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Mounjaro vs Ozempic in Canada: what’s the difference?

Two different medicines, both approved in Canada for type 2 diabetes: how they work, what the one head-to-head trial found, what they cost, and which plans cover them.

GLP Guidebook teamPublished 14 Oct 20268 min read18 sourcesWritten from published sources
What we checked18 sources, each one opened and linked to the sentence it supportsLast checked 14 Oct 2026 · Next review due 14 Apr 2027 · How we write

Written for Canada, from Canadian sources.

The short answer

Mounjaro (tirzepatide) and Ozempic (semaglutide) are different medicines, both approved in Canada for type 2 diabetes, not weight loss. In SURPASS-2, people on Mounjaro lost 7.6 to 11.2 kg, against 5.7 kg on semaglutide 1 mg, and about 1 in 5 people felt sick on each. Public plans cover Ozempic with criteria; we found none covering Mounjaro.

At a glance

OzempicMounjaro
Medicine and makerSemaglutide, Novo Nordisk1Tirzepatide, Eli Lilly2
Approved in Canada forType 2 diabetes in adults, including lowering heart and kidney risks in some people with type 2 diabetes1Type 2 diabetes in adults and ages 10 to under 182Not approved for weight loss under this name; Zepbound is
How it’s takenInjection under the skin once a week, from a multi-dose pen1Injection under the skin once a week, from a 4-dose KwikPen, single-dose pen or vial2
Dose steps0.25 mg for 4 weeks, then 0.5 mg; 1 mg and then 2 mg if needed12.5 mg for 4 weeks, then 5 mg; up 2.5 mg at a time after at least 4 weeks, to 15 mg2
Weight change in the head-to-head trial (SURPASS-2, 40 weeks)−5.7 kg on 1 mg318 in 100 felt sick (nausea)−7.6 kg on 5 mg to −11.2 kg on 15 mg2,317 to 22 in 100 felt sick (nausea)
Most common side effectsNausea and diarrhea: very common, more than 1 in 10 (EU Ozempic label)4Nausea and diarrhea: very common, more than 1 in 10 (EU Mounjaro label)5
Official price$227.94 a pen (Ontario formulary): about $247 a month, $2,963 a year at 0.5 or 1 mg. Generic semaglutide $78.14 a pen: about $85 a month, $1,016 a year6$300 a pen at 2.5 or 5 mg to $540 at 12.5 or 15 mg (maker’s price submitted to Canada’s Drug Agency): about $325 to $585 a month, $3,900 to $7,020 a year7
Coverage in CanadaPublic plans cover it for type 2 diabetes with criteria (Ontario, BC, Quebec, First Nations and Inuit)8,9,10We found no public plan that lists it, as of 14 Oct 20266,10

Side by side, not ranked. Prices: one pen holds 4 weekly doses; a year is 52 doses (13 pens); a month is a twelfth of a year; our arithmetic. Pharmacies add their own markup and fees. Checked 14 Oct 2026.

Key takeaways

  • Mounjaro (tirzepatide) and Ozempic (semaglutide) are different medicines, and Health Canada has approved both for type 2 diabetes, not for weight loss.2,1
  • In SURPASS-2, a 40-week head-to-head trial in type 2 diabetes, Mounjaro lowered weight by 7.6 to 11.2 kg, against 5.7 kg on semaglutide 1 mg.2
  • Nausea was similar in that trial: 17 to 22 in 100 people on Mounjaro and 18 in 100 on semaglutide; serious adverse events were 5 to 7 in 100, against 3 in 100.3
  • Ontario lists Ozempic at $227.94 a pen and generic semaglutide at $78.14; Lilly’s submitted Mounjaro price is $300 to $540 a pen.6,7
  • Ozempic is covered by public plans for type 2 diabetes with criteria; we found no public plan that lists Mounjaro on 14 October 2026.8,9,10
Before you go further
  • GLP‑1 medicines are prescription drugs in Canada. Nothing here is a reason to start, stop or switch one.11
  • We name brands and official prices as facts. We don’t recommend, rank or link to any brand, pharmacy, clinic or program.
  • Canadian law bans advertising any drug to the general public as a treatment, preventative or cure for obesity or diabetes.12 This page is information, not an ad, and nothing here is for sale.
  • Trial results are averages. Some people lose much less, and every benefit comes with risks: see our side effects guide.
On this page
  1. What is the difference between Mounjaro and Ozempic?
  2. What are they approved for in Canada?
  3. What did the head-to-head trial find?
  4. How do their side effects compare?
  5. How much do they cost, and who covers them?
  6. Which one? What does a doctor weigh?
  7. Questions people ask
  8. How we researched this
  9. Sources

What is the difference between Mounjaro and Ozempic?

