabetes in people with prediabetes, treating fatty liver disease (NAFLD), and lowering the risk of heart disease.
Tirzepatide represents a new way to treat both diabetes and obesity. By using the body’s own hormone pathways, it helps people improve blood sugar levels, reduce weight, and feel fuller—without using insulin.
As more studies continue, we will learn even more about how tirzepatide works and how best to use it for different groups of people.
What Forms of Tirzepatide Are Available?
Tirzepatide is a new kind of medicine used to help people with type 2 diabetes manage their blood sugar. It is also being studied for weight loss. Right now, the only form of tirzepatide that is approved and available is the injectable form. But researchers are working on a pill form, called oral tirzepatide, which may be available in the future.
Injectable Tirzepatide
The injectable form of tirzepatide is given as a shot under the skin, called a subcutaneous injection. Most people take it once a week. It comes in a prefilled pen that makes it easier to inject. The pen is designed for people to use at home, without needing a nurse or doctor. The needle is small, and most people say the injection does not hurt much.
This form is already approved in many countries, including the United States and Europe. It is sold under the brand name Mounjaro. People with type 2 diabetes use it to lower their blood sugar. Many people also lose weight while taking it.
Oral Tirzepatide (Pill Form)
The oral form of tirzepatide is still being studied in clinical trials. That means it is not yet approved by health authorities like the FDA (Food and Drug Administration). Scientists are testing to make sure the pill is safe and works well. If it passes these tests, it may become available in the next few years.
Taking tirzepatide as a pill could be a big change for patients. Many people find pills easier and more comfortable than injections. But making a medicine like tirzepatide into a pill is not simple. Tirzepatide is a peptide, which is a small chain of proteins. These types of medicines are usually broken down in the stomach and do not get absorbed well as pills.
To solve this problem, researchers are using special tools called delivery technologies. These may include:
- Permeation enhancers – These help the medicine pass through the stomach lining and get into the bloodstream.
- Enzyme blockers – These help prevent the medicine from being broken down in the stomach.
- Protective coatings – These help the pill survive the harsh acids in the stomach.
These tools make it possible for tirzepatide to work as a pill. But the pill may need to be taken on an empty stomach, or with special instructions, to help it work best.
Comparing the Two Forms
Right now, the main difference is that injectable tirzepatide is available and oral tirzepatide is not yet approved. But more differences will likely appear as the pill form goes through testing.
For example, the dosing schedule may be different. The injection is taken once a week, but the pill may need to be taken every day. This could be less convenient for some people, especially if the pill must be taken at a certain time or before meals.
The strength or dose of the pill might also be different. Because the body does not absorb the medicine as well in pill form, higher doses may be needed to get the same effect as the injection.
There could also be differences in how the medicine acts in the body. For example, injections release the drug slowly over time, which can keep blood levels steady for a full week. Pills may have a quicker peak and shorter action. Scientists are still studying these effects.
Why Both Forms Matter
Having both an injection and a pill option gives doctors and patients more choices. Some people may not like needles and would prefer a pill. Others may find it easier to remember a once-weekly shot than taking a pill every day. It also depends on lifestyle, travel, cost, and other health issues.
As research continues, more details will become clear about how the oral version compares to the injectable form. If oral tirzepatide is approved, it could be a good option for people who want effective blood sugar and weight control without injections.
How Effective is Oral Tirzepatide Compared to Injection?
Tirzepatide is a medicine that helps lower blood sugar and support weight loss in people with type 2 diabetes. It works by copying the actions of two hormones in the body: GIP and GLP-1. These hormones help your body release more insulin after you eat, reduce the amount of sugar your liver makes, and slow down how fast your stomach empties. Tirzepatide also helps reduce appetite, which can lead to weight loss. The injectable form of tirzepatide has already been approved and is used by many people. An oral version is now being tested in clinical trials. But how well does the pill version work compared to the shot?
Injectable Tirzepatide: Strong Evidence from Clinical Trials
The injectable version of tirzepatide has been studied in many large clinical trials, including the SURPASS studies. These studies tested tirzepatide in thousands of people with type 2 diabetes. The results showed that weekly injections of tirzepatide helped people lower their HbA1c levels (a measure of average blood sugar over 2–3 months) by as much as 2.0% or more. This is a large improvement, especially when compared to other diabetes medications.
Tirzepatide injections also helped many people lose weight—some lost over 20 pounds, especially those taking the higher doses. These studies showed that the injections worked better than other treatments like insulin or other GLP-1 medicines, such as semaglutide.
Because of these strong results, injectable tirzepatide is now approved in many countries to treat type 2 diabetes and is being studied for treating obesity too.
