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Home/United States/Compare/Mounjaro vs Ozempic: how do blood sugar, weight loss, side effects and cost compare?
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Mounjaro vs Ozempic: how do blood sugar, weight loss, side effects and cost compare?

The one head-to-head trial, each US label’s side effects, the makers’ cash prices and how Medicare treats them. Not a recommendation.

GLP Guidebook teamPublished Oct 14, 20267 min read13 sourcesWritten from published sources
What we checked13 sources, each one opened and linked to the sentence it supportsLast checked Oct 14, 2026 · Next review due Apr 14, 2027 · How we write

Written for the United States. Reading from India? India version

The short answer

In the one head-to-head trial, SURPASS-2, adults with type 2 diabetes lost 17 to 25 lb on Mounjaro (tirzepatide) and 13 lb on Ozempic (semaglutide) 1 mg over 40 weeks. Nausea was similar, about 1 in 5. Cash prices are $499 a month for Mounjaro and $349 to $499 for Ozempic.

At a glance

ItemMounjaroOzempic
Medicine and makerTirzepatide, made by Eli Lilly2Semaglutide, made by Novo Nordisk3
Approved in the US forType 2 diabetes in adults and children 10 and older; lowering heart risk in adults with type 2 diabetes at high risk2Type 2 diabetes in adults; lowering heart risk with heart disease; lowering kidney and heart risk with chronic kidney disease (all with type 2 diabetes)3
How it’s takenInjection under the skin, once a week2Injection under the skin, once a week3
Dose steps2.5 mg for 4 weeks, then up 2.5 mg at a time if needed, after at least 4 weeks each; at most 15 mg for adults and 10 mg for children20.25 mg for 4 weeks, then 0.5 mg; 1 mg and 2 mg if needed, after at least 4 weeks each3
Weight change in the head-to-head trial (SURPASS-2, 40 weeks)17 to 25 lb (7.6 to 11.2 kg) lost on average, by dose. Nausea: 17 to 22 in 1001,213 lb (5.7 kg) lost on average, at 1 mg. Nausea: 18 in 1001,2
Most common side effects (label)Nausea, diarrhea, less appetite, vomiting, constipation, indigestion, stomach pain2Nausea, vomiting, diarrhea, stomach pain, constipation3
Maker’s self-pay price$499 a month at every dose; about $6,487 a year (13 fills)5$349 a month (0.25 to 1 mg) or $499 (2 mg); about $4,537 or $6,487 a year4
List price$1,112.16 a month7$1,027.51 a month, falling to $675 on Jan 1, 20276,8
CoveragePrivate plans set their own drug lists; Medicare Part D can cover it for type 2 diabetes; not on the $50 Medicare Bridge10,11Private plans set their own drug lists; Medicare Part D can cover it for type 2 diabetes; not on the $50 Medicare Bridge10,11

Not a ranking: the columns sit in alphabetical order. Prices are the makers’ published self-pay and list prices, checked Oct 14, 2026. A year of weekly doses is 13 four-week fills (our arithmetic). Weight figures are averages from one trial in adults with type 2 diabetes taking metformin.

Key takeaways

  • In SURPASS-2, a 40-week head-to-head trial in 1,879 adults with type 2 diabetes, weight fell 17 to 25 lb on Mounjaro and 13 lb on Ozempic 1 mg.1,2
  • Mounjaro contains tirzepatide, which acts on GIP and GLP‑1 receptors; Ozempic contains semaglutide, which acts on GLP‑1 receptors only.2,3
  • Nausea was the most common side effect of both in SURPASS-2, reported by 17 to 22 in 100 on Mounjaro and 18 in 100 on Ozempic.1
  • Mounjaro’s self-pay price is $499 a month at every dose; Ozempic’s is $349 a month up to 1 mg and $499 at 2 mg.4,5
  • Medicare Part D can cover both for type 2 diabetes, but the $50 Medicare GLP‑1 Bridge for weight covers neither.10,11
Before you go further
  • This compares labels and trials. It doesn’t say which medicine suits you, and we don’t rank brands: a prescriber decides.
  • Prices are the makers’ published self-pay and list prices, never a seller’s.
  • Both carry the same class of risks: see below and our side effects guide.
On this page
  1. What is the difference between Mounjaro and Ozempic?
  2. Has anyone tested Mounjaro against Ozempic?
  3. How do the side effects compare?
  4. What do Mounjaro and Ozempic cost without insurance?
  5. Will insurance or Medicare cover Mounjaro or Ozempic?
  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 from different makers: Mounjaro is tirzepatide from Eli Lilly, and Ozempic is semaglutide from Novo Nordisk.2,3