They are different medicines. Ozempic is semaglutide, which acts on one gut-hormone receptor, GLP‑1; Mounjaro is tirzepatide, which acts on two, GIP and GLP‑1.1,2

GLP‑1 and GIP are hormones your gut releases after you eat. Both help the pancreas release insulin when blood sugar is high.1,2 The medicine is what works in your body; the brand is the name on the box. Mounjaro and Zepbound are both tirzepatide; Ozempic, Wegovy and Rybelsus are all semaglutide.13,14,15

Both are weekly injections under the skin, and both start at a low dose that goes up every 4 weeks or more.1,2 The slow start is meant to reduce stomach side effects.14

What are they approved for in Canada?

Both are approved for type 2 diabetes. Ozempic also carries heart and kidney uses for some people with diabetes, and Mounjaro is approved from age 10.1,2

Neither is approved in Canada for weight management. For that, Health Canada has approved Wegovy (semaglutide 2.4 mg) and Zepbound (tirzepatide).14,13 Using Ozempic or Mounjaro only for weight is off-label: outside the use Health Canada approved.

Canada’s obesity guideline discourages prescribing medicines “solely for obesity management if they lack regulatory approval for this indication or evidence-based recommendations for their use”.16 If weight is the question, see Wegovy vs Zepbound and Zepbound vs Mounjaro.

What did the head-to-head trial find?

SURPASS-2 gave 1,879 adults with type 2 diabetes Mounjaro 5, 10 or 15 mg or semaglutide 1 mg for 40 weeks. Blood sugar and weight fell more on each Mounjaro dose.2,3

A trial like this splits people into groups at random, so the groups start alike. Everyone also took metformin. The gap between groups is what the different medicine added.3

  • Blood sugar. HbA1c is your average blood sugar over about 3 months. It fell by 2.0, 2.2 and 2.3 points on Mounjaro 5, 10 and 15 mg, against 1.9 points on semaglutide 1 mg.2
  • Weight. People started at about 94 kg (207 lb). They lost 7.6, 9.3 and 11.2 kg on the three Mounjaro doses, against 5.7 kg on semaglutide.2
  • Who paid. Eli Lilly, Mounjaro’s maker, funded the trial. It was open-label, so people knew which medicine they took.3

Two limits matter. The trial tested semaglutide 1 mg, not Ozempic’s 2 mg top dose.1,3 And these are averages: some people lose much more, some very little.

RisksThe risks, in brief
  • Stomach effects are very common (more than 1 in 10 people) on the EU Ozempic and Mounjaro labels, mostly while the dose goes up. In SURPASS-2, 17 to 22 in 100 people on Mounjaro felt sick (nausea), against 18 in 100 on semaglutide 1 mg.4,5,3
  • Low blood sugar is more likely when either medicine is taken with insulin or a sulfonylurea, such as gliclazide.1,2
  • Pancreatitis (an inflamed pancreas) is uncommon (up to 1 in 100 people) on both EU labels: severe stomach pain that won’t go away, sometimes spreading to the back.4,5
  • Gallstones are common (up to 1 in 10) on the EU Ozempic label and uncommon (up to 1 in 100) on the EU Mounjaro label.4,5
  • Thyroid, pregnancy and the pill. Neither is for anyone with a personal or family history of medullary thyroid cancer or MEN 2. Mounjaro can make the contraceptive pill less reliable for 4 weeks after starting and after each dose increase.1,2
Full detail in our side effects guide →
Get help now: call 911 or go to the nearest emergency department for severe stomach pain that won’t go away, with or without vomiting. It can be pancreatitis. Not sure? Call 811 to speak to a nurse in most provinces (Info-Santé 811 in Quebec).17

How do their side effects compare?