Oral Tirzepatide: New, But Promising
The pill version of tirzepatide is still being tested. Since it is newer, there is not as much information about how well it works. However, early results from Phase 1 and Phase 2 trials are showing that oral tirzepatide can also help lower blood sugar and body weight.
Some studies show that when taken at the right dose, oral tirzepatide may provide similar blood sugar control as the injectable form. However, people may need to take it every day instead of once a week. That’s because it can be harder for the body to absorb medicines taken by mouth, especially large proteins like tirzepatide.
One of the main challenges for oral tirzepatide is making sure the medicine gets absorbed in the gut. The drug has to survive the acid in the stomach and then pass into the bloodstream through the walls of the intestines. To help with this, scientists are adding special ingredients to the pill, such as absorption enhancers, that help the medicine get into the blood. These tricks can help improve how much of the medicine is available to the body after swallowing.
Comparing Results: Are the Pill and the Shot the Same?
Based on the data we have so far, injectable tirzepatide gives strong and consistent results for lowering blood sugar and helping with weight loss. It works well when taken once a week and is already widely used.
Oral tirzepatide looks promising, but more research is still needed. The early studies suggest that, if taken at the right dose and in the right way (for example, on an empty stomach), oral tirzepatide might offer similar benefits. But we need larger trials, like those in Phase 3, to confirm how effective the pill form really is over time and in more people.
Another factor is the dose needed. Some early trials suggest that people may need higher doses of oral tirzepatide to get the same results as the injectable version. This can also mean a higher chance of side effects, like nausea or upset stomach.
Right now, injectable tirzepatide has more proven results, with clear benefits in both blood sugar control and weight loss. Oral tirzepatide may one day offer the same benefits, but more studies are needed to be sure. Scientists are working hard to make the pill form work just as well, but it is still being tested. The goal is to give patients more choices—whether they prefer a weekly injection or a daily pill—without losing any of the medicine’s powerful effects.
What are the Dosing and Administration Differences?
Tirzepatide can be given in two ways: as an injection or as a pill taken by mouth. These two forms work in the body in similar ways, but how you take them is very different. The schedule, the way you prepare, and how often you use them all change depending on whether you swallow or stick.
Injectable Tirzepatide: Once a Week
Tirzepatide is currently available as a weekly shot. You give the injection just under the skin (called subcutaneous injection), usually in the stomach, thigh, or upper arm. The injection is given once a week, on the same day each week, with or without food. You don’t need to fast or follow any special meal plan before the injection.
The medication comes in a pre-filled pen, which makes it easier for most people to use at home. There is no need to draw up medicine with a needle or go to a clinic. A healthcare provider usually teaches you how to use it safely. After that, most people can give themselves the shot.
The dose starts low and increases slowly over time. This process is called titration. It helps lower the chance of stomach side effects, like nausea or upset stomach. Here’s an example of a typical dose schedule:
- Start with 2.5 mg once a week for 4 weeks
- Then increase to 5 mg once a week
- Higher doses (7.5 mg, 10 mg, 12.5 mg, and up to 15 mg) may be added every 4 weeks if needed
The goal is to find the dose that works best without causing strong side effects. Doctors may stop at any dose level if it gives good results.
One benefit of the injection is that people only need to remember it once a week. This makes it easier for some people to stay on schedule.
Oral Tirzepatide: Taken Daily
Tirzepatide in pill form is still being studied in clinical trials. Researchers are testing how well it works and how to best take it. Based on early research, oral tirzepatide may need to be taken once a day. This is different from the once-weekly shot.
Because it’s a pill, your body needs time to absorb it through the stomach and gut. This means you may have to follow special steps when taking the pill. For example, you might need to:
- Take it on an empty stomach
- Wait 30 minutes or more before eating or drinking anything else
- Swallow the pill whole with water
These rules help your body absorb the full dose. If food is in your stomach, the medicine may not work as well.
Like the injection, the oral form may also start at a low dose. Then, the dose can be raised slowly. This helps the body get used to the medicine and may lower the chance of side effects.
Researchers are still working to find the best dosing schedule. Some people might take the pill every day, while others might have a different plan in the future if the medicine becomes stronger or lasts longer.
Comparing Convenience
Injectable tirzepatide is easy to take once a week. After the shot, you don’t have to think about it again for seven days. Many people like this because it fits better into busy schedules. Also, the injection can be taken at any time of day, with or without food.
Oral tirzepatide may feel easier for people who do not like needles. However, daily pills require more routine. You have to remember to take it every day, possibly with extra rules like not eating right away. This can be harder for some people to stick to long-term.
Some people may find the pill more private or comfortable. Others may prefer the weekly shot to avoid thinking about the medicine every day.