Both copy gut hormones your body releases after eating. These hormones help the pancreas release insulin when blood sugar is high, and they slow how fast the stomach empties.2,3 Semaglutide copies one hormone, GLP‑1. Tirzepatide copies GLP‑1 and a second one, GIP (glucose-dependent insulinotropic polypeptide).2

Both are approved in the US for type 2 diabetes, not for weight loss.2,3 The same medicines are sold for weight under other names: tirzepatide as Zepbound and semaglutide as Wegovy. Those two are compared in Zepbound vs Wegovy, and the two tirzepatide brands in Mounjaro vs Zepbound.

Has anyone tested Mounjaro against Ozempic?

Yes: SURPASS-2 compared them directly for 40 weeks in 1,879 adults with type 2 diabetes who were already taking metformin.1

People got Mounjaro 5, 10 or 15 mg, or Ozempic 1 mg, once a week. They knew which medicine they had (open-label). Eli Lilly, Mounjaro’s maker, paid for the trial.1

Blood sugar. HbA1c is a blood test showing your average blood sugar over about 3 months. It started at 8.3% on average. It fell 2.0 to 2.3 points on Mounjaro and 1.9 points on Ozempic.1,2

SURPASS-2
Average weight change after 40 weeks
1,879 adults with type 2 diabetes on metformin · average start 207 lb (93.7 kg) · no placebo group
Mounjaro 15 mg−24.7 lb
Mounjaro 10 mg−20.5 lb
Mounjaro 5 mg−16.8 lb
Ozempic 1 mg−12.6 lb
From the US Mounjaro label’s SURPASS-2 table: −11.2, −9.3, −7.6 and −5.7 kg. Pounds are our conversion. Averages: some people lost much more, some very little.2

Two limits matter. The trial used Ozempic 1 mg, not the 2 mg dose approved since. In Ozempic’s own 40-week trial, people on 2 mg lost 14.1 lb (6.4 kg) and those on 1 mg lost 12.3 lb (5.6 kg). The label calls that gap not statistically significant.3 And the trial was in diabetes, so its weight numbers are not the weight-loss doses.

For weight, a separate trial (SURMOUNT-5) compared the same two medicines at the doses sold as Zepbound and Wegovy, in adults without diabetes.12 See Zepbound vs Wegovy.

How do the side effects compare?

Both mostly cause stomach effects, worst while the dose goes up; in SURPASS-2, nausea affected 17 to 22 in 100 on Mounjaro and 18 in 100 on Ozempic.1

In the same trial, diarrhea affected 13 to 16 in 100 on Mounjaro and 12 in 100 on Ozempic. Vomiting affected 6 to 10 in 100 and 8 in 100. Serious side effects of any kind were reported in 5 to 7 in 100 on Mounjaro and 3 in 100 on Ozempic.1

Each US label also counts side effects against a dummy injection (placebo), in separate trials:

  • Mounjaro: 12 to 18 in 100 felt sick, against 4 in 100 on placebo. Stomach side effects made 3 to 7 in 100 stop, against under 1 in 100.2
  • Ozempic 0.5 and 1 mg: 16 to 20 in 100 felt sick, against 6 in 100 on placebo. Stomach side effects made about 3 to 4 in 100 stop, against under 1 in 100.3

Those two lists come from different trials, so they can’t be set against each other directly.2,3