Much the same in kind. Stomach effects lead on both, and in SURPASS-2 nausea was similar: 17 to 22 in 100 people on Mounjaro, 18 in 100 on semaglutide.3

  • Vomiting: 6 to 10 in 100 on Mounjaro, against 8 in 100 on semaglutide.3
  • Diarrhea: 13 to 16 in 100, against 12 in 100.3
  • Serious adverse events: 5 to 7 in 100 on Mounjaro, against 3 in 100 on semaglutide.3

In Canada’s monographs, 20 in 100 people on Ozempic 1 mg felt sick, against 6 in 100 on comparison treatments (a dummy injection or other diabetes medicines). On Mounjaro 15 mg it was 18 in 100, against 4 in 100 on a dummy injection.1,2 Those were separate trials, so the numbers can’t be compared directly.

How much do they cost, and who covers them?

Ontario lists Ozempic at $227.94 a pen and generic semaglutide at $78.14. Lilly’s submitted Mounjaro price is $300 to $540 a pen, depending on the dose.6,7

Each pen holds 4 weekly doses, so a year is 13 pens. That is about $2,963 for Ozempic and $1,016 for generic semaglutide by our arithmetic.6 For Mounjaro, it is $3,900 a year held at 5 mg and $7,020 at 15 mg.7 Generic semaglutide is approved as a generic of Ozempic; no generic tirzepatide can be approved before data protection ends on 24 November 2030.11,18

Ozempic is covered for type 2 diabetes with criteria: Limited Use in Ontario, Special Authority in BC, an exception drug in Quebec, and Limited Use for First Nations and Inuit.8,9,10 Mounjaro is not on Ontario’s formulary, and Quebec lists it as private insurance only.6,10 Canada’s Drug Agency recommended in 2026 that plans cover it for type 2 diabetes, with conditions including a lower price.7

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Which one? What does a doctor weigh?

We don’t recommend either. These are the points a doctor and a person with type 2 diabetes usually talk through, from the labels and Canadian sources.

  • The approved use. Both are for type 2 diabetes. Ozempic’s label adds heart and kidney uses for some people with diabetes.1
  • Blood-sugar and weight goals. SURPASS-2 is the only head-to-head trial, and it tested semaglutide 1 mg.3
  • Coverage. Your provincial plan or private insurer decides what you pay; Mounjaro has no public listing we could find.6,10
  • Other medicines. Insulin or a sulfonylurea raises the chance of low blood sugar with either.1,2
  • Contraception and pregnancy. Mounjaro can make the pill less reliable at the start and after each dose increase.2
  • Side effects so far on any earlier GLP‑1 medicine.

Our guide to getting a prescription and the medicines covers the visit itself.

Questions people ask

Does Mounjaro lower weight more than Ozempic?

In the one head-to-head trial, SURPASS-2, Mounjaro lowered blood sugar and weight more than semaglutide 1 mg in people with type 2 diabetes: 7.6 to 11.2 kg lost, against 5.7 kg. Nausea was similar, but serious adverse events were 5 to 7 in 100 on Mounjaro, against 3 in 100.2,3

Are Mounjaro or Ozempic approved for weight loss in Canada?

No. Both are approved for type 2 diabetes. The weight-management brands of the same medicines are Zepbound (tirzepatide) and Wegovy (semaglutide).2,1,13,14

Can you take Mounjaro and Ozempic together?

No. Zepbound’s Canadian monograph says tirzepatide should not be used with any other GLP‑1 medicine.13

Is Mounjaro covered in Canada?

We found no public drug plan that lists it on 14 October 2026. Some private plans may; ask your insurer.6,10

Is there a generic Mounjaro in Canada?

No. Data protection on tirzepatide runs to 24 November 2030. Generic semaglutide, a generic of Ozempic, has been sold since May 2026.18,11

How we researched this

We compared the Canadian product monographs for Ozempic (13 July 2026) and Mounjaro (23 June 2026), the SURPASS-2 trial paper, the EU package leaflets for frequency bands, and Health Canada’s Drug Product Database on 14 October 2026.