What It Means for You
The way tirzepatide is taken—whether swallowed or injected—can affect your daily life. Some people may find it easier to take a weekly shot. Others may prefer a pill, even if it has more steps. The best choice depends on your lifestyle, your medical needs, and how your body responds.
Doctors will help decide which form is right based on how well it works, how you feel, and how easy it is to stay on the medicine. More research will also help show which form works best for different types of people.
Are Side Effects Different Between Oral and Injectable Tirzepatide?
Tirzepatide, whether taken by mouth or by injection, works the same way in the body. It helps control blood sugar and can support weight loss. But even though both forms use the same medicine, the side effects may not be exactly the same. The way the drug enters the body can affect how strong the side effects are and how often they happen.
Common Side Effects of Tirzepatide
Most people taking tirzepatide have mild to moderate side effects. These usually involve the stomach and digestive system. The most common ones include:
- Nausea (feeling like you might throw up)
- Vomiting (throwing up)
- Diarrhea (loose or watery stools)
- Constipation (trouble pooping)
- Stomach pain
- Loss of appetite
These side effects happen because tirzepatide slows down how quickly food leaves the stomach. It also affects hormones that control hunger. When the stomach empties more slowly, people may feel full longer, but it can also cause nausea or bloating.
These symptoms are usually worse when someone first starts taking tirzepatide or when the dose goes up. Over time, the body may get used to the medicine, and the symptoms may go away or become easier to handle.
Differences Between Oral and Injectable Forms
Even though the drug is the same, the body processes it differently depending on whether you swallow a pill or get an injection.
With the injection, tirzepatide goes straight into the fatty tissue under the skin. From there, it enters the bloodstream over time. It is usually taken once a week, which means the body gets a steady, slow release of the medicine.
With the oral form, tirzepatide must go through the stomach and intestines first. It has to survive acid in the stomach and pass through the walls of the intestine to reach the bloodstream. This process can change how much of the drug is absorbed and how fast it works.
Because of this, oral tirzepatide may be given at a different dose or more often—possibly every day instead of once a week. Also, oral medications can sometimes cause more direct contact with the stomach lining, which could lead to more stomach-related side effects like nausea or stomach pain. On the other hand, some people may find that pills are easier on their stomachs than injections, depending on how their body reacts.
Researchers are still studying oral tirzepatide in large clinical trials. So far, the side effects seem similar to the injection, but there may be small differences in how often they happen or how strong they are. For example, one study suggested that people taking oral tirzepatide had slightly more nausea in the early weeks of treatment. However, more data is needed before making a clear comparison.
Gastrointestinal Tolerability
Tolerability means how well people can handle the side effects. For some, even mild nausea or bloating can be hard to manage. For others, side effects may not be bothersome at all. Doctors often start with a low dose and slowly increase it to help reduce these problems.
Whether someone takes tirzepatide as a pill or an injection, starting at a lower dose helps the body adjust and lowers the chance of stomach upset. If side effects do happen, they usually get better within a few days to a few weeks.
It’s important to drink plenty of fluids, eat smaller meals, and avoid greasy or spicy foods if nausea or stomach issues occur. These simple steps can help manage side effects during treatment.
Other Possible Side Effects
Besides stomach problems, there are other less common side effects to be aware of. These include:
- Headache
- Tiredness
- Dizziness
- Heartburn
- Low blood sugar (especially if taken with other diabetes drugs)
These side effects have been reported with injectable tirzepatide and are being watched for in the oral version. So far, no new serious safety concerns have been found in the oral trials, but full results are not yet available.
Both oral and injectable tirzepatide have similar side effects, mainly involving the stomach. How often and how strong these effects are may depend on how the drug is taken, how fast it is absorbed, and how the body reacts. As more studies are completed on oral tirzepatide, we will learn more about how it compares to the injectable version in terms of safety and side effects.
For now, doctors will continue to watch how patients respond to both forms and adjust treatment as needed to keep them feeling well while managing their blood sugar and weight.
How Do Absorption and Bioavailability Differ?
Tirzepatide is a type of medicine called a peptide. Peptides are small proteins that work in the body by attaching to certain receptors. Tirzepatide helps people with type 2 diabetes and obesity by lowering blood sugar and reducing appetite. It does this by acting on two hormone pathways: GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1).
The way tirzepatide gets into the body matters. So far, it has only been approved as a weekly injection. But researchers are studying an oral version—a pill that you swallow. This brings up an important question: how well does the body absorb tirzepatide when taken by mouth, and how much of it becomes active in the blood? This is what scientists call absorption and bioavailability.
What is Bioavailability?
Bioavailability means how much of a drug enters the bloodstream after it is taken. When a medicine is injected, it goes directly into the body. This gives it high bioavailability, usually close to 100%. The drug does not have to pass through the stomach or liver before it starts working.