RisksThe risks, in brief
  • Low blood sugar. Taken with insulin or a sulfonylurea (a type of diabetes pill), both raise the risk of low blood sugar, including severe lows. The dose of those may need lowering.2,3
  • Pancreatitis (an inflamed pancreas): severe stomach pain that won’t go away and may spread to the back. Both labels say to stop the medicine if it is suspected.2,3
  • Gallbladder. Gallbladder problems were reported in 6 in 1,000 people on Mounjaro, against none on placebo.2 Gallstones were reported in 4 to 15 in 1,000 on Ozempic, against none on placebo.3
  • Eyes. Diabetic eye disease (retinopathy) can briefly worsen when blood sugar falls fast. Both labels say people with it should be monitored.2,3
  • Thyroid warning. Both carry a boxed warning: not for people with a personal or family history of medullary thyroid cancer (MTC) or MEN 2, a rare inherited condition that causes gland tumors.2,3
  • Surgery and sedation. Both slow the stomach. Tell the team before any planned procedure, because food left in the stomach can be breathed in under anesthesia.2,3
  • Pregnancy and the pill. The Ozempic label says to stop at least 2 months before a planned pregnancy.3 Mounjaro can make birth-control pills less reliable for 4 weeks after starting and after each dose step.2
Full detail in our side effects guide →
Get help now: call 911 or go to the ER for severe stomach pain that won’t go away, with or without vomiting (it can be pancreatitis), for swelling of the face or throat or trouble breathing, or for very low blood sugar with confusion or fainting. For a possible overdose, Poison Control is 1-800-222-1222.2,3,13
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What do Mounjaro and Ozempic cost without insurance?

Paying cash, Mounjaro is $499 a month at every dose; Ozempic is $349 a month up to 1 mg and $499 at 2 mg.4,5

  • Mounjaro: $499 a month for single-dose pens from 2.5 to 15 mg, Lilly’s self-pay price. A year of 13 fills comes to $6,487.5
  • Ozempic: $349 a month for 0.25, 0.5 or 1 mg and $499 for 2 mg. New patients pay $199 for their first 2 fills, through Dec 31, 2026. A year at $349 comes to $4,537.4

List prices (wholesale acquisition cost) are what makers charge wholesalers before discounts and rebates. Mounjaro lists at $1,112.16 a month and Ozempic at $1,027.51.6,7 Novo Nordisk says Ozempic’s list price falls to $675 a month on January 1, 2027, and that this doesn’t change self-pay prices.8 Each has its own answer: Ozempic and Mounjaro without insurance.

Will insurance or Medicare cover Mounjaro or Ozempic?

For type 2 diabetes, Medicare Part D plans can cover both, and private plans set their own lists; neither is covered for weight loss alone by Medicare.10

Medicare. The law bars Part D from paying for drugs used only for weight loss. Plans can cover GLP‑1 medicines for type 2 diabetes, heart-risk reduction or sleep apnea.10 The $50 Medicare GLP‑1 Bridge for weight covers Foundayo, Wegovy and the Zepbound KwikPen, not Mounjaro or Ozempic.11 More on how Medicare covers GLP‑1s.

Private plans. Each plan decides which brand it prefers and may ask for prior authorization. If your plan covers the drug, both makers offer savings cards that can bring a copay to $25; they exclude Medicare, Medicaid and other government plans.4,9 See prior authorization, step by step.

Which one? What does a doctor weigh?

There is no single right answer, and we don’t recommend either: a prescriber looks at your blood sugar goals, other conditions, other medicines and what your plan covers.

  • Blood sugar and weight goals. SURPASS-2 is the one head-to-head trial, with the limits above.1
  • Kidney disease. Ozempic is approved to lower the risk of kidney failure and heart death in type 2 diabetes with chronic kidney disease. Mounjaro’s label has no kidney approval.2,3
  • Heart disease. Both are approved to lower heart risk in type 2 diabetes, for slightly different groups of people.2,3
  • Children. Mounjaro is approved for type 2 diabetes from age 10; Ozempic’s label is for adults.2,3
  • Other medicines. Insulin or a sulfonylurea may need a lower dose with either. On Mounjaro, birth-control pills need a backup method at the start and after each dose step.2,3
  • Cost and coverage. Which brand your plan prefers can decide what you pay.9,4

If you have type 2 diabetes, our type 2 diabetes path walks through the options.

Questions people ask

Does Mounjaro lower weight and blood sugar more than Ozempic?

In SURPASS-2, average weight loss was 17 to 25 lb on Mounjaro and 13 lb on Ozempic 1 mg over 40 weeks, and HbA1c fell slightly more on Mounjaro. Serious side effects were reported in 5 to 7 in 100 on Mounjaro and 3 in 100 on Ozempic. Lilly paid for the trial, and it didn’t test Ozempic 2 mg.1,2

Are Mounjaro and Ozempic the same thing?

No. Mounjaro is tirzepatide, which acts on GIP and GLP-1 receptors; Ozempic is semaglutide, which acts on GLP-1 receptors only.2,3

Can you switch from Ozempic to Mounjaro?

