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 where you are, and gives you two options to talk through with your prescriber: restart, or join at a similar position. It covers the Wegovy pill and Foundayo (orforglipron) too.
Written by Anna Bromley, Healthcount Founder · Dose ladders checked against the US labels · Last reviewed: November 2026
There is no official Zepbound to Wegovy dose conversion. The FDA labels don't publish an mg-to-mg equivalence between tirzepatide (Zepbound), semaglutide (Wegovy) or orforglipron (Foundayo), and they don't say how to switch between them. The only switches a label sets out are inside Wegovy: between the 2.4 mg injection and the 25 mg pill, and to the 1.7 mg injection for people who don't tolerate the 25 mg pill. What you can compare is each ladder. Zepbound's maintenance doses are 5, 10 or 15 mg, and Wegovy's are 1.7 or 2.4 mg. When you switch, your prescriber decides where to start. The planner below shows two options to talk through, 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
On the Zepbound ladder, 10 mg weekly sits under Later steps. On Wegovy injection, here are two options to talk through with your prescriber:
Option 1 · Restart the ladder
0.25 mg weekly
Restart the new medicine's own ladder at its starting dose and step up as its label describes. It's the slowest option, and the one each label's dose steps are written for.
Option 2 · Join at a similar position
2.4 mg weekly
A similar position on the new ladder (later steps). Where the map falls between steps, it shows the lower one. It's a place on a ladder, not an equal dose, and no label backs it up.
Zepbound ladder
Wegovy injection ladder
Read before you talk to your prescriber
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.
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 position. The groups are ours, not the labels'. Read across a row and you're comparing places on a ladder, not potency.
| Position | Zepbound (weekly) | Wegovy injection (weekly) | Wegovy tablets (daily) | Foundayo (daily) |
|---|---|---|---|---|
| Starting dose | 2.5 mg | 0.25 mg | 1.5 mg | 0.8 mg |
| Early steps | 5 mg, 7.5 mg | 0.5 mg, 1 mg, 1.7 mg | 4 mg, 9 mg | 2.5 mg, 5.5 mg |
| Later steps | 10 mg, 12.5 mg | 2.4 mg | 25 mg | 9 mg, 14.5 mg |
| Highest step | 15 mg | 7.2 mg | No step | 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: the label estimates that only about 1% to 2% of a swallowed dose reaches your blood.
This is what each label says, for adults using these medicines for weight reduction.
| Medicine | Starting dose | Maintenance dose | Maximum |
|---|---|---|---|
| Zepbound | 2.5 mg weekly, to start only | 5, 10 or 15 mg weekly (10 or 15 mg for sleep apnea) | 15 mg weekly |
| Wegovy injection | 0.25 mg weekly | 1.7 or 2.4 mg weekly (2.4 mg is the recommended one) | 7.2 mg weekly, for adults after at least 4 weeks on 2.4 mg |
| Wegovy pill | 1.5 mg daily | 25 mg daily | 25 mg daily |
| Foundayo | 0.8 mg daily | Not a term the label uses. You reach 5.5 mg, then 9, 14.5 or 17.2 mg may follow | 17.2 mg daily |
From the Zepbound (revised 08/2026), Wegovy (06/2026) and Foundayo (07/2026) labels, read November 1, 2026.
This is the anxiety behind most switching searches, and the honest answer is that nobody has settled it. The Zepbound and Wegovy labels say nothing about moving from one to the other. A paper published in October 2026 says there are no guidelines for moving from semaglutide to tirzepatide, and that switching trials are still needed.
Published opinion points both ways. A Pharmaceutical Journal article, updated in July 2026, calls restarting semaglutide at its lowest dose the safest approach after tirzepatide. That's UK advice, from an author who works as a clinical trainer for Eli Lilly. The October 2026 paper argues for an approximate matched dose when moving to tirzepatide, because always starting at the bottom can leave a gap in treatment. That's one group's opinion, not a regulator's chart.
Direction matters too. In SURMOUNT-5, the head-to-head trial, people on the highest tirzepatide dose they could tolerate (10 or 15 mg) lost about 20% of their body weight on average at 72 weeks. People on the highest semaglutide dose they could tolerate (1.7 or 2.4 mg) lost about 14%. So moving from Wegovy to Zepbound may feel like a step up, and moving from Zepbound to Wegovy may feel like a step down. Those are group averages, not a prediction for you.