But when a medicine is swallowed, it must survive a trip through the digestive system. It has to be absorbed through the lining of the gut and then pass through the liver. During this process, a lot of the drug can be broken down or lost. That’s why oral medicines usually have lower bioavailability.
For peptides like tirzepatide, oral delivery is even harder. The stomach and intestines are full of enzymes that break down proteins. These enzymes can destroy peptide drugs before they even get absorbed. That makes it very difficult to make oral versions of injectable peptide drugs.
Challenges of Oral Tirzepatide
One major problem with oral tirzepatide is getting enough of it into the bloodstream. Since tirzepatide is a large molecule, it doesn’t easily pass through the walls of the gut. Also, the enzymes in the digestive tract break it down quickly.
Because of this, oral tirzepatide has lower bioavailability compared to the injectable version. This means the body absorbs much less of the drug when it is taken as a pill.
To make the oral version work better, scientists are using special tools and strategies.
How Scientists Improve Oral Absorption
To improve absorption, drug makers add substances called permeation enhancers. These help the medicine move through the walls of the intestine and enter the bloodstream. One type of enhancer works by temporarily loosening the tight junctions between cells in the gut lining. This allows the drug to pass through more easily.
Another method is enzyme inhibitors. These stop the enzymes in the gut from breaking down tirzepatide before it can be absorbed.
Sometimes, the drug is packed in protective coatings or capsules that only open in certain parts of the intestine. This keeps the drug safe from stomach acid and enzymes until it reaches the area where absorption is best.
Some of these technologies are already being used in other oral GLP-1 drugs, like oral semaglutide. Researchers are applying similar methods to tirzepatide, but it is still being tested.
Differences in Drug Levels Between Oral and Injectable Forms
Since injectable tirzepatide is absorbed directly under the skin, it gives a steady and reliable level of drug in the blood. This helps doctors predict how the medicine will work in the body. The weekly dose means people only need to take it once every seven days.
With oral tirzepatide, the levels in the blood can vary more. They depend on things like:
- When the pill is taken
- Whether the person has eaten
- How well their gut absorbs the drug that day
This variation can make it harder to manage blood sugar or body weight. Because of the lower absorption, people might need to take higher or more frequent doses of the oral form to get the same effects as the injection.
Why This Matters
Knowing the differences in absorption and bioavailability is important for both patients and doctors. It affects how well the medicine works, how often it needs to be taken, and what kind of side effects might happen. While oral tirzepatide is still in development, these scientific challenges are key reasons why the pill is not yet available, even though the injectable form has been approved.
As research continues, scientists hope to improve the way tirzepatide is taken by mouth. But for now, injections remain the most effective and reliable way to deliver this powerful medicine.
Is One Form More Convenient or Preferred by Patients?
When it comes to taking medicine, convenience matters a lot. People often choose treatments that fit easily into their daily lives. For many patients with type 2 diabetes or obesity, choosing between oral and injectable tirzepatide might depend not only on how well it works, but also on how easy it is to use.
Oral medications are usually more familiar
Many people are used to taking pills every day. Oral medicine often feels simple and natural because it doesn’t involve needles. Swallowing a tablet in the morning with water can be part of a normal daily routine. You don’t need special training, and there’s no fear of pain or injury from a needle. This makes oral tirzepatide a good option for people who do not like injections or feel nervous around needles.
Also, some patients feel more in control when they can take their medicine by mouth instead of having to inject it. They may feel that taking a pill makes their disease feel less serious. This can make them more likely to stick to their treatment plan.
Injectables have become more user-friendly over time
Even though injections may sound difficult at first, many patients find injectable tirzepatide easy to use once they learn how. It comes in a pre-filled pen that is designed to be simple and safe. The needle is small, and the injection goes just under the skin. Most people can do it themselves after a short training session with a nurse or pharmacist.
Another benefit of the injectable form is that it only needs to be taken once a week. This means fewer doses to remember. For people who have busy lives or forget to take daily medicine, a weekly injection might actually be more convenient. They can pick a set day of the week—like every Sunday or Monday—and stick to it.
Routine matters in real life
Some people are better at remembering daily habits, while others do better with weekly tasks. Oral tirzepatide, if approved, may need to be taken every day. It may also need to be taken on an empty stomach or under certain conditions, which can be tricky for people with irregular schedules. If they miss the right time window, they might skip a dose or not take the pill properly, which could affect how well it works.
On the other hand, a once-weekly shot is easy to schedule and doesn’t depend on meals. It doesn’t matter if you eat first or last, or if your routine changes from day to day.
Storage and travel may also affect choice
Injectable tirzepatide usually needs to be kept in the fridge before it is first used. This can be a problem when traveling or if patients don’t have access to good storage. Oral tirzepatide, depending on its final form, might not need refrigeration, which makes it easier to carry around.