A prescriber can switch you. We found no dose conversion between them on either US label.2,3

Which has more side effects, Mounjaro or Ozempic?

In SURPASS-2, nausea was similar: 17 to 22 in 100 on Mounjaro and 18 in 100 on Ozempic. Serious side effects were reported in 5 to 7 in 100 and 3 in 100.1

Is Mounjaro or Ozempic approved for weight loss?

Neither. Both are approved for type 2 diabetes. The weight-loss brands of the same medicines are Zepbound and Wegovy.2,3

How we researched this

We used the SURPASS-2 paper (New England Journal of Medicine, 2021), the current US labels for Mounjaro (revised August 2026) and Ozempic (revised May 2026), the makers’ self-pay and list prices, and KFF and CMS documents on Medicare, all checked on October 14, 2026.1,2,3,4,10,11

Pound conversions and yearly totals are our arithmetic.

Before you move on

  • Ask which brand your plan prefers for type 2 diabetes.
  • Ask whether your heart or kidney health changes the choice.
  • List every diabetes medicine you take, especially insulin.
  • Plan for stomach side effects while the dose rises.
  • Tell every doctor and dentist you take it before a procedure.
Cost calculatorSide effects and risksType 2 diabetes pathAll GLP-1 prices

More comparisons

USUnited StatesZepbound vs Wegovy: which loses more weight, and how do side effects, cost and coverage compare?USUnited StatesMounjaro vs Zepbound: what is the difference, and why is coverage different?USUnited StatesOzempic vs Wegovy: same medicine, so what is the difference in dose, weight loss, cost and coverage?
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: FDA approvals and warnings, Medicare and Medicaid changes, and makers’ price changes. How we write

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Sources

  1. Frías JP, et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2). N Engl J Med 2021;385:503-515. doi:10.1056/NEJMoa2107519. PMID 34170647. Funded by Eli Lilly. Link
  2. Eli Lilly. Mounjaro (tirzepatide): US prescribing information. Revised 08/2026. US label. Link
  3. Novo Nordisk. Ozempic (semaglutide) injection: US prescribing information. Revised 05/2026. US label. Link
  4. Novo Nordisk. Ozempic pill and pen price guide (US26NC00009, May 2026): pen $349 a month for 0.25, 0.5 or 1 mg and $499 for 2 mg; new patients $199 for the first 2 fills of 0.25 or 0.5 mg through Dec 31, 2026; insured copay “as little as $25”, “Government beneficiaries excluded”. Checked Oct 14, 2026. Link
  5. Eli Lilly. LillyDirect Mounjaro page: self-pay price “Starting at $499/month” for every single-dose pen strength from 2.5 to 15 mg. Checked Oct 14, 2026. Not linked because the page sells medicine.
  6. Novo Nordisk Pricing. Ozempic wholesale acquisition cost (list price): $1,027.51 per pen at every dose. Checked Oct 14, 2026. Link
  7. TrumpRx.gov (US government price-listing site). Mounjaro single-dose pen: “Original Price” $1,112.16 at every strength. Checked Oct 14, 2026. Link
  8. Novo Nordisk. Novo Nordisk announces significant reduction in US list price for Wegovy, Ozempic and Rybelsus ($675 a month from Jan 1, 2027). News release, February 24, 2026. Link
  9. Eli Lilly. Mounjaro savings and resources: commercially insured with coverage “may pay as little as $25” for up to a 3-month fill; commercially insured without coverage “as low as $499” a month; “Governmental beneficiaries excluded”. Checked Oct 14, 2026. Maker’s terms page; plain text, no link.
  10. KFF. What to know about the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. May 11, 2026. Link
  11. Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge: information for prescribers (covers Foundayo, Wegovy and the Zepbound KwikPen; July 1, 2026 to Dec 31, 2027). June 2026. Link
  12. Aronne LJ, et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025;393:26-36. doi:10.1056/NEJMoa2416394. PMID 40353578. Funded by Eli Lilly. Link
  13. Poison Control (National Capital Poison Center). Poison help line 1-800-222-1222. Link

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

How this page was made. Written by the GLP Guidebook team from the sources above. It’s general information, not medical advice. Talk to your doctor, pharmacist or prescriber before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand or provider. How we write