Peptide Comparison
LixisenatidevsSemaglutide
Short-acting prandial GLP-1 receptor agonist for postprandial glucose control
The revolutionary once-weekly GLP-1 medication that helps your body feel full faster and longer, leading to significant weight loss while also protecting your heart—FDA approved and backed by some of the largest clinical trials in obesity medicine history.
At a Glance
Quick
comparison
Dose Range
Lixisenatide
10 mcg–20 mcg mcg
Semaglutide
0.25–2.4 mg
Frequency
Lixisenatide
Once daily
Semaglutide
Once weekly
Administration
Lixisenatide
subcutaneous injection
Semaglutide
Subcutaneous injection
Cycle Length
Lixisenatide
Ongoing/indefinite
Semaglutide
Ongoing/indefinite
Onset Speed
Lixisenatide
Moderate (1-2 weeks)
Semaglutide
Moderate (1-2 weeks)
Evidence Level
Lixisenatide
Strong human trials (Phase 3 or FDA approved)
Semaglutide
Strong human trials (Phase 3 or FDA approved)
Efficacy
Benefit
ratings
Blood Sugar Control
Cardiovascular Safety
Weight Management
Weight Loss
Appetite Control
Heart Protection
Technical Data
Compound
specifications
Lixisenatide
Molecular Formula
C215H347N61O65S
Molecular Weight
4,858 Da
Half-Life
2.8-3 hours
Bioavailability
55% subcutaneous bioavailability
CAS Number
320367-13-3
Semaglutide
Molecular Formula
C187H291N45O59
Molecular Weight
4113.58 g/mol
Half-Life
Approximately 7 days (168 hours)
Bioavailability
89% (subcutaneous); 0.4-1% (oral, with absorption enhancer)
CAS Number
910463-68-2
Protocols
Dosing
tiers
Lixisenatide
Semaglutide
Applications
Best
suited for
Lixisenatide
Managing postprandial hyperglycemia in type 2 diabetes
Lixisenatide is particularly well-suited for individuals focused on managing postprandial hyperglycemia in type 2 diabetes. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Improving glycemic control as add-on to oral antidiabetics
Lixisenatide is particularly well-suited for individuals focused on improving glycemic control as add-on to oral antidiabetics. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Supporting weight management in T2DM patients
Lixisenatide is particularly well-suited for individuals focused on supporting weight management in t2dm patients. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Combination therapy with basal insulin glargine
Lixisenatide is particularly well-suited for individuals focused on combination therapy with basal insulin glargine. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Semaglutide
People with Obesity Seeking Significant Weight Loss
If your BMI is 30 or higher (or 27+ with weight-related health conditions), semaglutide is currently one of the most effective non-surgical weight loss options available. Clinical trials show average weight loss of 15% of body weight—that's 30+ pounds for someone starting at 200 pounds.
Those Who've Struggled with Diet and Exercise Alone
Semaglutide works by changing the biological signals that drive hunger and cravings. If you've tried to lose weight through willpower alone and found yourself constantly battling hunger, this medication addresses that underlying biology rather than just telling you to eat less.
People with Type 2 Diabetes Needing Better Control
Originally developed for diabetes, semaglutide excellently controls blood sugar while also promoting weight loss—addressing two major health concerns simultaneously. It can often allow people to reduce or eliminate other diabetes medications.
Individuals at High Cardiovascular Risk
The SELECT trial proved that semaglutide reduces heart attacks, strokes, and cardiovascular death by 20% in people with obesity and existing heart disease—even without diabetes. It's one of the few weight loss medications proven to improve hard cardiovascular outcomes.
Safety Profile
Side
effects
Lixisenatide
Common
- Nausea
- Vomiting
- Diarrhea
- Headache
Uncommon
- Injection Site Reactions
Serious
- Acute Pancreatitis
Semaglutide
Common
- Nausea
- Constipation or Diarrhea
- Decreased Appetite
- Vomiting
Uncommon
- Gallbladder Problems
- Hair Loss (Telogen Effluvium)
Serious
- Pancreatitis
- Thyroid Tumors (Theoretical Risk)
Research Status
Safety
& evidence
Lixisenatide
Evidence Level
Strong human trials (Phase 3 or FDA approved)
FDA Status
FDA approved for this use
Safety Overview
Lixisenatide (Lyxumia, Adlyxin) is an FDA and EMA-approved GLP-1 receptor agonist with safety data from Phase 3 trials (LEAD program, 2012-2013) involving 4,000+ patients with type 2 diabetes. Gastrointestinal side effects (nausea, vomiting) are most common during dose escalation (30-40% of patients) but typically resolve after 2-3 weeks of stable dosing. The short half-life (3 hours) compared to longer-acting GLP-1 agonists means side effects have rapid onset and offset. No serious adverse events exceed background diabetes population rates in pivotal trials.
Contraindications
- xKnown hypersensitivity to lixisenatide or excipients
- xPersonal or family history of medullary thyroid carcinoma
- xPatients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- xSevere gastrointestinal disease including gastroparesis
Semaglutide
Evidence Level
Strong human trials (Phase 3 or FDA approved)
FDA Status
FDA approved for this use
Safety Overview
Semaglutide has been studied in over 20,000 participants across multiple large clinical trials, making it one of the most thoroughly researched weight loss medications available. The FDA approved it after rigorous review of safety data. While GI side effects are common (especially early on), serious side effects are rare. The SELECT trial showed it actually reduces cardiovascular events, adding a safety benefit beyond just weight loss.
Contraindications
- xPersonal or family history of medullary thyroid carcinoma (MTC)
- xMultiple Endocrine Neoplasia syndrome type 2 (MEN2)
- xHistory of serious allergic reaction to semaglutide
- xCurrent or recent pancreatitis
- xPregnancy or planning to become pregnant
Decision Guide
Which is
right for you?
Choose Lixisenatide if...
- Managing postprandial hyperglycemia in type 2 diabetes
- Improving glycemic control as add-on to oral antidiabetics
- Supporting weight management in T2DM patients
- Combination therapy with basal insulin glargine
Choose Semaglutide if...
- Significant weight loss
- Long-term weight management
- Cardiovascular risk reduction
- Blood sugar control