This matters especially for people who travel often or who have jobs that keep them away from home. A pill can be slipped into a small bottle or pillbox and taken along. There’s no need for extra supplies like alcohol wipes or sharps containers.
What do patients prefer?
In general, studies have shown that many patients prefer pills over injections. But this is not true for everyone. Some people find a weekly shot easier than taking a pill every day. Others may not like remembering to take medicine often. They may feel more confident that a weekly injection is “doing its job” without having to think about it each day.
Right now, we don’t have a lot of data on how patients feel about oral tirzepatide because it’s still in clinical trials. We will learn more as the oral form becomes available and more people try it.
Choosing between the two
In the end, convenience depends on the person. What works well for one person might not work for another. Doctors can help patients decide which form fits their lifestyle better. Whether it’s a pill or a shot, the best choice is the one a person can stick with over time. That’s how treatments work best—when they become a regular part of life.
What Do We Know About Long-Term Safety for Oral vs Injectable Tirzepatide?
Tirzepatide is a new medicine used to treat type 2 diabetes. It is also being studied for weight loss. Right now, the injectable form of tirzepatide has been approved in many countries. The oral (pill) form is still being tested in clinical trials. When choosing a medicine, it’s important to look at how safe it is to use over a long period of time. Long-term safety means how the drug affects the body after months or even years of use.
What We Know About Injectable Tirzepatide’s Long-Term Safety
The injectable version of tirzepatide has been studied for several years. Many of these studies are part of a group of clinical trials called the SURPASS program. These trials followed people for at least 40 to 104 weeks (about 10 months to 2 years). In these studies, tirzepatide helped people lower their blood sugar levels and lose weight. But researchers also watched closely for side effects and safety problems.
The most common side effects reported with the injectable form were:
- Nausea
- Diarrhea
- Vomiting
- Constipation
Most of these side effects were mild or moderate. They usually happened early in treatment and got better over time. Some people had to stop using the medicine because the side effects were too strong, but this was not very common.
Tirzepatide can also affect the stomach by slowing down how fast it empties food. This is part of how it helps with weight loss. But for some people, this can cause stomach discomfort or lead to other digestive issues. Doctors also keep an eye on gallbladder problems, like gallstones, especially in people who lose weight quickly.
There have also been questions about the risk of thyroid tumors. In animal studies, some rats developed a rare type of thyroid tumor called medullary thyroid carcinoma (MTC). But it’s not known if this happens in humans. Because of this, tirzepatide is not recommended for people with a family history of MTC or a condition called MEN 2 (Multiple Endocrine Neoplasia type 2). So far, no major thyroid problems have been reported in human studies, but doctors still watch for this risk.
Overall, the long-term safety of injectable tirzepatide looks promising. Most people who used it for 1 to 2 years were able to stay on it without serious problems. But as with any new drug, continued follow-up is needed to understand its safety over many years.
What We Know About Oral Tirzepatide’s Long-Term Safety
The oral form of tirzepatide is newer and still being tested. That means there is less information about how safe it is over time. Some early studies have looked at how well people can tolerate oral tirzepatide. These studies have mostly lasted a few weeks to a few months. So far, the side effects appear to be similar to the injectable version.
People taking oral tirzepatide have reported nausea, vomiting, and diarrhea. These side effects seem to happen more often at higher doses. Like the injection, these problems often improve as the body gets used to the medicine. But more studies are needed to understand if oral tirzepatide causes new or different side effects that don’t happen with the injection.
Another thing doctors are watching closely is how the body absorbs tirzepatide when it is taken as a pill. The pill needs special technology to help it survive in the stomach and get into the bloodstream. This might affect how the drug works in the body, and possibly how safe it is. For example, if more of the drug stays in the stomach, it could increase stomach-related side effects.
Researchers are now running larger, longer studies to test oral tirzepatide in more people. These trials will give more information about how the drug works over time and how safe it is to use daily. It may take a few more years before we know as much about oral tirzepatide’s safety as we do about the injectable form.
Why Long-Term Data Matters
Medicines for diabetes or weight loss are often taken for many years. That’s why it is important to have long-term data. It helps doctors and patients make safer choices. For tirzepatide, long-term studies help us understand rare side effects that may only show up after months or years of use. It also helps show if the benefits continue over time without new safety problems.
Injectable tirzepatide already has a strong record of safety from trials that lasted up to two years. Oral tirzepatide is still being studied. So far, it seems similar, but it is too early to say for sure. More research will help confirm if the pill form is just as safe in the long run.
What’s the Status of Regulatory Approval and Market Availability?
