Evidence review
Ozempic vs Mounjaro: Semaglutide vs Tirzepatide for Diabetes, Weight Loss and Cost
The short answer
Ozempic (semaglutide) and Mounjaro (tirzepatide) are both FDA-approved for type 2 diabetes, not for weight loss. In the head-to-head SURPASS-2 trial, every Mounjaro dose lowered A1c and weight more than Ozempic 1 mg. For weight loss, the same drugs are sold as Wegovy and Zepbound, which cost less without insurance.
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Ozempic and Mounjaro are the two weekly diabetes shots people ask about most, and they're often prescribed off-label for weight loss too. They aren't the same drug, and the one direct trial between them came out clearly in one direction. Here's what each one is, how the results compare, what the doses look like, and what you'd pay.
CoreAge Rx
$99/mo sema · $149/mo tirz
- Semaglutide
- $99/mo
- Tirzepatide
- $149/mo
- Coverage
- All 50 states
- Brand-name
- Compounded only
- Modeled / yr
- $1,188
CoreAge Rx charges one flat price at every dose, $99 a month for semaglutide and $149 for tirzepatide, with no membership fee.
Read the full CoreAge Rx review →Assume any provider we list may compensate us — we may earn a commission at no cost to you. It never moves the Index. See our disclosure.
Trimi Health
78/100- Semaglutide
- $175/moMonth-to-month ($99/mo only on a 12-month prepay)
- Tirzepatide
- $235/moMonth-to-month ($125/mo only on a 12-month prepay)
Are Ozempic and Mounjaro the same kind of drug?
Close, but not identical. Ozempic is semaglutide, which acts on one hormone receptor, GLP-11. Mounjaro is tirzepatide, which acts on two: GLP-1 and GIP2. Both are once-weekly injections, and both carry the same boxed warning about thyroid C-cell tumors.
Their approved uses overlap but aren't identical:
- Ozempic lowers blood sugar in adults with type 2 diabetes. It also lowers the risk of heart attack, stroke and cardiovascular death in adults with diabetes and heart disease, and the risk of kidney decline in adults with diabetes and chronic kidney disease1.
- Mounjaro lowers blood sugar in adults and children 10 and older with type 2 diabetes, and lowers the risk of heart attack, stroke and cardiovascular death in adults with diabetes at high risk of them2.
Neither is approved for weight loss. The weight-loss versions are Wegovy (semaglutide) and Zepbound (tirzepatide). Ozempic vs Wegovy and Mounjaro vs Zepbound explain each pair.
Which lowers A1c and weight more?
SURPASS-2 put them head to head: 1,879 adults with type 2 diabetes, randomly assigned to Mounjaro 5, 10 or 15 mg or Ozempic 1 mg for 40 weeks3.
| Result at 40 weeks | Mounjaro 5 mg | Mounjaro 10 mg | Mounjaro 15 mg | Ozempic 1 mg |
|---|---|---|---|---|
| A1c change (percentage points) | −2.01 | −2.24 | −2.30 | −1.86 |
| Extra weight lost vs Ozempic | 1.9 kg | 3.6 kg | 5.5 kg | — |
Every Mounjaro dose beat Ozempic 1 mg on both A1c and weight3. One caveat: Ozempic now goes up to 2 mg, and SURPASS-2 only tested 1 mg.
For weight loss in people without diabetes, SURMOUNT-5 compared the weight-loss doses directly: tirzepatide 10 or 15 mg against semaglutide 1.7 or 2.4 mg. After 72 weeks, average weight loss was 20.2% on tirzepatide and 13.7% on semaglutide4. Semaglutide vs tirzepatide goes deeper on those numbers.
What are the doses?
Both start low and step up at least four weeks apart12.
| Step | Ozempic (weekly) | Mounjaro (weekly) |
|---|---|---|
| 1 (start) | 0.25 mg for 4 weeks | 2.5 mg for 4+ weeks |
| 2 | 0.5 mg | 5 mg |
| 3 | 1 mg (if needed) | 7.5 mg |
| 4 | 2 mg (if needed) | 10 mg |
| 5 | — | 12.5 mg |
| 6 | — | 15 mg (adult maximum) |
Ozempic's label adds that people taking it for kidney protection should step up to 1 mg1. For children 10 and older, Mounjaro's maximum is 10 mg2.
Which has more side effects?
They were similar in SURPASS-2. Stomach side effects were the most common on both and mostly mild to moderate:
| Side effect | Mounjaro (5–15 mg) | Ozempic 1 mg |
|---|---|---|
| Nausea | 17–22% | 18% |
| Diarrhea | 13–16% | 12% |
| Vomiting | 6–10% | 8% |
| Serious adverse events | 5–7% | 3% |
Source: SURPASS-23. Low blood sugar was uncommon on both, from 0.2% to 1.7% on Mounjaro and 0.4% on Ozempic. The risk climbs if either drug is taken with insulin or a sulfonylurea.
