Ozempic vs Mounjaro: The Diabetes Pair, Compared Head-to-Head
Ozempic (semaglutide, Novo Nordisk) vs Mounjaro (tirzepatide, Eli Lilly)
Last verified November 2026
The verdict
Neither drug carries a weight-loss label. Both treat type 2 diabetes, and both get prescribed off-label for weight constantly. SURPASS-2 compared them directly: −11.2 kg on Mounjaro 15 mg against −5.7 kg on Ozempic 1 mg over 40 weeks, with a larger A1C drop too. Ozempic has SUSTAIN-6 (MACE −26%). Mounjaro now has SURPASS-CVOT (NEJM, December 2025), in which it was noninferior to dulaglutide, and its label carries a cardiovascular indication too. Ozempic lists at about $1,028 and now has a $349–$499 NovoCare self-pay price; LillyDirect lists Mounjaro at $499 a month at every strength.
Side-by-side comparison
| Field | Ozempic | Mounjaro |
|---|---|---|
| Mean weight loss (TBWL, head-to-head) | -5.7 kg / 40 wks (Ozempic 1mg) | -11.2 kg / 40 wks (Mounjaro 15mg) |
| A1C reduction (SURPASS-2) | -1.86% (Ozempic 1mg) | -2.30% (Mounjaro 15mg) |
| Mechanism | GLP-1 receptor agonist | Dual GIP / GLP-1 agonist |
| FDA-approved indication | Type 2 diabetes; CV risk reduction in T2D + CVD | Type 2 diabetes (weight management requires Zepbound) |
| Cardiovascular outcome | MACE -26% (SUSTAIN-6, 2016) | SURPASS-CVOT (2025): noninferior to dulaglutide (HR 0.92); MACE indication on the label |
| Dosing | Once-weekly subq 0.25-2.0 mg (4-step titration) | Once-weekly subq 2.5-15 mg (6-step titration) |
| Most common adverse event | Nausea (~20% at 1 mg; Ozempic label) | Nausea (~22% at 15mg; SURPASS-2) |
| Cash price (US, ~2026) | $349–$499/mo via NovoCare self-pay ($499 at 2 mg) | $499/mo via LillyDirect self-pay at every strength |
What each one costs in the compounded market
Standing monthly cash prices from the 734 sellers on this register. These are compounded preparations, not the approved products compared above.
Ozempic — semaglutide
from $47 /mo
463 sellers publish a standing price. This is the lowest of all 463; the median is $174 a month.
Where to get semaglutide — a selection of sellers, not a price ranking
- Embody review$79/mo
- SnagRx review$99/mo
- Collective review$59/mo + membership
Mounjaro — tirzepatide
from $69 /mo
453 sellers publish a standing price. This is the lowest of all 453; the median is $228.28 a month.
Where to get tirzepatide — a selection of sellers, not a price ranking
- Embody review$129/mo
- SnagRx review$149/mo
- Collective review$69/mo + membership
⚠ A compounded preparation is not the approved product. No agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed when the shortages closed. The price gap is real, and so is the difference in oversight. Every seller, with its price record.
Frequently asked questions
Which works better for weight loss, Ozempic or Mounjaro?
On the trial evidence, Mounjaro: Ozempic at -5.7 kg / 40 wks (Ozempic 1mg) against Mounjaro at -11.2 kg / 40 wks (Mounjaro 15mg), measured head-to-head. That is the strongest form of this evidence, because both arms run under one protocol rather than being two separate studies set side by side.
Are Ozempic and Mounjaro the same drug?
No. Ozempic is semaglutide and Mounjaro is tirzepatide — different molecules, and they work differently: GLP-1 receptor agonist against Dual GIP / GLP-1 agonist. Results with one do not predict results with the other.
Is Ozempic or Mounjaro cheaper?
On the manufacturers' own cash pricing: Ozempic at $349–$499/mo via NovoCare self-pay ($499 at 2 mg), Mounjaro at $499/mo via LillyDirect self-pay at every strength. That is the list-price comparison, and it is not what most people pay. What you actually pay depends on whether your plan covers it, which formulary tier it sits in, and whether you have met your deductible — and for many people the honest comparison is between an insured copay and a cash-pay compounded alternative rather than between these two figures.
Does either one have better cardiovascular evidence?
Ozempic does. Ozempic: MACE -26% (SUSTAIN-6, 2016). Mounjaro: SURPASS-CVOT (2025): noninferior to dulaglutide (HR 0.92); MACE indication on the label. This matters more than it first appears — a drug with a completed outcomes trial has evidence about events that matter, not only about weight, and that is often what decides coverage.
Which has worse side effects, Ozempic or Mounjaro?
The most common adverse event reported was Nausea (~20% at 1 mg; Ozempic label) for Ozempic and Nausea (~22% at 15mg; SURPASS-2) for Mounjaro. Rates come from separate trial populations and are not a like-for-like comparison. In practice how fast the dose is escalated affects tolerability at least as much as which drug it is, which is one reason a slower titration is worth asking for.
How is each one taken?
Ozempic: Once-weekly subq 0.25-2.0 mg (4-step titration). Mounjaro: Once-weekly subq 2.5-15 mg (6-step titration). Worth weighing honestly against your own habits — the best drug for you is partly the one you will still be taking in eight months, and a dosing routine that does not fit a life gets abandoned.
What does a compounded version of each actually cost?
Across the 734 sellers in this register, the cheapest standing monthly cash prices we hold are semaglutide from $47 a month and tirzepatide from $69 a month. A compounded preparation is not the approved product: no agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed once the shortages closed. The price gap is real and so is the difference in oversight.
Can I switch from Ozempic to Mounjaro?
Yes, with a prescriber. Expect to re-titrate from the bottom of the new drug's ladder rather than starting where you left off: these are different molecules and tolerance to one does not transfer to the other. Both the old drug's washout and the new drug's schedule apply.
Which one should I ask for?
That is a prescriber's call, and anyone answering it from a table is guessing. What a page like this can do is tell you what the trials measured, what the manufacturers charge, and where the evidence is still missing, so the conversation starts from the record rather than from an advertisement.
References
- 1.Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). N Engl J Med. 2021. PMID: 34170647.
- 2.Pratley RE, Aroda VR, Lingvay I, Lüdemann J, Andreassen C, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018. PMID: 29397376.
- 3.Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6). N Engl J Med. 2016. PMID: 27633186.
- 4.Novo Nordisk Pharmaceutical Industries, LP. OZEMPIC (semaglutide) injection prescribing information. DailyMed (FDA label). 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- 5.Eli Lilly and Company. MOUNJARO (tirzepatide) injection prescribing information. DailyMed (FDA label). 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
- 6.Nicholls SJ, et al. Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes N Engl J Med. 2025. PMID: 41406444.
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See the full drug-vs-drug verdict index or provider rankings.