Mounjaro vs Ozempic: how the two diabetes shots compare

Mounjaro and Ozempic are both once-weekly type 2 diabetes injections, but they contain different drugs: Mounjaro is tirzepatide from Eli Lilly, which acts on two gut-hormone receptors (GIP and GLP-1), and Ozempic is semaglutide from Novo Nordisk, which acts on one (GLP-1). In SURPASS-2, the trial that tested them against each other, tirzepatide lowered blood sugar and body weight more than semaglutide 1 mg, an Ozempic dose.

Neither is approved for weight loss. The same two molecules are sold for weight loss as Zepbound and Wegovy, which matters for what you pay and what insurance covers. Here is how the two compare, with prices as of October 27, 2026.

Mounjaro and Ozempic at a glance

Sources: the Mounjaro and Ozempic labels, LillyDirect and NovoCare Pharmacy.

Tirzepatide vs Ozempic: what SURPASS-2 found

SURPASS-2 randomly assigned 1,879 adults with type 2 diabetes whose blood sugar wasn’t controlled on metformin to tirzepatide 5, 10 or 15 mg or semaglutide 1 mg, once a week for 40 weeks. Average A1C at the start was 8.3%. The trial was open-label, so people knew which drug they took, and Lilly funded it.

Scroll sideways to see the full table

Source: Mounjaro label, Table 5.

Every tirzepatide dose lowered A1C more than semaglutide 1 mg, and the weight gap grew with dose, from 1.9 kg at 5 mg to 5.5 kg at 15 mg. Two limits apply. First, 1 mg isn’t Ozempic’s top dose. In a separate 40-week trial on the Ozempic label, people on Ozempic 2 mg lost 6.4 kg against 5.6 kg on 1 mg, a difference the label calls not statistically significant. No trial has tested Mounjaro against Ozempic 2 mg. Second, individual results vary widely around these averages.

Approved uses beyond blood sugar

Both labels go beyond A1C, in different directions:

• Mounjaro is approved to lower the risk of cardiovascular death, heart attack and stroke in adults with type 2 diabetes at high risk of them. In SURPASS-CVOT, 13,299 adults with type 2 diabetes and heart disease took Mounjaro or dulaglutide (Trulicity), another GLP-1 drug. Mounjaro was shown to be no worse than dulaglutide, with a hazard ratio of 0.92, but it wasn’t shown to be better. Mounjaro is also approved for blood sugar control in children 10 and older, up to 10 mg.
• Ozempic is approved to lower the risk of major cardiovascular events in adults with type 2 diabetes and established heart disease, and to lower the risk of sustained kidney decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. It’s approved for adults only.

If you have kidney disease, that indication is on Ozempic’s label and not on Mounjaro’s.

Side effects

Both labels carry a boxed warning for thyroid C-cell tumors: each drug caused these tumors in rats, and it isn’t known whether it does in people. Neither is for anyone with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2).

After that, stomach side effects lead on both. SURPASS-2 put the two drugs in one trial, which makes its rates the fairest comparison:

Source: SURPASS-2. Most stomach effects were mild to moderate.

On their own labels, against placebo in type 2 diabetes, nausea affected 12% to 18% on Mounjaro 5 to 15 mg (4% on placebo) and 15.8% to 20.3% on Ozempic 0.5 mg and 1 mg (6.1% on placebo). Both labels also warn about pancreatitis, low blood sugar when combined with insulin or a sulfonylurea, kidney injury from dehydration, severe stomach problems and diabetic eye complications. Our GLP-1 side effects guide covers what helps.

Doses and devices

Mounjaro starts at 2.5 mg once a week. If blood sugar needs more control, the dose rises in 2.5 mg steps at least 4 weeks apart, to a maximum of 15 mg for adults. It comes as single-dose pens and vials, plus a multi-dose vial and a KwikPen that each hold four weekly doses. LillyDirect’s self-pay price covers the single-dose pen.

Ozempic starts at 0.25 mg once a week for 4 weeks, then 0.5 mg. If blood sugar needs more control, it can go to 1 mg and then 2 mg, each after at least 4 weeks on the dose below. The 1 mg and 2 mg pens each hold four weekly doses. Novo Nordisk also sells Ozempic tablets (1.5, 4 and 9 mg), taken daily on an empty stomach for type 2 diabetes. Both injections can be taken at any time of day, with or without meals.

