Ozempic vs. Mounjaro

Ozempic and Mounjaro manage Type 2 diabetes by helping the body make more insulin in response to food, preventing the liver from making glucose and delaying gastric emptying. These actions reduce the appetite, reduce food intake and result in lower blood glucose.

In addition to these three mechanisms of action, Mounjaro also reduces blood sugar by reducing glucagon. Glucagon is a hormone that increases blood sugar levels and keeps them from getting too low. As GLP-1 receptor agonists, Ozempic and Mounjaro mimic glucagon-like peptide 1, a hormone that affects digestion and blood sugar control.

Can You Take Both at the Same Time?

You should not take Ozempic and Mounjaro at the same time. Health care providers don’t recommend combining or taking two GLP-1 drugs together. However, you can switch from one drug to the other because they both treat Type 2 diabetes and work similarly. Keep in mind that switching between drugs could result in more side effects as your body must adjust to the new medication.

Your health care provider will adjust your dose accordingly if you need more or less blood sugar control. If neither drug works for you, your health care provider will recommend another medication.

Ozempic and Mounjaro are both GLP-1 drugs, but they have different active ingredients, doses, mechanisms of action and U.S. Food and Drug Administration-approved indications. Novo Nordisk manufactures Ozempic, and Mounjaro is made by Eli Lilly and Company.

The FDA approved Mounjaro and Ozempic to treat Type 2 diabetes, but Ozempic is also approved to reduce the risk of major cardiovascular events in people with Type 2 diabetes and established cardiovascular disease.

Ozempic is made with semaglutide and is available in 0.25 mg, 0.5 mg, 1 mg and 2 mg doses. Mounjaro’s active ingredient is tirzepatide and it is available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg or 15 mg doses.

Mounjaro delivers these doses in a single-use pen injector. While Ozempic also uses pen injectors, each pen may contain more than one dose per pen.

Mounjaro and Ozempic both mimic the GLP-1 hormone. But according to Eli Lilly, Mounjaro is the first and only approved drug that activates the glucose-dependent insulinotropic polypeptide — also known as gastric inhibitory polypeptide — and GLP-1 receptors in the body.

Everyone reacts to medications differently, but studies have shown Mounjaro is more effective than Ozempic for controlling blood sugar. In the SURPASS-2 clinical trial, Mounjaro reduced A1C levels more than Ozempic.

According to the study results published in The New England Journal of Medicine, Ozempic reduced A1C levels by about 1.86 percentage points for the 1 mg dose. Mounjaro reduced A1C by 2.01, 2.24 and 2.30 for the 5 mg, 10, mg and 15 mg doses, respectively.

Ozempic vs. Mounjaro for Weight Loss

Mounjaro is more effective than Ozempic for weight loss, though it’s important to note that neither drug is approved for weight loss. Participants in Mounjaro clinical trials lost 12 to 25 pounds, according to Eli Lilly’s clinical trials.

In Eli Lilly’s SURMOUNT-3 and SURMOUNT-4 clinical trials, study participants who took Mounjaro achieved 21.1% weight loss after 12 weeks and a total mean weight loss of 26.6% over 84 weeks.

In Novo Nordisk’s SUSTAIN 7 and SUSTAIN FORTE clinical trials, study participants who took Ozempic lost 9.3 to 14.1 pounds. On average, people who took Ozempic lost about 15% of their body weight after 68 weeks, according to clinical trials results published in The New England Journal of Medicine.

Overall, side effects of Ozempic and Mounjaro are similar, though Mounjaro may have more side effects and more severe side effects. Mounjaro’s prescribing information warns of severe gastrointestinal disease in its warnings and precautions, while Ozempic’s does not. 

More people stopped taking Mounjaro in clinical trials because of gastrointestinal side effects than those who took Ozempic. In both drugs, more side effects occurred in those taking higher doses of the medication.

Ozempic and Mounjaro have boxed warnings for thyroid C-cell tumors, including cancer. The warnings and precautions section of the drugs’ labels warn about pancreatitis, diabetic retinopathy, hypoglycemia, acute kidney injury, hypersensitivity reactions and acute gallbladder disease.

In post-marketing studies, some people reported ileus side effects with Mounjaro. An ileus is also called gastrointestinal atony, which is the inability of the intestine to contract normally. This can cause digestive issues and problems moving waste out of the body.

Recent Safety Concerns

Recent safety concerns for both drugs surfaced after patients started reporting serious gastrointestinal problems such as gastroparesis, also known as a paralyzed stomach, that could lead to hospitalization. Mounjaro’s warnings and precautions mention severe gastrointestinal side effects. It warns that the drug hasn’t been tested in people with gastroparesis, so it shouldn’t be used in these patients.

In contrast, Ozempic’s prescribing label doesn’t mention gastroparesis or severe gastrointestinal side effects. The label only cautions that people who report gastrointestinal side effects should be monitored for acute kidney injury.

One patient filed an Ozempic and Mounjaro lawsuit in August 2023 after she took both drugs and had severe gastroparesis. She experienced chronic, severe vomiting that led her to be hospitalized.

Ozempic and Mounjaro have similar drug interactions listed in their prescribing information. Both drugs warn that the risk of hypoglycemia is greater when they are taken with a sulfonylurea or with insulin. Patients should talk to their doctors about potentially reducing their doses of insulin or sulfonylurea medications while on either drug. 

Mounjaro and Ozempic slow gastric emptying and can interfere with the way oral medications work. Ozempic’s prescribing label didn’t note any clinically relevant absorption problems with oral medications. However, Mounjaro’s drug label advised patients to switch to a nonoral contraceptive method or add a barrier contraceptive for four weeks after starting treatment and for four weeks after each dose escalation.

The cost difference between Ozempic and Mounjaro isn’t much, though Mounjaro is more expensive than Ozempic. On average, Ozempic costs about $1,000 a month in the U.S.

Mounjaro’s list price is $1,023.04 per fill, according to Eli Lilly. Some reports say the drug can cost as much as $1,300.

Novo Nordisk and Eli Lilly offer some drug discount programs to help with costs, and depending on insurance coverage, the out-of-pocket cost to patients could be much less. Currently, most insurance companies do not cover the cost of Mounjaro or Ozempic for weight loss because these drugs are not FDA-approved to treat obesity.

Whether you should take Ozempic or Mounjaro depends on your individual treatment needs. Mounjaro is more effective for weight loss and lowering A1C, but it could also come with a greater risk of side effects — particularly severe gastrointestinal side effects.

Ozempic is effective at lowering A1C and helping people lose weight, but it’s also FDA-approved to prevent cardiovascular events in people with established cardiovascular disease. People with Type 2 diabetes already have an increased risk of these health problems. Using Ozempic could help lower the risk of serious heart attack, stroke or even death.

Before making a choice on which drug to take, make sure to talk with your health care providers about the pros and cons of each medication. It’s possible to switch from one drug to the other if your results aren’t optimal with the first drug you take.