Timing is another gap. The labels don't say how long to leave between the two, but each one says using it with another GLP-1 medicine isn't recommended. Tirzepatide has a half-life of about 5 days and semaglutide about a week, so the old medicine is still in your body when the next one would start. Ask your prescriber when to take your first dose.
That's why the planner always shows two answers. Restarting is the route each label's dose steps are written for. The other option lines up positions on two ladders, and no label backs it up. The gap between them is the conversation to have at your next appointment.
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 mg numbers can look alarming across routes, and that is normal. With the Wegovy pill, the bigger number on the box doesn't mean a stronger dose. It mostly means less of it gets absorbed.
Three reasons come up over and over: price, side effects and coverage. Self-pay prices move often and differ 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.
There is no official equivalent, and the mg numbers can't be compared directly because tirzepatide (Zepbound) is a different molecule. Here's what the labels do say: 2.4 mg is Wegovy's recommended maintenance dose, and Zepbound's maintenance doses are 5, 10 or 15 mg. Neither label says which Zepbound dose follows Wegovy 2.4 mg, so that's your prescriber's call.
Nobody can say for you, and we couldn't find a trial that followed people through this switch. In SURMOUNT-5, the head-to-head trial, people on tirzepatide lost more weight on average than people on semaglutide: about 20% of body weight against about 14% at 72 weeks, at the highest doses they could tolerate. So some people may notice their appetite coming back after this switch. That isn't a failure. Tell your prescriber how it's going.
No official chart exists in either direction. The closest thing is a position map: Wegovy 0.25 mg sits opposite Zepbound 2.5 mg (both are starting doses), Wegovy 0.5 to 1.7 mg sits opposite 5 and 7.5 mg, and 2.4 mg sits opposite 10 mg. That's a map of places on two ladders, not equal doses. Tirzepatide came out stronger in the head-to-head trial, so your prescriber may choose a lower step than the map shows.
The labels don't say. Neither Zepbound's nor Wegovy's covers a switch from the other, and published opinion differs: a 2026 UK pharmacy article suggests restarting semaglutide at its lowest dose, and a 2026 expert paper prefers an approximate matched dose when moving to tirzepatide. Your prescriber decides. The planner shows both options so you can have that conversation properly.
No trial has compared them head to head. In OASIS 4, people on the 25 mg tablet lost about 14% of their body weight at 64 weeks, against about 2% on placebo. In STEP 1, people on the 2.4 mg injection lost about 15% at 68 weeks, against about 2% on placebo. Those are separate trials, so the numbers can't be set exactly side by side. The FDA approved the Wegovy pill in December 2025. The mg numbers aren't comparable between routes: the label estimates that only about 1% to 2% of a swallowed tablet is absorbed, which is why the pill's numbers run so much higher.
That's for your prescriber, and no label sets it out. It's two changes at once: a different molecule (tirzepatide to semaglutide) and a different routine (a weekly injection to a daily tablet with strict morning rules: empty stomach, up to 4 ounces of plain water, then a 30-minute wait). Your prescriber sets the dose and when the first tablet follows your last injection, since tirzepatide has a half-life of about 5 days and stays in your body for weeks.
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. Its label doesn't set out a switch from Zepbound or Wegovy, so ladder position is the only comparison this page makes. One published trial, ATTAIN-MAINTAIN, moved people from tirzepatide or semaglutide onto orforglipron, but it doesn't give a dose conversion.
Because there is nothing exact to put in one. Semaglutide, tirzepatide and orforglipron are different molecules, tablets and injections absorb differently, and the FDA labels don't publish conversions between them. In October 2026 one group of authors proposed approximate bands, and they say themselves that switching trials are still needed. Any tidy mg-to-mg chart you see online is somebody's estimate. This page maps ladder positions instead, and says so plainly.
The dose ladders come straight from the official US prescribing information, and the trial figures from the published papers. All were read on November 1, 2026:
Appetite and side effects can change around a switch. Healthcount is a free food journal that keeps your doses, what you ate and how you felt in one place, so you have something real to show your prescriber. Numbers are optional.
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