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Zepbound to Wegovy dose conversionthe switching map, worked out honestly

Here is the thing nobody selling you a neat conversion chart will say: there isn't one. No regulator publishes an equivalence between Zepbound and Wegovy, in either direction, injection or pill. What does exist is each medicine's published dose ladder. This planner lines those ladders up, shows which stage you're on, and gives you the two options a prescriber actually weighs: restart, or join at the same stage. It covers the Wegovy pill and Foundayo (orforglipron) too.

Dose ladders from the official US labels. Works in every direction between the four medicines.

The short answer

There is no official Zepbound to Wegovy dose conversion. The FDA labels do not publish an mg-to-mg equivalence between tirzepatide (Zepbound), semaglutide (Wegovy) or orforglipron (Foundayo). The closest safe comparison is ladder position: Zepbound 10 mg, the Wegovy 2.4 mg injection, the 25 mg Wegovy pill and Foundayo 9 mg are all maintenance-stage doses. When you switch, a prescriber chooses between restarting the new medicine's ladder at its starting dose or joining it at your current stage. The planner below shows both options for any dose, in any direction.

A dose ladder is the fixed sequence of doses a medicine's label sets out, from starting dose through titration to maintenance.

This is arithmetic on published dose ladders, not medical advice. There is no official conversion between these medicines, and this planner does not invent one. It lines the ladders up so you can see the shape of a switch. Your prescriber decides the actual dose and timing.

I currently take

My current dose

Switching to

10 mg weekly is the maintenance stage of the Zepbound ladder. On Wegovy injection, a prescriber would usually be weighing up two places to land:

Option 1 · Restart the ladder

0.25 mg weekly

Restart the new medicine's own ladder at its starting dose and titrate up as its label describes. The slowest, gentlest option, and the only one some labels formally cover.

Option 2 · Join at the same stage

2.4 mg weekly

Join the new ladder at the maintenance stage, the position closest to where you are now. Where the map falls between steps, it shows the lower one.

Zepbound ladder

  1. 2.5 mg weeklyStarting dose
  2. 5 mg weeklyTitration
  3. 7.5 mg weeklyTitration
  4. 10 mg weeklyMaintenanceYou are here
  5. 12.5 mg weeklyMaintenance
  6. 15 mg weeklyHigher maintenance

Wegovy injection ladder

  1. 0.25 mg weeklyStarting doseRestart
  2. 0.5 mg weeklyTitration
  3. 1 mg weeklyTitration
  4. 1.7 mg weeklyTitration
  5. 2.4 mg weeklyMaintenanceSame stage
  6. 7.2 mg weeklyHigher maintenance

Read before you talk to your prescriber

  • No regulator publishes a conversion between these medicines. These options line up positions on the two published dose ladders, nothing more. They are not equivalent doses.
  • Your prescriber makes the actual switching decision: which step to start on, whether to retitrate from the bottom, and how to time the changeover.
  • Semaglutide and tirzepatide are different molecules. Tirzepatide works on two gut hormones (GIP and GLP-1), so there is no true mg-for-mg equivalence between them, only positions on each ladder.
  • In trials (SURMOUNT vs STEP), tirzepatide produced more average weight loss than semaglutide, so an aligned step can feel like a step down in effect. Some appetite returning over the first few weeks is expected, not failure.
What about taking two forms at once?â–¾

You will see people online combining forms: tablets alongside a reduced injection dose, or tablets bridging a supply gap between injections. The usual reasons are price, availability and side effects.

This planner deliberately does not add doses across two forms. The mg scales are not comparable, so a combined total is exactly where home-made arithmetic gets dangerous. If combining forms is on your mind, take the question to your prescriber; that conversation is the whole plan, not a footnote to it.

The conversion chart, done properly

If you came here searching for a Zepbound to Wegovy conversion chart, this is the honest version: all four US ladders side by side, grouped by stage. Read across a row and you're comparing positions, not potency. The milligrams don't translate; the stages roughly do.

Zepbound, Wegovy injection, Wegovy pill and Foundayo dose ladders grouped by stage
StageZepbound (weekly)Wegovy injection (weekly)Wegovy tablets (daily)Foundayo (daily)
Starting dose2.5 mg0.25 mg1.5 mg0.8 mg
Titration5 mg, 7.5 mg0.5 mg, 1 mg, 1.7 mg4 mg, 9 mg2.5 mg, 5.5 mg
Maintenance10 mg, 12.5 mg2.4 mg25 mg9 mg, 14.5 mg
Higher maintenance15 mg7.2 mg—17.2 mg

Why can't the milligrams translate? Tirzepatide (Zepbound) is a dual-hormone molecule with no mg-for-mg relationship to semaglutide (Wegovy), orforglipron (Foundayo) is a third molecule again, and the Wegovy pill's numbers are inflated by absorption: only around 1% of a swallowed dose reaches your blood.

Do you really restart from the bottom?

This is the anxiety behind most switching searches, and the answer is: usually not, but sometimes yes. In practice, prescribers tend to start a switcher at the nearest step their body is likely to tolerate rather than the full beginner dose. Someone on 2.4 mg Wegovy rarely goes back to a 2.5 mg Zepbound starting dose for four months of climbing; equally, they rarely jump straight to a top step of a molecule their body has never met.

The direction matters too. Moving from Wegovy to Zepbound is usually a step up in effect, so prescribers lean cautious and pick a lower step than the stage map suggests. Moving from Zepbound to Wegovy is the opposite: even the aligned step may feel weaker, and the first few weeks can bring appetite back. Neither is a reason to panic. It is a reason to plan the switch with the person prescribing it.

