The trials behind semaglutide and tirzepatide enrolled many people past 65, mostly in the diabetes and heart studies. Each label has a section 8.5 on geriatric use. Those sections are short, and they depend on how many older people the trials enrolled.
This page sets out what each label says, how thin the data are past 75, and what the fracture and kidney findings show. It is general information, not medical advice for your situation.
What each label says about age 65 and over
The wording is close across labels. None of the geriatric-use sections sets a separate dose or starting point for older patients.
| Label | Older patients in the trials | What the label concludes |
|---|---|---|
| Ozempic | 23.6% aged 65+ and 3.2% aged 75+ in the glycemic trials; 48% aged 65+ in the heart trial | No overall differences; greater sensitivity of some older people cannot be ruled out |
| Wegovy | 9% aged 65 to 74 and 1% aged 75+ in the weight trials; 30% and 8% in the heart trial | No overall difference in effectiveness; more hip and pelvis fractures at 75+ |
| Zepbound | 9% aged 65+ and 0.5% aged 75+ in two weight trials | No overall differences; too few older patients in the sleep apnea trials to judge |
| Mounjaro | 30.1% aged 65+ and 4.1% aged 75+ across seven trials | No overall differences in safety or effectiveness |
| Saxenda | 6.9% aged 65+ and 0.5% aged 75+ | No overall differences; greater sensitivity of some older people cannot be ruled out |
The Ozempic label states there were “no overall differences in safety or efficacy” by age [1]. It adds that “greater sensitivity of some older individuals cannot be ruled out.”
The Saxenda label uses the same caveat [5]. The Zepbound and Mounjaro labels do not include it [3] [4].
How few people over 75 were studied
The percentages hide small counts. In the two Zepbound weight trials, 13 people on the drug were 75 or older [3]. In the Wegovy injection weight trials, it was 23 [2].
The Wegovy tablet trial had 5 patients aged 75 or older on the drug. The Zepbound label says its sleep apnea trials had too few patients 65 or older to tell whether they respond differently.
The diabetes and heart trials enrolled older people in far larger numbers. That is where most of the age data come from. Sleep apnea on tirzepatide is covered in Zepbound for sleep apnea.
The fracture finding
The Wegovy heart-outcomes trial enrolled 703 patients aged 75 or older on the drug. Its label reports what happened to their bones [2].
| Group | Wegovy | Placebo |
|---|---|---|
| Aged 75 and older | 2.4% (17 of 703) | 0.6% (4 of 663) |
| Female patients | 1% (24 of 2,448) | 0.2% (5 of 2,424) |
The label also notes that patients 75 and older reported more serious adverse reactions overall than younger adults. That held on the drug and on placebo alike.
The label does not state a cause for the fractures. It reports the counts and places them in its adverse reactions and geriatric sections.
Dehydration and the kidneys
The Wegovy label warns of acute kidney injury from volume depletion, in some cases requiring dialysis [2]. Most reported cases followed nausea, vomiting or diarrhea that led to dehydration.
It asks for kidney function to be monitored in patients with those reactions, especially while the dose is rising. The Zepbound label also asks for kidney monitoring in patients with reactions that could cause volume depletion [3].
Neither warning is written for older patients specifically. The Zepbound label recommends no dose change for kidney impairment. The gut side effects behind the warning are covered in semaglutide side effects and tirzepatide side effects.
What the age analyses found
Several trial programs have split their results by age after the fact. These are secondary analyses, and none was designed around older adults.
In the STEP-HFpEF heart failure trials, 25.5% of 1,145 participants were 75 or older [7]. The effect of semaglutide 2.4 mg on weight did not differ by age group (p-interaction 0.41).
A pooled analysis of two semaglutide heart trials in type 2 diabetes split patients at 60, 65 and 70 [8]. Weight reductions versus placebo were consistent across the age groups (p-interaction 0.124).
A tirzepatide analysis of the SURMOUNT and SUMMIT trials compared adults 65 and older with younger adults [6]. It reported no clinically meaningful difference from placebo in falls, fractures or gut tolerability at 65 and over.
Five of that paper’s seven authors are employees of the drug’s maker. Three authors of the pooled diabetes analysis are employees of semaglutide’s maker.
How much evidence there is
A 2025 systematic review searched for weight-loss drug studies that reported adults 65 and over separately [10]. It found six experimental studies and two observational ones.
The number of older adults per study ranged from 13 to 6,728. The authors found that “few studies reported on adverse events.”
They judged the best evidence to be for semaglutide in older adults with obesity and cardiovascular disease. They called for larger studies to settle tolerability in this age group.
Lean mass lost alongside fat is covered, with its trial measurements, in GLP-1 muscle loss. The label data at the other end of the age range are in Wegovy for teens, and options are compared on the weight-loss peptide rankings.