Comparing GLP-1 medicines available in the UK

Overview

Several incretin medicines are licensed in the UK, and they differ in dosing frequency, average weight loss and cost. For kidney patients the deciding factors are tolerability, hydration risk and monitoring burden.

Why it's done and who it helps

• Tirzepatide (Mounjaro): weekly, dual agonist, largest average weight loss.
• Semaglutide (Wegovy): weekly, two-year NICE limit under TA875.
• Liraglutide (Saxenda): daily injection, smaller average effect.
• Oral semaglutide: tablet form, strict fasting administration rules.

Why cost matters

These are private prescriptions supplied by Healist Pharmacy; the monthly cost differs meaningfully between agents and doses and should be part of the decision.

Tolerability trade-offs

Daily injections allow finer titration but more injections; weekly agents are simpler but a bad week lasts longer.

Kidney-specific choice

There is no absolute renal contraindication that separates these agents, so the choice is driven by side-effect profile, diabetes status and your ability to maintain hydration.

Preparing for your appointment

Which one is right for me?

That is decided at your face-to-face consultation after review of your kidney function and history.

Can I change agent later?

Yes, and switching restarts a lower escalation step.

When to contact your care team

Contact the clinic promptly if you have any of the following:

• Vomiting or diarrhoea lasting more than 24 hours, or you cannot keep fluids down
• Passing much less urine than usual, or new swelling of the legs or face
• Severe pain in the upper abdomen that spreads to your back, with or without vomiting
• A weight change of more than 2 kg in a week that is not explained by fluid
• A missed weekly weight, a missed dose, or any hospital admission

If you are seriously unwell, contact NHS 111 or your renal unit directly rather than waiting for your next review.

Your care at KidneyWeight Clinic

Every dose change, weekly weight and kidney blood test is recorded in your clinical monitoring record, reviewed by Professor Mohammed Mahdi Althaf at six-weekly intervals and formally reassessed at 26 weeks. Booking and your initial payment are handled by professoralthaf.co.uk, medication supply by Healist Pharmacy, and follow-up appointment payments by Carebit.

References

• NICE TA1026: tirzepatide for managing overweight and obesity
• NICE TA875: semaglutide for managing overweight and obesity
• NICE CG189: obesity identification, assessment and management
• NHS: weight-loss medicines

This article is general patient information reviewed by a consultant nephrologist. It is not individual medical advice; treatment decisions are made at a face-to-face consultation.