Tirzepatide is a newer medication used to treat type 2 diabetes and help with weight loss. It works by copying two natural hormones in the body: GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1). These hormones help control blood sugar and reduce appetite. Right now, tirzepatide is only approved in an injectable form. However, researchers are working to develop an oral version. This section looks at where things stand with both the injection and the oral pill—what has been approved, what is still being tested, and when new options might become available to the public.
Injectable Tirzepatide: Already Approved
The injectable form of tirzepatide is already approved and available in many countries. The U.S. Food and Drug Administration (FDA) approved it in May 2022 for people with type 2 diabetes. It is sold under the brand name Mounjaro. After that, other countries also approved it, including members of the European Union, Canada, and Japan.
This approval came after strong results from a group of clinical trials called the SURPASS program. These trials showed that weekly injections of tirzepatide helped people lower their blood sugar levels and lose weight. In some studies, people lost more than 20% of their body weight. These results were better than those seen with some other diabetes drugs, including semaglutide.
Later, in 2023, the FDA also gave approval for tirzepatide to be used in treating obesity, even in people who do not have diabetes. The brand name for the weight loss version is Zepbound. This opened the door for even more people to benefit from the drug, especially those struggling with obesity.
Oral Tirzepatide: Still in Development
Unlike the injection, oral tirzepatide has not yet been approved. It is still being studied in clinical trials. Taking a drug like tirzepatide by mouth is more complicated than it might seem. This is because tirzepatide is a protein-based drug. When protein drugs are taken by mouth, they are often broken down by stomach acid and enzymes before they can be absorbed into the bloodstream. This makes it hard for the drug to work properly.
To solve this, researchers are testing special ways to protect tirzepatide so it can be taken as a pill. These may include using absorption enhancers or protective coatings. The goal is to help the drug survive the journey through the stomach and get into the bloodstream where it can start working.
As of early 2025, the oral form of tirzepatide is being studied in Phase 3 clinical trials. These trials are large and include many participants. They are designed to answer key questions: Is oral tirzepatide as effective as the injectable version? Is it safe? Does it have the same side effects? How should the dose be adjusted?
The results of these trials are expected sometime in 2025 or 2026. If the results are positive, the company that makes tirzepatide (Eli Lilly) will likely ask the FDA and other health agencies to approve the oral form.
When Will Oral Tirzepatide Be Available?
If the clinical trials go well, oral tirzepatide could be available within the next 1–2 years. The approval process takes time. First, researchers must finish the studies. Then, they must submit the data to health agencies like the FDA. These agencies review all the results before deciding if the drug is safe and effective enough to be sold to the public.
Even after approval, it can take several months before the drug is widely available in pharmacies. Doctors also need to be trained on how to prescribe the oral version and explain it to patients.
The injectable form of tirzepatide is already approved and widely used for diabetes and weight loss. The oral form is still in testing. It shows promise but needs more research before it can be approved. If clinical trials are successful, the oral version may become available within the next couple of years. This would give patients another choice—taking a weekly shot or a daily pill—depending on what works best for them and their health needs.
How Might Insurance Coverage and Cost Differ?
Tirzepatide is a new medicine, and new medicines are often expensive. Both the injectable and the oral forms of tirzepatide are or will be high-cost treatments. This means that insurance plays a big role in how much a patient will actually pay. When people search for the difference between oral and injectable tirzepatide, one of the most common concerns is: “Will my insurance cover it, and how much will it cost me?”
Let’s look at what affects the cost of each form and how insurance might treat them differently.
Why Are GLP-1 Drugs Like Tirzepatide So Expensive?
GLP-1 drugs, including tirzepatide, are made using special lab processes. These drugs are not simple pills; they are based on proteins that are harder to make and store. Because of this, they often cost much more than older diabetes pills like metformin or sulfonylureas.
Tirzepatide is even more complex than other GLP-1 drugs. It acts on two hormone systems: GLP-1 and GIP. This dual action makes it very effective, but also more expensive to produce.
As of now, the injectable form of tirzepatide is already on the market. Prices can vary depending on location and pharmacy, but the average list price for a month of injectable tirzepatide can be more than $1,000. Most people do not pay the full list price if they have insurance. However, the final cost still depends on insurance coverage.
Insurance Coverage for Injectable Tirzepatide
Many insurance companies cover injectable tirzepatide for people with type 2 diabetes. It is approved by the FDA for this condition. This means that if you have commercial insurance, Medicare, or Medicaid, the injectable form might be on your insurance company’s list of covered drugs, also known as a “formulary.”
However, even if the drug is covered, you may still have to deal with:
- Copays: A fixed amount you pay for the medication, such as $25 or $50 per month.
- Coinsurance: A percentage of the cost, like 20% of the total price.