What does each cost without insurance?
Brand prices read in October 2026:
| Option | Self-pay price per month | First 12 fills |
|---|---|---|
| Ozempic, via TrumpRx (to 1 mg) | $199, then $349 | $3,888 |
| Mounjaro, via LillyDirect | $499 at every dose | $5,988 |
| Wegovy pen (semaglutide for weight loss) | $199, then $349 | $3,888 |
| Zepbound vial (tirzepatide for weight loss) | $299 to $449 | $5,188 |
| Compounded semaglutide (median, our tracking) | $178 | $2,136 |
| Compounded tirzepatide (median, our tracking) | $239 | $2,868 |
The $199 brand prices cover the first two fills for new patients, through December 31, 2026. Ozempic at 2 mg is $499. Sources: TrumpRx5, LillyDirect's Mounjaro page6, and our TrumpRx price breakdown. The compounded figures are medians of published starting prices across the more than 340 programs we track per drug, as of October 2026. Compounded versions aren't FDA-approved.
Two things stand out. Mounjaro costs more out of pocket than Zepbound, even though they're the same drug. And if you don't have diabetes, insurance is unlikely to cover either diabetes brand for weight loss, which is why most people paying cash use Wegovy, Zepbound or a compounded version. See Wegovy and Ozempic cost and Zepbound cost for programs that prescribe the brands.
Can you switch from Ozempic to Mounjaro?
Yes, with a new prescription. The Mounjaro label gives a single starting dose, 2.5 mg, and has no conversion table from Ozempic2. Prescribers decide how to time the switch and where to restart. Switching from semaglutide to tirzepatide covers how that usually goes.
Why would a doctor prescribe Wegovy or Zepbound instead?
Because they're the versions approved for weight loss. If you don't have type 2 diabetes, an Ozempic or Mounjaro prescription for weight loss is off-label. Insurers often won't cover it, and the doses stop below the weight-loss maximums: Wegovy goes to 2.4 mg (or 7.2 mg) where Ozempic stops at 2 mg. If you do have diabetes, Ozempic or Mounjaro may be the version your plan covers. Either way, the drug inside is the same. Not medical advice; see our medical disclaimer.
Frequently asked questions
Is Mounjaro better than Ozempic?
In the only head-to-head trial, SURPASS-2, every Mounjaro dose (5, 10 and 15 mg) lowered A1c and body weight more than Ozempic 1 mg over 40 weeks. The trial did not test Ozempic's 2 mg dose. Side effects were similar.
Is Ozempic or Mounjaro approved for weight loss?
No. Both are approved for type 2 diabetes. The weight-loss versions of the same drugs are Wegovy (semaglutide) and Zepbound (tirzepatide).
How much do Ozempic and Mounjaro cost without insurance?
As of October 2026, TrumpRx lists Ozempic at $199 for the first two fills for new patients, then $349 a month up to 1 mg and $499 at 2 mg. LillyDirect lists Mounjaro at $499 a month at every dose.
What is the Mounjaro dose equivalent to Ozempic 1 mg?
There is no official conversion. The drugs act on different receptors, and the Mounjaro label starts everyone at 2.5 mg. In SURPASS-2, even the lowest Mounjaro maintenance dose studied, 5 mg, lowered A1c more than Ozempic 1 mg.
Do Ozempic and Mounjaro have the same side effects?
Mostly. In SURPASS-2, nausea affected 17–22% on Mounjaro and 18% on Ozempic, diarrhea 13–16% and 12%, and vomiting 6–10% and 8%. Both carry the same boxed warning about thyroid C-cell tumors.
References
- U.S. Food and Drug Administration (2026). OZEMPIC (semaglutide) injection Prescribing Information — Indications; Dosage and Administration (SPL June 2026). DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- U.S. Food and Drug Administration (2026). MOUNJARO (tirzepatide) injection Prescribing Information — Indications; Dosage and Administration (SPL September 2026). DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
- Frías JP, Davies MJ, Rosenstock J, et al. (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/34170647/
- Aronne LJ, et al. (2025). Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/40353578/
- TrumpRx.gov (2026). Ozempic (semaglutide) pen: price by strength and prior fills, offer terms (read October 2026). TrumpRx.gov. https://trumprx.gov/p/ozempic
- Eli Lilly and Company (2026). LillyDirect Mounjaro: self-pay price by dose (read October 2026). LillyDirect, Eli Lilly and Company.
Medical disclaimer: This content is for general educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional before starting, stopping, or changing any treatment.
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