Prices are from Ontario’s formulary (checked 14 October 2026) and Lilly’s price submitted to Canada’s Drug Agency. Coverage is from the provincial plans’ own pages and Diabète Québec’s March 2026 table.

Before you move on

  • Check which medicine and brand is on your prescription, and why.
  • Ask whether your use is on-label or off-label.
  • Ask your plan which of the two it covers, and on what criteria.
  • Never use two GLP‑1 medicines together.
  • Know the warning signs in the risks box.
Cost calculatorSide effects and risksWhat GLP‑1s do

More from the Canada blog

CACanadaHow much do Ozempic, Wegovy, Mounjaro and Zepbound cost in Canada?CACanadaDoes your province cover Ozempic? Ontario, BC, Alberta, Quebec and others comparedCACanadaWhich generic versions of Ozempic and Wegovy are approved in Canada?
About GLP Guidebook

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An independent guide to GLP‑1 medicines. We don’t sell medicines, take drug-company money, earn commissions or link to any provider. Once a month: Health Canada approvals, recalls, provincial coverage changes and official prices. How we write

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Sources

  1. Novo Nordisk Canada. Ozempic (semaglutide injection) Product Monograph, 13 July 2026 (type 2 diabetes indications, including reducing the risk of major heart and blood-vessel events in adults with type 2 diabetes and heart or chronic kidney disease, and of kidney decline in type 2 diabetes with chronic kidney disease; GLP‑1 receptor agonist; 0.25 mg for 4 weeks, then 0.5 mg, then 1 mg and 2 mg if needed, maximum 2 mg; SUSTAIN 2 and SUSTAIN 9 results; Table 2 adverse reactions: nausea 17.0% on 0.5 mg and 19.9% on 1 mg vs 6.3% on comparators; once weekly “at any time of the day, with or without meals”; missed dose within 5 days; stop at least 2 months before a planned pregnancy; perioperative aspiration warning). PDF
  2. Eli Lilly Canada. Mounjaro (tirzepatide injection) Product Monograph, 23 June 2026 (type 2 diabetes in adults and ages 10 to under 18; “a GIP and a GLP-1 receptor agonist”; dose steps; oral hormonal contraceptives: switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase; SURPASS-2 Table 10; Table 2 adverse reactions: nausea 12.2%, 15.4% and 18.3% on 5, 10 and 15 mg vs 4.3% on placebo; aspiration warning). PDF
  3. Frías JP, Davies MJ, Rosenstock J, et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2). N Engl J Med 2021;385:503–515. Open-label, 40 weeks, 1,879 people; nausea 17 to 22% on tirzepatide and 18% on semaglutide; funded by Eli Lilly. doi:10.1056/NEJMoa2107519, PMID 34170647. PubMed
  4. European Medicines Agency. Ozempic: EPAR product information (package leaflet section 4: nausea and diarrhea “very common (may affect more than 1 in 10 people)”; vomiting and gallstones “common”; acute pancreatitis “uncommon (may affect up to 1 in 100 people)”). PDF
  5. European Medicines Agency. Mounjaro: EPAR product information (package leaflet section 4: nausea and diarrhea “very common (may affect more than 1 in 10 people)”; vomiting and constipation very common in people treated for weight management; acute pancreatitis and gallstones “uncommon (may affect up to 1 in 100 people)”). PDF
  6. Ontario Ministry of Health. Ontario Drug Benefit Formulary search (Ozempic $227.94 a pen, with the plan paying $78.141; Apo-Semaglutide and Dr. Reddy’s semaglutide $78.141 a pen; Sevmia $325.048 a pen and Wegovy with no price, both “Off-Formulary Interchangeable”; Rybelsus $7.5303 a tablet at every strength; no tirzepatide). Checked 14 October 2026. Link
  7. Canada’s Drug Agency (CDA-AMC). Tirzepatide (Mounjaro) reimbursement recommendation SR0886, meetings 25 March 2026 and reconsideration: “Reimburse with conditions” for type 2 diabetes; the 5 mg cost should not exceed semaglutide 1 mg, and price reductions are needed for 10 and 15 mg; same submitted pen prices of $300, $420 and $540. Link