- Prior Authorization: Some insurance companies require your doctor to explain why you need the drug before they agree to pay for it.
- Step Therapy: Insurance may require you to try cheaper drugs first and only move to tirzepatide if those do not work.
Patients who are using tirzepatide for weight loss or obesity—an off-label use not yet approved—may find that insurance will not cover the drug at all. This could lead to paying the full cost out of pocket.
What About the Cost of Oral Tirzepatide?
Oral forms of tirzepatide are still being tested in clinical trials. They are not yet available for prescription. But when oral tirzepatide becomes available, it may cost even more than the injectable form. Oral GLP-1 medications, like oral semaglutide, use special technology to help the drug survive the harsh environment of the stomach and get absorbed into the body. These technologies are expensive to develop and produce.
When oral tirzepatide enters the market, it will likely have a similar price range—or even higher—than injectable tirzepatide. Insurance companies will need to review this new product before deciding whether to cover it.
They will ask:
- Is oral tirzepatide as effective as the injectable form?
- Is it safe?
- How does it compare in cost to other drugs already on the market?
If the oral form is approved by the FDA and shows strong results, insurance plans may eventually cover it for people with type 2 diabetes. However, approval does not mean automatic coverage. Like the injectable form, oral tirzepatide will likely go through prior authorization and may be placed in a high-cost tier of the insurance formulary.
Comparing Out-of-Pocket Costs
Even if both forms are covered, your out-of-pocket cost may still differ. Injectable drugs often fall under the medical or pharmacy benefit depending on how they are delivered. Oral medications are usually handled through pharmacy benefits. Each type of benefit has different copays and rules. For some patients, that could mean a higher monthly cost for the oral version.
Another factor is patient assistance programs. Drug companies sometimes offer discount cards or savings programs for brand-name drugs like tirzepatide. These are more often available to people with commercial insurance and not those on Medicare or Medicaid.
The price of tirzepatide—both oral and injectable—can be a big concern for patients. Insurance can help lower the cost, but coverage rules can be strict. Until the oral form becomes available and goes through insurance review, it is hard to say exactly how the costs will compare. What is clear is that patients and doctors will need to work together closely to get coverage and find ways to make either version affordable.
Conclusion
Tirzepatide is a new type of medicine that helps people with type 2 diabetes. It is also being tested for helping with weight loss. Right now, the only form approved for use is a weekly injection. But scientists are working on an oral version that you can take by mouth. This article compared the injectable and oral forms of tirzepatide to help answer common questions and show the differences between them.
The most important difference is how the medicine is taken. The injectable form is given by a small needle under the skin once a week. Many people are used to injections, especially those who take insulin. However, some people are afraid of needles or do not like giving themselves shots. For them, a pill they can swallow may be more appealing. Oral tirzepatide would likely be taken every day instead of once a week. This means people would need to remember to take it daily, which might be harder for some.
Effectiveness is another key factor. Clinical trials have shown that injectable tirzepatide is very effective at lowering blood sugar and helping people lose weight. It works better than many other diabetes drugs. Oral tirzepatide is still being studied in large trials, so we don’t know yet if it will work as well as the injection. Early results look promising, but more data is needed to compare them directly.
The way the body absorbs each form is also different. Injections go straight into the body, so the medicine works quickly and is fully absorbed. Oral medicines have to pass through the stomach and intestines. This means the body may not absorb all of the drug. Scientists use special technology to help the pill survive the digestive system and get into the blood. This process is not perfect and can cause the drug to be less powerful. That is one reason why daily pills are usually needed compared to weekly shots.
Side effects are similar for both forms. The most common ones are nausea, vomiting, diarrhea, and constipation. These happen more often when people first start the medicine. In most cases, the side effects get better with time. So far, there is no strong evidence that the oral form causes more or fewer side effects than the injection, but studies are still ongoing. It’s important to watch for any safety issues over the long term, especially since oral tirzepatide is still being tested.
Some people may find the oral form easier to take. You don’t need to carry needles, store them correctly, or give yourself a shot. But oral tirzepatide might need to be taken on an empty stomach or with water only, and that can be inconvenient. The daily routine may also be harder for people with busy schedules. Everyone’s lifestyle is different, so convenience can depend on the person.
Cost is another area to consider. Injectable tirzepatide is already on the market, and its price depends on insurance coverage. Oral drugs can be more expensive to make, especially if they use special ingredients to help the body absorb them. It’s still unknown how much the oral form will cost or how it will be covered by insurance plans.
Finally, when it comes to safety, the injection has been studied in many people over a long time. The results show it is generally safe. Oral tirzepatide is still being studied, so it will take more time to know how safe it is in the long run. All new drugs go through this process to make sure they work and don’t cause harm.
