Key Takeaways
- Tirzepatide acts on two appetite signals, GIP and GLP-1, and may help reduce hunger and cravings.
- LIV offers tirzepatide in two forms: an injection, and an oral prescription a licensed pharmacy compounds for you to take by mouth.
- Which form fits you depends on your routine, your preferences and your health history, which your provider reviews with you.
- Whichever form you use, your provider reviews your progress before each refill.
Some people are ready to work on their weight but would rather not give themselves an injection. If that sounds like you, an oral option might be right for you. LIV offers tirzepatide both as an injection and as a prescription you take by mouth.
How Do Tirzepatide Pills and Injections Compare?
Either way, a licensed provider writes your prescription and reviews your progress before every refill. The main difference is how you take it.
Tirzepatide injection: Tirzepatide given under the skin. LIV offers it as Zepbound or as a compounded injection mixed for you by a licensed pharmacy.
Oral tirzepatide: Tirzepatide you take by mouth, compounded for you by a licensed pharmacy to your prescription.
| Tirzepatide injection | Oral tirzepatide | |
|---|---|---|
| How you take it | An injection under the skin | By mouth |
| Your dose and schedule | Set by your provider | Set by your provider |
| Instructions | Included with your prescription | Included with your prescription |
| Weight-loss research | Large studies of tirzepatide injections | Ask your provider what's known about the oral form |
| Provider review | Before every refill | Before every refill |
How Can Tirzepatide Help With Hunger?
It works on two of your body's appetite signals, GIP and GLP-1. The label for approved tirzepatide injections says it selectively binds to and activates both receptors. It also reduces calorie intake, likely through its effects on appetite.
In a six-week study of adults who were overweight or living with obesity, tirzepatide reduced hunger before meals and food cravings.
That can make it easier to get started. In a national survey of US adults living with obesity, 49% agreed that controlling hunger was a barrier to starting a weight-loss effort. Tell your provider which part of hunger is hardest for you, so your plan can be built around it.
What Tirzepatide Injections Have Shown
In a 72-week trial, adults lost an average of 20.9% of their starting weight with tirzepatide injections. More than 9 in 10 lost at least 5%. In a large real-world study, people still taking approved tirzepatide injections lost an average of 5.9% of their starting weight at 3 months, 10.1% at 6 months and 15.3% at 12 months.
These results are from injections, not the oral form, and no two people respond in quite the same way. Your provider reviews your progress with you along the way.
How Is Taking It by Mouth Different?
Tirzepatide is a peptide, and your stomach breaks down peptides much like the protein in your food. That's why medicines like it started as injections, and why a pill's instructions matter.
Semaglutide, another GLP-1 medicine, shows the difference. Its label reports how much of a dose reaches your bloodstream: 89 percent of a dose injected under the skin, and roughly 1 to 2 percent of a tablet. Approved semaglutide tablets use an absorption enhancer, a much larger dose and strict instructions: an empty stomach, a limited amount of water and a wait before anything else.
Those figures are for semaglutide, not tirzepatide. For oral tirzepatide, follow the instructions that come with your prescription, and ask your provider about anything that's unclear.
WHY A PILL IS HARDER
Your stomach breaks down peptides.
For semaglutide, 89% of a dose injected under the skin reaches your bloodstream. Roughly 1 to 2% of a tablet does.
| Tirzepatide | Semaglutide | |
|---|---|---|
| Receptors | GIP and GLP-1 | GLP-1 |
| Approved injection | Yes | Yes |
| Approved tablet | None approved | Yes, on their own separate labels |
Approval attaches to a product, not to a molecule.
Would a Pill Be Easier to Live With?
It may be. If needles are the hard part for you, you take your prescription by mouth instead of giving yourself an injection.
With an injection, you give yourself a shot and choose where each time, and the injection-site guide covers how. With a pill, you follow its instructions every time you take it.
Think about which one you're more likely to stick with on a busy week, and tell your provider. What you prefer matters.
What Your Provider Weighs With You
A licensed provider starts by learning about you: your health history, the medicines you take and your required labs. From there, they decide whether tirzepatide is right for you, and work out with you which form fits.
If it is, your provider chooses your dose and how much to prescribe. Before each refill, you tell LIV how you're doing, and your provider reviews your progress and adjusts your plan as needed. You can change your plan, skip a shipment or cancel from your account, and your care team is available between refills.
Side Effects and Safety Notes
The side effects most often listed on the Zepbound label involve the stomach: nausea, diarrhea, vomiting, constipation, abdominal pain and indigestion. Your refill check-ins are a good time to mention any of them.
Whichever form you're considering, your provider will ask about:
- Thyroid history: a personal or family history of medullary thyroid cancer or MEN 2.
- Past conditions: pancreatitis, gallbladder disease or kidney problems.
- Other medicines: especially diabetes medicines that can lower blood sugar.
- Allergies: any serious allergic reaction to a medicine.
Let your provider know right away about severe or lasting stomach pain, ongoing vomiting or signs of dehydration. Report a lump in your neck, trouble swallowing or breathing, or hoarseness that doesn't go away.
Choosing the Form That Fits You
Bring your questions about hunger, needles, pills and your daily routine. Your provider will walk you through both forms and how your progress will be reviewed. The compounded tirzepatide guide explains how a compounded prescription is prepared, and an evaluation is the next step.