That's why the planner always shows two answers. The conservative restart is the option every label covers. The stage-aligned step is where many switchers actually land. The gap between them is the conversation to have at your next appointment.

Switching from an injection to a pill

A lot of 2026 switching questions are really route questions, because the US now has two daily GLP-1 pills alongside the weekly injections. They are not interchangeable with each other, and they behave differently:

  • The Wegovy pill is oral semaglutide, the same molecule as the Wegovy injection, at 25 mg matching the 2.4 mg injection on trial outcomes. It comes with strict morning rules: empty stomach, no more than 120 mL of plain water, then at least 30 minutes before food, other drinks or other oral medicines.
  • Foundayo (orforglipron) is a different, non-peptide molecule with its own ladder and no food or water rules. No switching studies against Zepbound or Wegovy have been published, so any move onto it is a fresh clinical decision, not a conversion.
  • Whichever pill is involved, weekly becomes daily, and the changeover needs timing: a weekly injection keeps working for weeks after the last dose. Your prescriber will tell you when the first tablet goes in; don't guess.

The mg numbers will look alarming across routes, and that is normal. A bigger number on a pill box does not mean a stronger dose; it mostly means less of it gets absorbed.

Why people switch at all

Three reasons come up over and over: price, side effects and coverage. Self-pay prices move often and differ by hundreds of dollars a month between medicines, which is why we keep a verified comparison on the GLP-1 price table. Side effects are personal: some stomachs simply get on better with one molecule than the other. And insurance is its own weather system; a formulary change can force a switch overnight, whatever your weight trend was doing.

Questions people actually ask

What is Wegovy 2.4 equivalent to on Zepbound?

There is no official equivalent, and the mg numbers can't be compared directly because tirzepatide (Zepbound) is a different molecule. What you can say: 2.4 mg is Wegovy's standard maintenance dose, and Zepbound's ladder reaches its maintenance steps at 10 mg. Trials suggest tirzepatide is the stronger of the two step for step, so prescribers often start switchers lower, commonly at 5 mg, and titrate from there.

Will I gain weight switching from Zepbound to Wegovy?

Some people do notice appetite returning, because on trial averages tirzepatide outperformed semaglutide: roughly 21% of body weight in SURMOUNT-1 (2022) against 15% in STEP 1 (2021) at top doses. Moving to Wegovy at the matched stage can feel like a step down in effect for a few weeks. That is expected, not failure, and plenty of people hold their weight fine on Wegovy. Tracking your weight trend through the switch tells you quickly whether the new dose is holding.

What is the dosage chart for switching from Wegovy to Zepbound?

No official chart exists in either direction, so the honest version is a stage map: Wegovy 0.25 mg sits opposite Zepbound 2.5 mg (both starting doses), the 0.5 to 1.7 mg titration steps sit opposite 5 and 7.5 mg, and the 2.4 mg maintenance dose sits opposite 10 mg. Because tirzepatide is the stronger molecule step for step, many prescribers pick one step below the aligned position when moving this way.

Do I have to restart titration when I switch?

Not always from the very bottom. Prescribers usually start a switcher at the nearest tolerated step rather than the full beginner dose, but the labels differ by drug and by direction, and some prefer a full restart to protect your stomach. The planner shows both options so you can have that conversation properly.

Is the Wegovy pill as effective as the injection?

At the top dose, yes on trial outcomes. In OASIS 4, the 25 mg oral semaglutide tablet produced about 14% weight loss at 64 weeks, comparable to the 2.4 mg weekly injection. The FDA approved the Wegovy pill in December 2025. The mg numbers are not comparable between routes, though: only around 1% of a swallowed tablet is absorbed, which is why the pill's numbers run so much higher.

Can I switch from Zepbound to the Wegovy pill?

Clinically it is a switch prescribers do make, but it is two changes at once: a different molecule (tirzepatide to semaglutide) and a different routine (weekly injection to a daily tablet with strict morning rules: empty stomach, up to 120 mL of plain water, then a 30-minute wait). Your prescriber sets the landing dose and when the first tablet follows your last injection, since the old dose keeps tapering out of your body for weeks.

Where does Foundayo (orforglipron) fit on the ladder?

Foundayo is a once-daily non-peptide GLP-1 pill, FDA-approved in April 2026, with its own six-step ladder from 0.8 mg to 17.2 mg and no food or water timing rules. There are no published switching studies between it and Zepbound or Wegovy, so ladder stage is the only honest comparison, and that is exactly how the planner places it.

Why is there no official conversion chart?

Because there is nothing exact to put in one. Semaglutide, tirzepatide and orforglipron are different molecules, tablets and injections absorb differently, and bioavailability varies from person to person. The FDA labels don't publish conversions between them, so any tidy mg-to-mg chart you see online is somebody's estimate. This page maps ladder stages instead, and says so plainly.

Sources

The dose ladders come straight from the official US prescribing information, and the trial figures from the published papers:

Switching is when tracking earns its keep

The weeks around a switch are exactly when appetite, side effects and weight wobble. Healthcount logs your dose, food and weight in one place and shows the trend line through the change, so you and your prescriber are looking at data, not guesswork.

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Keep reading

The Wegovy pill, explained

Oral semaglutide 25 mg: the morning rules, the trials and the cost.

Foundayo (orforglipron) approved

What the first non-peptide GLP-1 pill is and how its ladder works.

Zepbound units calculator

Convert units, mL and mg for US pens and vials.

Zepbound tracker

Doses, weight and food in one calm dashboard.