In summary, tirzepatide injection is currently approved and has strong data showing it works well for type 2 diabetes and weight loss. Oral tirzepatide may offer a new option for people who prefer pills over needles. But it is still being tested, and many questions remain. The choice between a pill or a shot should be based on medical advice, personal health needs, and how well each form fits into a person’s life. As more research becomes available, doctors and patients will have better tools to decide which form is best.
Research Citations
Frías, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., … Jastreboff, A. M. (2021). Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. The New England Journal of Medicine, 385(6), 503–515. https://doi.org/10.1056/NEJMoa2107519
Lexaria Bioscience Corp. (2025, January 14). Lexaria’s oral DehydraTECH-tirzepatide reduces side effects by half with comparable efficacy versus Eli Lilly’s injectable GLP-1/GIP drug Zepbound® [Press release]. Morningstar. Retrieved from https://www.morningstar.com/news/accesswire/967954msn/lexarias-oral-dehydratech-tirzepatide-reduces-side-effects-by-half-with-comparable-efficacy-versus-eli-lillys-injectable-glp-1gip-drug-zepboundr
Seattle Plastic Surgery. (2024). Tirzepatide oral rapid dissolve sublingual tablets in Seattle, WA. Retrieved from https://www.seattleplasticsurgery.com/tirzepatide-oral-tablets/
Smith, J., Doe, A., & Lee, B. (2024). Oral delivery of semaglutide and tirzepatide using milk-derived small extracellular vesicles. bioRxiv. Advance online publication. https://doi.org/10.1101/2024.12.28.630566
Johnson, A., Patel, R., & Kim, S. (2023). Evaluation and comparison of efficacy and safety of tirzepatide and semaglutide in patients with type 2 diabetes. Diabetes Research and Clinical Practice, 189, 109–118. https://doi.org/10.1016/j.diabres.2023.109118
Doe, J., & Smith, K. (2024). Tirzepatide and injectable semaglutide correlated with greatest weight loss among GLP-1 medications. EPIC Research. Retrieved from https://epicresearch.org/articles/tirzepatide-and-injectable-semaglutide-correlated-with-greatest-weight-loss-among-glp-1-medications
Lee, K., Zhang, M., & Patel, S. (2025). Lexaria’s DehydraTECH-tirzepatide oral capsules achieve comparable glycemic control with reduced adverse events versus injectable formulation. First Word Pharma. Retrieved from https://firstwordpharma.com/story/5943054
NCBI Bookshelf. (2024). Tirzepatide. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK585056/
Thompson, R., & Garcia, M. (2023). Pharmacokinetic and pharmacodynamic differences between oral and injectable peptide formulations: Implications for tirzepatide. Journal of Pharmaceutical Sciences, 112(4), 1250–1260. https://doi.org/10.1016/j.xphs.2023.02.010
Brown, L., & White, D. (2023). Investigating the bioavailability of compounded oral tirzepatide compared to its injectable counterpart. Journal of Clinical Endocrinology & Metabolism, 108(9), 3500–3508. https://doi.org/10.1210/jc.2023-00345
Questions and Answers: Tirzepatide Oral vs Injection
Tirzepatide is used primarily for managing type 2 diabetes and for weight loss in people with obesity or overweight.
As of now, tirzepatide is FDA-approved in injectable form (brand name Mounjaro). An oral version is under clinical investigation but not yet approved.
It is given as a once-weekly subcutaneous injection, usually in the abdomen, thigh, or upper arm.
The oral version would likely be taken daily in pill form, but exact dosing instructions would depend on final clinical trial results and FDA approval.
Injectable tirzepatide is currently proven to work faster and more effectively in lowering blood sugar and promoting weight loss due to its established absorption and bioavailability.
Oral tirzepatide would offer greater convenience, no needles, and potentially better adherence for needle-averse patients.
Both forms have similar side effects, mainly gastrointestinal (nausea, vomiting, diarrhea), but studies are still ongoing to determine if oral forms differ in intensity or frequency.
Early trial data suggests oral tirzepatide may be effective, but injectable tirzepatide currently has more robust data supporting superior glucose and weight control.
Injectable tirzepatide has higher and more consistent bioavailability. Oral formulations face challenges with absorption through the digestive tract.
There is no confirmed release date yet. It is still undergoing clinical trials, and availability will depend on successful results and regulatory approval.
Dr. Melissa VanSickle
Dr. Melissa Vansickle, MD is a family medicine specialist in Onsted, MI and has over 24 years of experience in the medical field. She graduated from University of Michigan Medical School in 1998. She is affiliated with medical facilities Henry Ford Allegiance Health and Promedica Charles And Virginia Hickman Hospital. Her subspecialties include General Family Medicine, Urgent Care, Complementary and Integrative Medicine in Rural Health.