  8. Ontario Ministry of Health. Executive Officer Notice, 26 January 2024: semaglutide (Ozempic) Limited Use for adults with type 2 diabetes when blood sugar isn’t controlled on the maximum tolerated dose of metformin, or metformin can’t be used. PDF
  9. BC PharmaCare. Limited coverage drugs: semaglutide (Special Authority for type 2 diabetes after inadequate control on maximum tolerated metformin; coverage up to 1 mg weekly; 2 mg under review). Checked 14 October 2026. Link
  10. Diabète Québec. Table of diabetes medications and their coverage, March 2026 (RAMQ: Ozempic an exception drug “in association with MET, where a SU is contraindicated, not tolerated or ineffective”; Mounjaro private insurance only; NIHB: Ozempic and Rybelsus Limited Use). A secondary source: we could not reach the RAMQ list itself. PDF
  11. Health Canada. Drug Product Database: product records, schedule, route and status for every semaglutide, tirzepatide, liraglutide and dulaglutide product (all on the “Prescription” schedule; all subcutaneous injections or oral tablets; for example Sevmia “Approved”, not marketed; first generic semaglutide marketed 6 May 2026). Searched 14 October 2026. Link
  12. Food and Drugs Act (R.S.C., 1985, c. F-27), section 3(1): “No person shall advertise any food, drug, cosmetic or device to the general public as a treatment, preventative or cure for any of the diseases … referred to in Schedule A.1”; Schedule A.1 lists diabetes and obesity. Justice Laws Website. Checked 14 October 2026. Link
  13. Eli Lilly Canada. Zepbound (tirzepatide injection) Product Monograph, 11 June 2026 (indications; 2.5 mg start, maintenance 5, 10 or 15 mg; “The ZEPBOUND multi-dose KwikPen contains 4 doses”; SURMOUNT-1 results; Table 2: nausea 28.0% on 15 mg vs 8.5% on placebo; not to be combined with other tirzepatide or GLP‑1 products; aspiration warning). PDF
  14. Novo Nordisk Canada. Wegovy (semaglutide injection) Product Monograph, 2 October 2026 (indications; dose escalation 0.25, 0.5, 1, 1.7 mg every 4 weeks to 2.4 mg; reassess after 12 weeks on the maintenance dose; STEP 1–3 results; Table 4: nausea 44% vs 16% on placebo; perioperative aspiration warning). PDF
  15. Novo Nordisk Canada. Rybelsus (semaglutide tablets) Product Monograph, 13 July 2026 (type 2 diabetes; 3 mg for 30 days, then 7 mg, then 14 mg if needed, or 1.5, 4 and 9 mg in the newer tablets; empty stomach, at least 30 minutes before food, with no more than 120 mL of water; PIONEER 1 results; Table 3: nausea 11.0% on 7 mg and 19.7% on 14 mg vs 6.4% on placebo; diabetic retinopathy events 4.2% vs 3.8% in pooled trials, and temporary worsening with rapid improvement in glucose; about 1–2% absolute bioavailability; SNAC absorption enhancer; missed dose skipped; aspiration warning). PDF
  16. Pedersen SD, Manjoo P, Dash S, et al. Canadian Adult Obesity Clinical Practice Guideline: Pharmacotherapy for Obesity Management in Adults, 2025 update. Obesity Canada, Version 3, 11 August 2025 (recommendations; six medicines approved for obesity in Canada; off-label use discouraged; trial summaries including when average weight plateaued; stopping and regain). PDF
  17. Heart and Stroke Foundation of Canada. Medical services by phone (811 in most provinces and Yukon; Info-Santé 811 in Quebec). Checked 12 October 2026. Link
  18. Health Canada. Register of Innovative Drugs, 24 January 2025 edition (semaglutide data protection ended 4 January 2026; tirzepatide data protection ends 24 November 2030). PDF

Last checked 14 Oct 2026 · Next review due 14 Apr 2027 · Report an error

How this page was made. Written by the GLP Guidebook team from the sources above. Prices are official list, formulary or maker-submitted prices, never a pharmacy, clinic, savings-card or coupon price. Figures marked as our arithmetic are worked out from those sources. It’s general information, not medical advice, and not an advertisement for any medicine. Talk to your family doctor, nurse practitioner or pharmacist before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand or provider. How we write