Canagliflozin vs Tirzepatide

Side-by-side comparison of mechanisms, dosing, interactions, and stacking potential.

CanagliflozinTirzepatide
CategoryPharmaceuticalsPharmaceuticals
Standard Dose
Timing
Cycle Duration
Evidence LevelModerate (longevity), Strong (cardiorenal)Strong (FDA-approved)
A

Canagliflozin

Pharmaceuticals

Mechanism

SGLT2 inhibitor originally developed for type 2 diabetes. Blocks glucose reabsorption in kidneys, creating a mild glucose deficit that activates AMPK and mimics caloric restriction. Extended lifespan in male mice in the ITP.

Contraindications

  • Type 1 diabetes (DKA risk)
  • Severe renal impairment (eGFR <30)
  • History of recurrent UTIs
B

Tirzepatide

Pharmaceuticals

Mechanism

Dual GIP/GLP-1 receptor agonist. Enhances insulin secretion, reduces glucagon, slows gastric emptying, and acts on hypothalamic appetite centers. Produces greater weight loss than semaglutide in head-to-head trials. Also improves cardiovascular risk markers.

Contraindications

  • Personal/family history of medullary thyroid carcinoma
  • MEN2 syndrome
  • Pancreatitis history
  • Severe GI disease

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