Frequently Asked Questions
Is there an FDA-approved oral tirzepatide?
The FDA-approved tirzepatide products, including Zepbound, are injections. LIV's oral tirzepatide is compounded: a licensed pharmacy mixes it for you to your prescription. Compounded medicines aren't FDA-approved, and the FDA doesn't review their safety, effectiveness or quality before they're marketed. If an approved injection is what you're after, your provider can talk with you about Zepbound.
How much of the oral form does the body take up?
The approved tirzepatide labels describe injections, so they don't establish how much tirzepatide your body takes up from an oral prescription. Ask your provider what is known about the oral form and how it fits your plan.
Where do the weight-loss figures come from?
The 20.9% and 91% figures come from SURMOUNT-1 (Jastreboff et al., NEJM, 2022), a trial of 2,539 adults living with obesity, or overweight with a weight-related complication, who didn't have diabetes. Both describe the 15 mg once-weekly injection group at 72 weeks, including dose increases, with lifestyle support; on placebo, the average loss was 3.1% and 35% lost at least 5%. They're treatment-regimen estimates, counting people whether or not they stopped treatment. The 91% is a share of participants, not an average loss.
The 3, 6 and 12 month figures come from a real-world observational study of 18,386 matched adults receiving an approved tirzepatide or semaglutide injection (Rodriguez et al., JAMA Internal Medicine, 2024); 52% had type 2 diabetes. They describe people still on treatment, and each timepoint is a separate estimate that shouldn't be added to the others. The tirzepatide injection studied is approved for type 2 diabetes, so its use for weight management was off-label. Both studies tested tirzepatide injections, not oral tirzepatide or a compounded preparation, and individual results vary. Doses weren't verified, more than half of people stopped treatment during follow-up (52.5% of those on semaglutide and 55.9% on tirzepatide), and missing weights were estimated statistically.
What did studies find about hunger?
In a six-week study, adults who were overweight or living with obesity and took tirzepatide reported less hunger before meals and fewer food cravings than those taking a placebo. The study didn't test an oral or compounded preparation, and results vary, so your provider will check in on how you're doing.
Are oral GLP-1 medicines approved at all?
Yes, for semaglutide. Semaglutide tablets have been approved since 2019 for blood sugar control in type 2 diabetes, and a tablet approved in December 2025 is indicated for weight reduction and cardiovascular risk reduction in adults. Semaglutide is a different molecule from tirzepatide, with its own label and its own studies.
What does the boxed warning on Zepbound say?
The Zepbound label carries a boxed warning about thyroid C-cell tumors. Tirzepatide caused these tumors in rats; it isn't known whether it does in people, including medullary thyroid cancer. Zepbound isn't for anyone with a personal or family history of medullary thyroid cancer or MEN 2, or a serious allergy to tirzepatide.
There's no approved oral tirzepatide product, so this injected-tirzepatide label is the reviewed source for tirzepatide's warnings. Discuss them with your provider whichever form you're considering. The label notes that routine blood tests (calcitonin) or thyroid ultrasound are of uncertain value for catching these tumors early, so tell your provider about a lump in your neck, trouble swallowing, shortness of breath or hoarseness that doesn't go away. Separately from the boxed warning, in the label's weight-management trials, 25% to 29% of adults taking it reported nausea, compared with 8% on placebo.
References
Eli Lilly and Company. (2026). Mounjaro (tirzepatide) injection, for subcutaneous use: Prescribing information (revised 4/2026). DailyMed, U.S. National Library of Medicine. Read 2026-08-20. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
Eli Lilly and Company. (2026). Zepbound (tirzepatide) injection, for subcutaneous use: Prescribing information (revised 4/2026). DailyMed, U.S. National Library of Medicine. Clinical Pharmacology, Boxed Warning, Contraindications and Adverse Reactions. Read 2026-08-20 and September 11, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., et al. (2022). Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, 387(3), 205-216. https://pubmed.ncbi.nlm.nih.gov/35658024/
Kaplan, L. M., Golden, A., Jinnett, K., Kolotkin, R. L., Kyle, T. K., Look, M., et al. (2018). Perceptions of barriers to effective obesity care: Results from the National ACTION Study. Obesity, 26(1), 61-69. https://pubmed.ncbi.nlm.nih.gov/29086529/
Novo Nordisk Pharmaceutical Industries, LP. (2026). Rybelsus and Ozempic (semaglutide) tablets: Prescribing information (revised 1/2026). DailyMed, U.S. National Library of Medicine. Read 2026-08-20. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=27f15fac-7d98-4114-a2ec-92494a91da98
Novo Nordisk Pharmaceutical Industries, LP. (2026). Wegovy (semaglutide) injection and tablets: Prescribing information (revised 6/2026). DailyMed, U.S. National Library of Medicine. Read 2026-08-20. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
Rodriguez, P. J., Goodwin Cartwright, B. M., Gratzl, S., et al. (2024). Semaglutide vs tirzepatide for weight loss in adults with overweight or obesity. JAMA Internal Medicine, 184(9), 1056-1064. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080
Tirzepatide on ingestive behavior in adults with overweight or obesity: A randomized 6-week phase 1 trial. (2025). Nature Medicine. doi:10.1038/s41591-025-03774-9. https://www.nature.com/articles/s41591-025-03774-9
U.S. Food and Drug Administration. (n.d.). Compounding and the FDA: Questions and answers. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
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