Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Head-to-head comparison of Semaglutide and Tesofensine — mechanism, side effects, legal status, and pricing.
Semaglutide is an FDA-approved GLP-1 receptor agonist marketed as Ozempic (SubQ, type 2 diabetes), Wegovy (SubQ, chronic weight management and cardiovascular risk reduction in obesity), and Rybelsus (oral, type 2 diabetes). It is a synthetic analog of native GLP-1 with a fatty-acid (C18 diacid) side chain that enables albumin binding, giving it a ~165-hour half-life suitable for once-weekly injection.
Tesofensine is a small-molecule triple monoamine reuptake inhibitor (serotonin, norepinephrine, dopamine) — NOT a peptide. Originally developed by NeuroSearch for Parkinson's and Alzheimer's disease (which it failed to benefit) and repositioned for obesity by Saniona. Not FDA-approved in the US.
Semaglutide
Tesofensine
Category
Legal Status
Mechanism
Half-life
Side Effects
COA-verified vendors · trust score ≥70 required · single-vial price — bulk/bundle deals may be lower
Semaglutide
Tesofensine
COA corpus from Disclosed Labs — independently tested batches only.
Semaglutide
128
COAs
99.6%
Avg purity
13
Labs
Tesofensine
15
COAs
99.4%
Avg purity
6
Labs
The STEP program (STEP 1–8) showed average weight loss of roughly 15% of body weight over 68 weeks with weekly 2.4 mg semaglutide (STEP 1: Wilding et al., NEJM 2021, PMID 33567185). The SUSTAIN program established A1c and cardiovascular benefit in type 2 diabetes. The PIONEER program established efficacy of oral semaglutide (Rybelsus) versus placebo, sitagliptin, empagliflozin, and liraglutide (PIONEER 4, PMID 31186120). The SELECT trial (Lincoff et al., NEJM 2023, PMID 37952131) showed a 20% relative reduction in major adverse cardiovascular events in adults with overweight/obesity and established cardiovascular disease but without diabetes, leading to an expanded Wegovy indication.
Pivotal Phase 2 (Astrup et al., Lancet 2008, n=203, 24 weeks, Denmark) showed placebo-subtracted weight loss of 4.5%, 9.2%, and 10.6% at 0.25, 0.5, and 1.0 mg/day — roughly twice orlistat at 0.5 mg. (The Lancet issued an expression of concern about that trial in 2013.) Saniona's Mexico partner Medix ran a Phase 3 registration study that met its primary endpoint; Medix filed with COFEPRIS in May 2023 with supplemental data submitted in 2024. As of April 2026 a final Mexican approval decision is still pending — the commonly repeated '2022 Mexico approval' claim is inaccurate. Tesomet (tesofensine + metoprolol, intended to blunt cardiovascular signal) is in development for hypothalamic obesity and Prader-Willi syndrome.
Semaglutide and Tesofensine are both in the Metabolic category and may have overlapping mechanisms. Researchers should review both profiles carefully, understand the mechanisms of action, and monitor the relevant biomarkers when combining compounds in the same class. As always, consult a licensed healthcare provider before making any decisions about combining research compounds.
This platform provides informational tools only, not medical advice. This comparison is for educational purposes only. Consult a licensed provider.
Contraindications
Lab Testing
Disclosed Labs