Mounjaro vs Ozempic: Head-to-Head Trial, Approved Uses, Doses and Cost (2026)

Short answer: Mounjaro (tirzepatide, Eli Lilly) and Ozempic (semaglutide, Novo Nordisk) are both weekly injections approved for type 2 diabetes. Mounjaro acts on two hormone receptors, GIP and GLP-1; Ozempic acts on GLP-1 alone.^[1][2] In SURPASS-2, the head-to-head trial in 1,879 adults with type 2 diabetes, tirzepatide lowered HbA1c by 2.01 to 2.30 points over 40 weeks against 1.86 on semaglutide 1 mg, and body weight by 1.9 to 5.5 kg more.^[3] Neither is approved for weight management; the same molecules are sold for that as Zepbound and Wegovy.^[4][5]

Whichever one a prescriber chooses, eating well on a smaller appetite matters on both, and that is the subject of our guide to what to eat when you're eating less. General information, not medical advice. Everything below is from the FDA labels, the published trials and the makers' own price pages, as of November 13, 2026.

Mounjaro vs Ozempic at a glance

	Mounjaro	Ozempic
Maker and molecule	Eli Lilly; tirzepatide (also sold as Zepbound for weight management)[1][6]	Novo Nordisk; semaglutide (also sold as Wegovy for weight management, and as Rybelsus)[2][7]
Receptors	GIP and GLP-1[1]	GLP-1[2]
FDA-approved uses (date)	Blood sugar control in adults with type 2 diabetes (May 13, 2022) and children 10 and older (December 19, 2025); lowering heart attack, stroke and cardiovascular death risk in adults with type 2 diabetes at high cardiovascular risk (August 27, 2026)[4][1]	Blood sugar control in adults with type 2 diabetes (December 5, 2017); lowering heart attack, stroke and cardiovascular death risk in adults with type 2 diabetes and heart disease (January 16, 2020); lowering the risk of kidney decline, kidney failure and cardiovascular death in adults with type 2 diabetes and chronic kidney disease (January 28, 2025)[5][2]
Approved for weight management?	No. Neither label lists it; the weight-management brands are Zepbound and Wegovy.[1][2]
Forms	Weekly injection: single-dose pen, vials or KwikPen. No pill.[1]	Weekly injection (pen); a separate daily tablet, Ozempic tablets, is also approved for type 2 diabetes[2][8]
Label dose range	Starts at 2.5 mg; up in 2.5 mg steps; maximum 15 mg in adults, 10 mg in children[1]	Starts at 0.25 mg; maintenance 0.5, 1 or 2 mg; maximum 2 mg[2]
Head to head (SURPASS-2, 40 weeks, type 2 diabetes)	HbA1c −2.01 / −2.24 / −2.30 points on 5 / 10 / 15 mg; body weight −7.6 / −9.3 / −11.2 kg[3][1]	Semaglutide 1 mg: HbA1c −1.86 points; body weight −5.7 kg[3][1]
Most common digestive adverse reactions (label, drug vs placebo)	5 / 10 / 15 mg: nausea 12% / 15% / 18% vs 4%; diarrhea 12% / 13% / 17% vs 9%; vomiting 5% / 5% / 9% vs 2%; constipation 6% / 6% / 7% vs 1%[1]	0.5 / 1 mg: nausea 15.8% / 20.3% vs 6.1%; diarrhea 8.5% / 8.8% vs 1.9%; vomiting 5% / 9.2% vs 2.3%; constipation 5% / 3.1% vs 1.5%[2]
Boxed warning	The same on both: risk of thyroid C-cell tumors, seen in rodents, human relevance unknown. Not for anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2.[1][2]
Maker's prices (November 2026)	As little as $25 with commercial coverage; as low as $499 a month with commercial insurance that does not cover it, under a savings card ending December 31, 2026[9]	Self-pay pen $349 a month for 0.25 to 1 mg, $499 for 2 mg; as little as $25 with commercial coverage[10]

The adverse reaction rows come from each drug's own placebo trials, in different people, so they are not a ranking: rates from one drug's trials cannot be compared directly with another's.^[1] The SURPASS-2 row is the like-for-like comparison. Each medicine has its own reference page: tirzepatide (Mounjaro, Zepbound) and semaglutide (Ozempic, Wegovy).

What did the head-to-head trial, SURPASS-2, find?

SURPASS-2 is the trial that put Mounjaro's and Ozempic's active ingredients side by side. It was published in the New England Journal of Medicine in 2021 and funded by Eli Lilly, the maker of tirzepatide.^[3]

• Who took part: 1,879 adults with type 2 diabetes on metformin, with an average HbA1c of 8.28%, average age 56.6 and average weight 93.7 kg.^[3]
• Design: phase 3 and open-label, so participants knew which drug they were on. Randomized 1:1:1:1 to tirzepatide 5, 10 or 15 mg or semaglutide 1 mg, once a week for 40 weeks.^[3]
• Main question: the change in HbA1c, the 3-month average of blood sugar.^[3]

SURPASS-2 at 40 weeks	Tirzepatide 5 mg	Tirzepatide 10 mg	Tirzepatide 15 mg	Semaglutide 1 mg
Change in HbA1c (points)	−2.01	−2.24	−2.30	−1.86
Change in body weight	−7.6 kg	−9.3 kg	−11.2 kg	−5.7 kg
Difference in body weight vs semaglutide	−1.9 kg	−3.6 kg	−5.5 kg	—
Low blood sugar (below 54 mg/dL)	0.6%	0.2%	1.7%	0.4%
Serious adverse events	5% to 7%			3%

Sources: the paper for HbA1c, the weight differences, low blood sugar and serious events,^[3] and the Mounjaro label for the weight changes in kilograms.^[1] Every tirzepatide dose was statistically superior to semaglutide on HbA1c and on body weight.^[3]

How to read it. Three limits matter. The trial was open-label and sponsored by Lilly. It lasted 40 weeks, not years. And it used semaglutide 1 mg, which was then Ozempic's top dose; the label now goes up to 2 mg, and no trial has compared Mounjaro 15 mg with Ozempic 2 mg.^[3][2]

Is Mounjaro better than Ozempic?

On HbA1c and body weight at 40 weeks, tirzepatide came out ahead in SURPASS-2.^[3] "Better" for one person depends on more than those averages, and these are the points a prescriber weighs:

• Heart and kidney disease. Ozempic is approved to lower cardiovascular risk in type 2 diabetes with heart disease, based on SUSTAIN 6 against placebo (6.6% vs 8.9% had a heart attack, stroke or cardiovascular death), and to lower kidney risk in type 2 diabetes with chronic kidney disease, based on FLOW (18.7% vs 23.2% had a major kidney event or cardiovascular death).^[2] Mounjaro's cardiovascular approval rests on SURPASS-CVOT, where it was compared with another GLP-1 drug, dulaglutide: 12.2% vs 13.1%, shown to be not worse, though superiority was not shown.^[11][1] Mounjaro has no kidney approval.
• Age. Mounjaro is approved for children 10 and older with type 2 diabetes; the Ozempic indications are for adults.^[1][2]
• Form. Semaglutide also comes as a daily tablet for type 2 diabetes; tirzepatide does not.^[8]
• Tolerability and cost, which vary by person and by plan.

Why do people search Mounjaro vs Ozempic for weight?

Because the molecules are the same as the weight-management brands. Mounjaro and Zepbound are both tirzepatide at the same 2.5 to 15 mg strengths; Ozempic and Wegovy are both semaglutide, at different doses.^[1][6][2][7] The difference is the approved use. Prescribing an approved drug for a use not on its label is called off-label use; the FDA says prescribers generally may do this when they judge it right for a patient, but the FDA has not found the drug safe and effective for that use.^[12]

So for body weight on its own, the products studied and approved are Zepbound and Wegovy, and the comparison people want is Zepbound vs Wegovy, where the SURMOUNT-5 trial compared them directly. The approved use also drives coverage: Medicare Part D cannot cover drugs used for obesity alone,^[13] while Lilly says many Part D plans cover Mounjaro for type 2 diabetes.^[9]

How do they work differently?

Semaglutide is a long-acting copy of GLP-1, a gut hormone released after eating. It raises insulin release when blood sugar is high, lowers glucagon, slows stomach emptying and acts on appetite centers in the brain.^[7] Tirzepatide is one molecule that activates both the GLP-1 receptor and the receptor for a second gut hormone, GIP; nonclinical studies suggest GIP may add to the regulation of food intake.^[6] That is why tirzepatide is called a dual agonist. Its half-life is about 5 days; semaglutide's is about 1 week.^[6][7]

Mounjaro and Ozempic dosing: what the labels say

Both start low and step up, to reduce digestive reactions. The schedules are reproduced so you can see what each label says, not so you can follow them yourself.

What the FDA labels say — not dosing advice; your prescriber sets your dose.^[1][2]

	Mounjaro (weekly injection)	Ozempic (weekly injection)
Starting dose	2.5 mg for 4 weeks	0.25 mg for 4 weeks
Steps	Up by 2.5 mg after at least 4 weeks on the current dose, if more blood sugar control is needed	0.5 mg after 4 weeks; then 1 mg, then 2 mg, each after at least 4 weeks, if more control is needed
Maximum	15 mg (adults); 10 mg (children 10 and older)	2 mg (the label dose for the kidney-risk use is 1 mg)
Missed dose	Take within 4 days; after that, skip it	Take within 5 days; after that, skip it

Mounjaro vs Ozempic side effects

Digestive reactions are the most common on both, mostly while the dose is being raised. In SURPASS-2, where they were counted in the same trial, the rates were close:^[3]

• Nausea: 17% to 22% on tirzepatide vs 18% on semaglutide 1 mg.
• Diarrhea: 13% to 16% vs 12%.
• Vomiting: 6% to 10% vs 8%.
• Most were mild to moderate. Serious adverse events were reported in 5% to 7% on tirzepatide and 3% on semaglutide.^[3]

From the labels, against placebo: stopping treatment because of digestive reactions was 3.0% to 6.6% on Mounjaro vs 0.4%,^[1] and 3.1% to 3.8% on Ozempic vs 0.4%.^[2] Both labels share the same core warnings: pancreatitis, gallbladder disease, kidney injury from dehydration, serious allergic reactions, low blood sugar with insulin or a sulfonylurea, worsening diabetic eye disease, and breathing in stomach contents under anesthesia.^[1][2]

How much do Mounjaro and Ozempic cost?

Prices change often. These are the makers' own figures as of November 13, 2026.

• Mounjaro: as little as $25 for up to a 3-month fill with commercial insurance that covers it, or as low as $499 a month for the single-dose pen with commercial insurance that does not, under a savings card that ends December 31, 2026. People on Medicare or Medicaid cannot use the card. Lilly says about 8 in 10 Medicare patients pay $0 to $50 for a 28-day supply.^[9]
• Ozempic: the self-pay pen is $349 a month for 0.25 to 1 mg and $499 for 2 mg, with new patients paying $199 for two fills; Ozempic tablets are $149, $199 and $299 by strength. With commercial coverage, as little as $25.^[10]
• Ozempic list price: Novo Nordisk will cut the list price of Ozempic, Wegovy and Rybelsus to $675 a month from January 1, 2027, about 35% off Ozempic.^[14]

Compounded copies of either are not FDA-approved products.^[15] If the choice is between Ozempic and the weight-management form of tirzepatide, see Zepbound vs Ozempic.

Switching from Ozempic to Mounjaro

Neither label has instructions for switching from the other, and neither gives a dose conversion. Each label's schedule starts at its own starting dose, 2.5 mg for Mounjaro and 0.25 mg for Ozempic.^[1][2] The tirzepatide label says not to use it with any GLP-1 receptor agonist,^[6] so a switch means stopping one before starting the other, and semaglutide stays in the circulation for 5 to 7 weeks after the last dose.^[7] The timing and the dose are your prescriber's decision; online "conversion charts" do not come from the labels.

What to eat on either one

Both labels pair the drug with diet and exercise but name no diet.^[1][2] The 2025 joint advisory from four US medical and nutrition societies sets the same priorities for every GLP-1 medication: protein first, small nutrient-dense meals, fiber from food, deliberate fluids and strength training.^[16] Our pages go one question at a time:

• What to eat on Wegovy or Ozempic and what to eat on Zepbound or Mounjaro: a small-appetite day, with amounts.
• How much protein on a GLP-1, and the protein calculator.
• Every GLP-1 medication on one map: GLP-1 medications explained.

For transparency about why this page exists on our site: we make one product, Zornava Replenish, a lemon-lime daily hydration and nutrient powder for lighter appetite days, including for people on GLP-1 medications. It is a dietary supplement, not a medication, and it does not replace or imitate any medicine on this page. It is not on sale yet; early access opens February 9, 2027, and the early-access list is open now.