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The Difference Between Mounjaro and Ozempic for Diabetes Management

Man holding injection for weight loss

Mounjaro, developed by Eli Lilly, and Ozempic, made by Danish pharma giant Novo Nordisk, are currently available as injectable diabetes management drugs. These drugs have very similar mechanisms of action and trigger a similar hormonal response, which can result in excellent diabetes management and even weight loss. However, neither of these drugs is approved for use in weight loss. Instead, a higher dose version of Ozempic known as Wegovy was approved as a weight loss drug at the end of 2022. Mounjaro is also being evaluated as a weight loss drug, and FDA approval is expected in the near future.

The Similarities

Mounjaro and Ozempic are GLP-1 receptor agonists, which means they promote the production and secretion of GLP-1, which can improve insulin sensitivity. To boot, most patients feel little hunger while taking these injections. Both types of injections are administered weekly.

However, There Are Some Differences Between the Two Drugs

While they are both GLP-1 receptor agonists, Ozempic is semaglutide, while Mounjaro is tirzepatide. This may not seem like a significant difference; however, data has generally shown that Mounjaro has slightly better diabetes control and showed more substantial weight loss in diabetic patients than Ozempic.¹ With the pending approval of Mounjaro (or a derivative) as a weight loss drug, it will be interesting to see if this slight benefit extends to its weight loss application versus Wegovy.

Cost Comparison

In addition to the physical effects of each of these Drugs, there is also the question of cost. While every insurance company and every plan will have different coverages, limits, and shared expenses, Mounjaro is slightly more expensive than Ozempic.

Side Effects

It’s also important to know that these two drugs share many common side effects. For one, not all patients will get sufficient blood sugar control. They may experience significant nausea or vomiting and may not wish to continue taking the drug. Patients have also reported pancreatitis or inflammation of the pancreas and gallbladder issues that can cause severe side effects and require stopping the medication. There seems to be the possibility of suicidal ideations or thoughts of self-harm, an issue currently being evaluated in Europe and the UK. Lastly, any GLP-one receptor agonist may risk causing or worsening gastroparesis, which involves slowed food movement through the stomach. Gastroparesis is severe, and we are unsure if the drugs cause it, activate underlying gastroparesis risk, or if it’s simply an unfortunate coincidence due to other lifestyle factors.

Mounjaro and Ozempic may indirectly cause bone density and muscle mass loss. This is because many patients are not eating enough while on these medications and may not work out as they should to maintain muscle mass.

While both drugs have similar side effects, clinical studies have shown slightly different incidence of each.

The Bottom Line

There are slight differences between Mounjaro and Ozempic; just as we expect, there will be slight differences between Wegovy and the Mounjaro derivative/evolution that may eventually be indicated for weight loss. We also know that one drug may be tolerated better than the other, so patients start with a relatively low dose, followed by progressively greater amounts each month until we find the sweet spot.

Whether you’re taking any of these drugs for diabetes management or weight loss, they are only effective as long as they are taken. Patients with severe or uncontrolled diabetes, as well as those who are morbidly obese, should schedule a consultation with our office and speak to Dr. Tsuda to understand more about bariatric surgery as an option. While these drugs are highly effective, they do not replace bariatric surgery, which remains the most effective, long-term option for sustained weight loss in obese patients.

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Reference:

  1. Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, Liu B, Cui X, Brown K; SURPASS-2 Investigators. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503-515. doi: 10.1056/NEJMoa2107519. Epub 2021 Jun 25. PMID: 34170647.