What's the Difference Between Mounjaro and Ozempic?

Medically reviewed by Kelly Wood, MD

Mounjaro (terzepatide) and Ozempic (semaglutide) are injectable medications that help control blood sugar (glucose) levels in people with type 2 diabetes. Both medications have quickly become popular, thanks to their weight loss benefits. While Mounjaro and Ozempic offer similar benefits, there are key differences that set both medications apart.

What Do Mounjaro and Ozempic Do?

Mounjaro and Ozempic belong to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists—also known as incretin mimetics—which work by mimicking the effects of two naturally occurring hormones in your body: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 and GIP are hormones that your stomach releases after eating food.

These hormones increase how much insulin your body makes and reduce the production of glucagon. Insulin is a hormone that your pancreas makes to help your body use the sugar from the foods you eat as energy—which helps prevent your blood sugar from being too high. Your pancreas also produces glucagon, which is a hormone that increases blood sugar and prevents your glucose levels from getting too low. Both hormones work together to regulate your blood sugar levels.

While Mounjaro and Ozempic can help regulate blood sugar levels in people with type 2 diabetes, they are not an insulin replacement. Research shows that both Mounjaro and Ozempic also increase the time it takes for food to leave the stomach, which helps reduce appetite and promotes weight loss.

How Mounjaro Works

Mounjaro (terzepatide) is an FDA-approved, once-a-week injection that you inject under the fatty tissue of your skin. This medication aids in controlling blood sugar levels in adults with type 2 diabetes. Healthcare providers recommend this drug alongside individualized diet and exercise plans. Mounjaro is the first and only drug in its class that activates two gut hormones that regulate blood sugar in people with type 2 diabetes: GLP-1 and GIP.

Currently, Mounjaro is only approved for use in treating type 2 diabetes. However, the FDA is also working on approval for this drug as a treatment for weight loss. In one study, almost two-thirds of participants receiving 10 or 15 milligrams (mg) of Mounjaro injections once a week reduced their body weight by 20% or more.

It's worth noting that people with type 2 diabetes are at an increased risk of heart disease, and Mounjaro—along with eating a healthy diet and regular physical activity—may help protect against cardiovascular (heart) problems. Research studies found that Mounjaro helps lower blood pressure, which may reduce the risk of cardiovascular events like heart attack and stroke. However, Mounjaro is not currently approved for heart problems.

How Ozempic Works

Ozempic (semaglutide) is also an FDA-approved medication for adults with type 2 diabetes. This drug helps control blood sugar when combined with diet and exercise. Healthcare providers typically prescribe Ozempic to people with type 2 diabetes and heart disease to reduce the risk of cardiovascular events, like stroke.

This medication is a GLP-1 agonist, which activates the body's GLP-1 receptors, prompts the pancreas to produce insulin after eating, and helps control blood sugar levels in people with type 2 diabetes. GLP-1 also signals to the brain that you've eaten, which can make you feel full early and help promote better weight control.

While Ozempic does not have FDA approval as a weight loss drug, it shows promise as a potential treatment for obesity and weight management. In a 68-week clinical trial published in the New England Journal of Medicine, study participants who took Ozempic injections once a week experienced a nearly 15% reduction in body weight, improvements in physical function, and fewer risk factors for heart disease.

Similarities Between Mounjaro and Ozempic

Mounjaro and Ozempic are prescription medications that you can inject subcutaneously (under the skin) once a week. They are similar in the following ways:

• Control blood sugar levels in people with type 2 diabetes effectively

• Help promote weight loss in people with obesity

• Reduce the risk of major cardiovascular events, such as heart attack and stroke

• Have similar side effects, including nausea, vomiting, stomach pain, diarrhea, constipation, and indigestion

Differences Between Mounjaro and Ozempic

Despite the similarities between Mounjaro and Ozempic, the two medications have some key differences.

How They Work Biologically

Mounjaro is a dual-acting GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist. It is the first and only drug of its kind, mimicking the effects of both hormones. Ozempic, on the other hand, is only a GLP-1 receptor agonist.

Effectiveness

Mounjaro is more effective than Ozempic for blood sugar control and weight loss. In clinical trials, 80% of people who took Mounjaro lost at least 5% of their body weight, and 36% lost more than 15%. Of those who took Ozempic, 54% of participants lost at least 5% of their body weight, while 8% lost more than 15%. Mounjaro also resulted in more significant reductions in A1C, a measure of long-term blood sugar levels.

Heart Health Benefits

Ozempic is FDA-approved for people with type 2 diabetes and cardiovascular (heart) disease to help reduce the risk of major cardiovascular events like heart attack, stroke, and death. Mounjaro is not currently approved for this use, though research shows it helps lower blood pressure, which may help lower the risk of heart complications.

Dose and Administration

Mounjaro and Ozempic are injections you administer once a week through pen injectors that come pre-filled with the medication. Ozempic is available in 0.25 mg, 0.5 mg, 1.0 mg, and 2.0 mg doses. Each pen injector contains four doses, which is equivalent to a month's worth of medication.

Mounjaro injector pens are single-use, meaning you will use a new pen for each injected dose. The pens contain either 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg of the drug, depending on your prescription and how much medication your provider thinks you need.

Cost

On average, Mounjaro is more expensive than Ozempic. In the United States, the monthly cost of Mounjaro is approximately $1,023 (15 mg/dose) without insurance. The monthly cost of Ozempic without insurance is $936 (1 mg/dose).

The cost of these medications varies, depending on your dosage, insurance coverage, and whether you qualify for the manufacturer's savings program. Many insurance plans provide at least partial coverage for Mounjaro and Ozempic. Contact your health insurance provider and insurance company to learn more about your plan's coverage for these medications.

Which Is Better?

Whether Mounjaro or Ozempic is better depends on your needs and treatment goals. While Mounjaro is more effective for lowering A1C (your average blood sugar levels over three months) and weight loss, Ozempic is FDA-approved to prevent heart complications in people with type 2 diabetes and cardiovascular disease.

Some people may be more sensitive to the side effects of Mounjaro or Ozempic than others. People prone to gastrointestinal side effects may prefer Ozempic, as higher doses of Mounjaro are more likely to cause side effects such as nausea, vomiting, diarrhea, and stomach pain. 

The best way to decide which medication is right for you is to talk to your healthcare provider. They can help you to weigh the pros and cons of each and choose the option that is best for you and your individual health needs.

Can You Switch From Ozempic to Mounjaro or Vice Versa?

It is possible to switch from Ozempic to Mounjaro or vice versa. You may want to change medications if you are not seeing the desired results or are having difficulty with the medication's side effects. Pharmacy data shows that up to 25% of people switch from their initial blood sugar medication to another after the first year of treatment.

Switching from one medication to another is a decision you should make in close consultation with your healthcare provider. These medications, though similar in some respects, work slightly differently and have different dosages. That said, making the decision to switch medicines requires careful consideration. If changing medications is the right choice, your healthcare provider will develop a safe and effective transition plan for you.

A Quick Review

Mounjaro (terzepatide) and Ozempic (semaglutide) are injectable medications with FDA approval that help lower blood sugar in people with type 2 diabetes. Ozempic is also approved to lower the risk of heart complications like heart attack and stroke among people with type 2 diabetes and heart disease. However, Mounjaro is better for weight loss and long-term blood sugar control.

Both medications require the use of injection pens once a week and offer similar benefits. If you have type 2 diabetes, talk to your healthcare provider about Ozempic or Mounjaro to determine whether these medications are a good option. They can help you understand which medication is right for you and create a treatment plan that meets your body's needs.

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