Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.

Evidence: Wharton S 2025 · sources last checked 2026-08-20

Reference tool — not medical advice. Deterministic suggestions to think with, grounded in current Canadian guidelines and outcome trials; clinician judgement, current product monographs, and live ODB coverage always required. Runs entirely in your browser — no data is collected.

GLP-1 & incretin-agonist selector

Pick the patient characteristics and get ranked suggestions across the Health Canada-approved GLP-1 and dual GIP/GLP-1 receptor agonists — with the guideline/trial reasoning and references behind each.

Patient characteristics

Primary goal

Cardiometabolic comorbidity

Treatment targets

Preferences & practical

Contraindications & cautions

MTC/MEN 2 and pregnancy make the whole class ineligible.

Select patient characteristics to begin.

e.g. Weight management + Large weight loss desired, or Established cardiovascular disease to see how the ranking shifts.

References

  1. [1]Diabetes Canada CPG Expert Committee. Pharmacologic Glycemic Management of Type 2 Diabetes in Adults — 2024 Update (Ch. 13). Can J Diabetes, 2024. link
  2. [2]Wharton S, et al. (Obesity Canada). Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update. CMAJ 2025;197(27):E797. doi:10.1503/cmaj.250502. link
  3. [3]Marso SP, et al. SUSTAIN-6: Semaglutide and cardiovascular outcomes in type 2 diabetes. NEJM 2016;375:1834. link
  4. [4]Lincoff AM, et al. SELECT: Semaglutide and cardiovascular outcomes in obesity without diabetes. NEJM 2023;389:2221. link
  5. [5]Marso SP, et al. LEADER: Liraglutide and cardiovascular outcomes in type 2 diabetes. NEJM 2016;375:311. link
  6. [6]Gerstein HC, et al. REWIND: Dulaglutide and cardiovascular outcomes (broad, ~69% primary prevention). Lancet 2019;394:121. link
  7. [7]Perkovic V, et al. FLOW: Semaglutide and kidney outcomes in type 2 diabetes with CKD. NEJM 2024 (stopped early for efficacy). link
  8. [8]Frías JP, et al. SURPASS-2: Tirzepatide vs semaglutide once weekly in type 2 diabetes. NEJM 2021;385:503. link
  9. [9]Jastreboff AM, et al. SURMOUNT-1: Tirzepatide once weekly for obesity. NEJM 2022;387:205. link
  10. [10]Wilding JPH, et al. STEP-1: Once-weekly semaglutide 2.4 mg in adults with overweight or obesity. NEJM 2021;384:989. link
  11. [11]SURMOUNT-5: Tirzepatide vs semaglutide 2.4 mg for obesity (head-to-head). 2025. link
  12. [12]Husain M, et al. PIONEER-6: Oral semaglutide and cardiovascular outcomes (non-inferior; superiority not shown). NEJM 2019;381:841. link
  13. [13]SURPASS-CVOT: Tirzepatide vs dulaglutide cardiovascular outcomes. NEJM 2025 (recent — non-inferiority met, superiority not; VERIFY against primary publication before clinical reliance). link
  14. [14]Health Canada — Drug Product Database & product monographs (Ozempic, Rybelsus, Wegovy, Victoza, Saxenda, Trulicity, Mounjaro, Zepbound, Xultophy, Soliqua). link
  15. [15]Ontario Drug Benefit (ODB) e-Formulary — Limited Use criteria (T2D); weight-management indications are not publicly covered. Check live before counselling on coverage. link