Setmelanotide vs Tirzepatide
A detailed comparison to help you understand the differences and choose the right peptide for your research goals.
Setmelanotide
Setmelanotide (Imcivree) is an FDA-approved MC4R agonist for chronic weight management in patients with obesity due to specific genetic conditions (POMC, PCSK1, or LEPR deficiency).
Full details →Tirzepatide
Tirzepatide is a first-in-class dual GIP/GLP-1 receptor agonist. FDA-approved as Mounjaro (diabetes) and Zepbound (weight loss), it has shown superior weight loss results compared to semaglutide in clinical trials.
Full details →Side-by-Side Comparison
| Aspect | Setmelanotide | Tirzepatide |
|---|---|---|
| Mechanism | Selective agonist of melanocortin 4 receptors (MC4R) in the hypothalamus, restoring the satiety signaling pathway that is disrupted in certain genetic obesity syndromes. | Activates both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptors, providing synergistic effects on insulin secretion, appetite suppression, and metabolic regulation. The dual mechanism may explain its enhanced efficacy. |
| Typical Dosage | Adults: Start 2mg daily, titrate based on tolerability up to 3mg daily. Pediatrics (6+): Weight-based dosing starting at 1mg daily. | Start at 2.5mg weekly, titrate every 4 weeks through 5mg, 7.5mg, 10mg, 12.5mg, to maximum 15mg weekly. Full titration takes approximately 20 weeks. |
| Administration | Subcutaneous injection once daily. Requires genetic testing to confirm eligible mutations before prescribing. | Subcutaneous injection once weekly. Rotate injection sites. Slower titration may help reduce GI side effects. |
| Side Effects | Injection site reactions, skin hyperpigmentation, spontaneous penile erections, depression, and suicidal ideation (boxed warning). GI effects less common than GLP-1s. | Similar to semaglutide: nausea, diarrhea, vomiting, constipation, abdominal pain, decreased appetite. Generally improve with continued use. |
| Best For |
What They Have in Common
Both Setmelanotide and Tirzepatide are commonly used for: