Mounjaro vs Ozempic for Type 2 Diabetes: Results, Doses, Side Effects and Price

Mounjaro and Ozempic are both weekly injections for adults with type 2 diabetes, but they contain different drugs and carry different approvals.

Neither label lists weight loss as an approved use.1,2 For weight loss, Lilly sells tirzepatide as Zepbound, and Novo Nordisk sells semaglutide as Wegovy. Our guide to semaglutide vs tirzepatide compares those two for people without diabetes.

Mounjaro did better than Ozempic on blood sugar and weight in SURPASS-2, the one head-to-head trial. That trial put 1,879 adults with type 2 diabetes, already on metformin, on Mounjaro 5 mg, 10 mg or 15 mg, or on semaglutide 1 mg, for 40 weeks.1 The results below count everyone who took at least one dose, including people who stopped the drug (treatment-policy estimand).1

Source: Mounjaro prescribing information, Table 5.1

The label calls the A1C drop on Mounjaro 10 mg and 15 mg a statistically significant improvement over semaglutide 1 mg.1 Weight fell 1.9 kg to 5.5 kg more on Mounjaro than on semaglutide, depending on the dose.1 Lilly funded the trial.4

Two limits matter. The trial tested semaglutide at 1 mg, not at the 2 mg dose Ozempic now allows.4,2 And "better" depends on more than A1C: your other conditions, your coverage and how you tolerate the drug count too.

The difference is the drug inside, how it acts, and what each one is approved for. Mounjaro contains tirzepatide, which acts on both the GIP and GLP-1 receptors.1 Ozempic contains semaglutide, which acts on the GLP-1 receptor only.2 Both lower blood sugar, and both slow how fast the stomach empties.1,2

Mounjaro is approved, with diet and exercise, to improve blood sugar in adults and children 10 and older with type 2 diabetes.1 Since August 2026, it is also approved to lower the risk of heart attack, stroke and heart-related death in adults with type 2 diabetes at high risk of those events.1

Ozempic is approved to improve blood sugar in adults with type 2 diabetes.2 It is also approved to lower the risk of heart attack, stroke and heart-related death in adults with type 2 diabetes and heart disease. A third approval covers adults with type 2 diabetes and chronic kidney disease: it lowers the risk of kidney decline, kidney failure and heart-related death.2 Ozempic's safety and effectiveness have not been established in children.2

The heart trials compared each drug with something different, so their numbers can't be set side by side.

• Ozempic, SUSTAIN 6: 3,297 adults with type 2 diabetes and heart disease or high heart risk took Ozempic or placebo for at least 2 years. A heart attack, stroke or heart-related death occurred in 6.6% on Ozempic against 8.9% on placebo.2
• Ozempic, FLOW: 3,533 adults with type 2 diabetes and chronic kidney disease took Ozempic 1 mg or placebo, followed for a median of 41 months. Major kidney events or heart-related death occurred in 18.7% on Ozempic against 23.2% on placebo.2
• Mounjaro, SURPASS-CVOT: 13,299 adults with type 2 diabetes and heart disease took Mounjaro or dulaglutide (Trulicity), another GLP-1 drug, over a median of 210.1 weeks. A heart attack, stroke or heart-related death occurred in 12.1% on Mounjaro against 13.0% on dulaglutide. Mounjaro proved no worse than dulaglutide, but not better (treatment-policy estimand).1

Both are injected once a week, at any time of day, with or without food.1,2 The dose steps differ.

Mounjaro starts at 2.5 mg a week. If blood sugar needs more control, the dose rises in 2.5 mg steps after at least 4 weeks on each dose, up to 15 mg in adults and 10 mg in children.1 It comes as single-dose pens and vials, and as a KwikPen or vial holding four weekly doses.1 Our Mounjaro dosage guide sets out each step.

Ozempic starts at 0.25 mg a week for 4 weeks, then goes to 0.5 mg. If blood sugar needs more control, it rises to 1 mg and then 2 mg, with at least 4 weeks on each dose.2 For chronic kidney disease, the dose is 1 mg.2 It comes in pens that each hold several weeks of doses, and the May 2026 label adds single-dose prefilled syringes.2

Ozempic now also comes as a daily tablet; Mounjaro does not. The FDA approved Ozempic tablets on January 30, 2026, on one label with Rybelsus.3 They are approved for blood sugar in adults with type 2 diabetes and to lower heart risk in adults with type 2 diabetes at high risk.3

The tablets come in 1.5 mg, 4 mg and 9 mg. You start at 1.5 mg a day for 30 days, a dose that does not control blood sugar, then take 4 mg, and from day 61 stay at 4 mg or move up to 9 mg.3 Each tablet is taken in the morning on an empty stomach with no more than 4 ounces of plain water, followed by a 30-minute wait before eating, drinking or taking other pills.3

Tirzepatide has no approved tablet. Mounjaro is an injection only.1 Our guide to GLP-1 pills vs injections compares every approved tablet.

The side effects are of the same kind: mostly nausea, diarrhea, vomiting and constipation, most often while the dose goes up.1,2 In SURPASS-2, where the two were given to similar patients, nausea hit 17% to 22% on tirzepatide against 18% on semaglutide 1 mg. Diarrhea hit 13% to 16% against 12%, and vomiting 6% to 10% against 8%.4 Serious adverse events were reported in 5% to 7% on tirzepatide and 3% on semaglutide.4

Each label also reports its own placebo-controlled trials. These pools are different, so compare each drug only with its own placebo:

• Mounjaro: nausea in 12% to 18% across the doses, against 4% on placebo; diarrhea in 12% to 17%, against 9%.1
• Ozempic: nausea in 15.8% on 0.5 mg and 20.3% on 1 mg, against 6.1% on placebo; diarrhea in 8.5% and 8.8%, against 1.9%.2

Both labels carry the same boxed warning about thyroid C-cell tumors in rodents, and both rule out people with a personal or family history of medullary thyroid cancer or MEN 2.1,2 Both warn about pancreatitis, gallbladder problems, low blood sugar when combined with insulin or a sulfonylurea, and kidney injury from dehydration.1,2 If you have side effects, talk to your provider. Each drug has its own guide: Mounjaro side effects and Ozempic side effects.

Both makers sell a savings card for people whose commercial insurance covers the drug, and both sell the injection self-pay, with no insurance. These are the makers' own prices, read on October 26, 2026.

Ozempic. With commercial insurance that covers GLP-1 drugs, you may pay as little as $25 for up to a 3-month prescription, with savings capped at $100 a month.5 Paying yourself through NovoCare Pharmacy, the injection costs $349 a month for 0.25 mg, 0.5 mg or 1 mg, and $499 a month for 2 mg.5 New patients pay $199 a month for their first 2 monthly fills of 0.25 mg or 0.5 mg, an offer that runs through December 31, 2026.5 Self-pay Ozempic tablets start at $149 a month, and the price varies by dose.5

Mounjaro. With commercial insurance that covers Mounjaro, the savings card brings a single-dose pen prescription down to as little as $25 for up to 3 months. Savings are capped at $150 a month and $1,950 a year.6 With commercial insurance that does not cover it, the card brings a 1-month fill down to as low as $499.6 The card is for adults and ends on December 31, 2026.6 Without insurance, LillyDirect sells Mounjaro for $499 a month at every dose, 2.5 mg to 15 mg. You need a prescription but no insurance, and the payment does not count toward a deductible or Medicare Part D out-of-pocket costs.7

Medicare. Neither savings card can be used with Medicare or other government plans.5,6 Lilly says about 8 in 10 people with Medicare Part D pay "between $0-$50 for a 28-day supply of Mounjaro", based on IQVIA data from October 2024 to September 2025.6 Our guide to Medicare GLP-1 coverage covers what Part D pays for.

Neither Mounjaro nor Ozempic is approved for weight loss, though both lowered weight in their diabetes trials.1,2 In SURPASS-2, people with type 2 diabetes lost 5.7 kg on semaglutide 1 mg and up to 11.2 kg on Mounjaro 15 mg (treatment-policy estimand).1

If weight loss is your goal and you do not have type 2 diabetes, the approved versions of these drugs are Zepbound (tirzepatide) and Wegovy (semaglutide). Our semaglutide vs tirzepatide guide compares their weight-loss trials, and Mounjaro vs Zepbound explains why one drug has two names.

Switching is a decision for your provider, because the labels give no plan for moving from one to the other. The Mounjaro label gives one starting dose, 2.5 mg a week.1 Both labels advise a lower dose of insulin or a sulfonylurea where needed, to avoid low blood sugar.1,2 If you move from Ozempic injections to Ozempic tablets instead, the tablet label sets out how: on 0.5 mg a week, start the tablets one week after your last injection.3

Is Mounjaro stronger than Ozempic? In SURPASS-2, Mounjaro 10 mg and 15 mg lowered A1C more than semaglutide 1 mg, and every Mounjaro dose lowered weight more.1 Doses in milligrams can't be compared, because they are different drugs.

Is Mounjaro the same as Ozempic? No. Mounjaro is tirzepatide, which acts on the GIP and GLP-1 receptors. Ozempic is semaglutide, which acts on GLP-1 only.1,2

Which has fewer side effects, Mounjaro or Ozempic? In SURPASS-2, stomach side effects were in the same range for both: nausea in 17% to 22% on tirzepatide and 18% on semaglutide 1 mg.4

Can I take Mounjaro or Ozempic without diabetes? Both are approved only for people with type 2 diabetes.1,2 For weight loss, the approved drugs are Zepbound and Wegovy.

If you and your provider settle on Ozempic and you pay yourself, compare what online programs charge in our cheapest Ozempic ranking. For more on each drug, see what Ozempic is and how to get Ozempic.

This article is for information only and is not medical advice. Talk to a licensed clinician before starting or switching any GLP-1 treatment.