What each costs in October 2026

Prices read on October 27, 2026, from LillyDirect and NovoCare Pharmacy. Mounjaro costs the same at every dose, so its self-pay price only matches Ozempic’s at Ozempic’s 2 mg dose. The Ozempic tablets start at $149 a month at NovoCare. Our Mounjaro cost and Ozempic cost guides go further.

With commercial insurance that covers the drug, both makers’ savings cards can bring a fill to as little as $25. Lilly’s Mounjaro card caps savings at $150 a month and $1,950 a calendar year (Lilly); Novo Nordisk’s Ozempic offer caps them at $100 a month. Lilly’s card isn’t open to people with Medicare, Medicaid or other government coverage, and it requires a prescription “for an approved use consistent with FDA approved product labeling,” which for Mounjaro means type 2 diabetes.

Ozempic vs Mounjaro for weight loss

Many people search this pair because of weight. Both drugs lower weight, but neither label includes weight management, so prescribing either for weight loss alone is off-label. The same molecules are approved for weight loss under other names:

• Zepbound is tirzepatide, approved for weight reduction in adults with obesity, or overweight with a weight-related condition, and for sleep apnea with obesity. When the FDA approved it on November 8, 2023, it said Zepbound should not be used with Mounjaro or a GLP-1 drug.
• Wegovy is semaglutide, approved for weight reduction from age 12.

For weight, the strongest comparison is SURMOUNT-5: 751 adults with obesity but without diabetes lost 20.2% of body weight on tirzepatide (10 or 15 mg) and 13.7% on semaglutide (1.7 or 2.4 mg) over 72 weeks. It was open-label and funded by Lilly.

Switching to the weight-loss brand can cost less too. As of October 27, 2026, LillyDirect sells Zepbound vials and KwikPens at $299 to $449 a month, with $449 at 7.5 mg and up when you refill within 45 days, against $499 for Mounjaro. See Mounjaro vs Zepbound, Wegovy vs Mounjaro and Zepbound vs Ozempic.

Insurance and Medicare

Coverage follows the reason for the prescription. A commercial plan that covers diabetes drugs may cover Mounjaro or Ozempic for type 2 diabetes and still exclude weight-loss drugs, and many plans prefer one brand, so check your plan’s drug list before you choose. Our insurance guide lists the questions to ask.

On Medicare, type 2 diabetes prescriptions go to your regular Part D plan. The Medicare GLP-1 Bridge form, which handles weight-loss prescriptions at $50 a month, lists Foundayo, Wegovy and the Zepbound KwikPen, not Mounjaro or Ozempic. See does Medicare cover Wegovy or Zepbound.

Which one fits you

• For the larger average drop in A1C and weight, tirzepatide led semaglutide 1 mg in SURPASS-2.
• With chronic kidney disease and type 2 diabetes, Ozempic carries the kidney-risk indication.
• With heart disease, both have a cardiovascular indication, worded differently on each label.
• For a lower cash price up to 1 mg, Ozempic is $150 a month less than Mounjaro.
• For a daily pill instead of a shot, Ozempic has a tablet form; Mounjaro doesn’t.
• For a child 10 to 17 with type 2 diabetes, Mounjaro is approved; Ozempic is for adults.
• If weight loss is the main goal, ask about Zepbound or Wegovy, which are approved for it.

A licensed clinician can weigh these with your history, other medicines and coverage. If weight loss is the goal, our brand-name GLP-1 rankings compare programs that prescribe the approved brands.

The bottom line

Mounjaro (tirzepatide) and Ozempic (semaglutide) are different drugs from different makers, both approved for type 2 diabetes. In SURPASS-2, tirzepatide lowered A1C by up to 2.3 points and weight by up to 11.2 kg over 40 weeks, against 1.9 points and 5.7 kg on semaglutide 1 mg. Ozempic costs less self-pay up to 1 mg, $349 a month against Mounjaro’s $499 as of October 27, 2026, and carries a kidney indication. Neither is approved for weight loss; for that, the like-for-like choices are Zepbound and Wegovy. Choose with a licensed clinician, and see our weight-loss hub for more.