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Jasmine Uchi, PharmD

What's the difference between Zepbound, Mounjaro, Wegovy, and Ozempic?

Updated: Feb 20

In the realm of weight loss medications, two pharmaceutical giants, Lilly and Novo Nordisk, are

battling it out on the field with their latest offerings. As the world grapples with rising obesity rates and its associated health risks, the demand for effective weight loss solutions has never been higher. In this blog post, we'll delve into the contenders: Lilly's Zepbound and Mounjaro, and Novo Nordisk's Wegovy and Ozempic. Let's see which medication emerges as the MVP in this Super Bowl of weight loss.


History of Weight Loss Medications 

The history of weight loss medication development spans centuries, from early thyroid extracts to 20th-century amphetamines like Fen-Phen, which, despite efficacy, were tainted by safety issues. Orlistat, approved in 1999, marked a shift with its fat-blocking mechanism, though limited by gastrointestinal side effects. More recently, GLP-1 receptor agonists like liraglutide have shown promise in weight loss. Emerging therapies targeting brain pathways and gut microbiota signify ongoing innovation. While setbacks have occurred, advancements in understanding and technology continue to drive progress in addressing the global obesity epidemic. Currently, the most talked about medications related to weight loss across social media and news platforms are Zepbound and Mounjaro manufactured by Lilly and Wegovy and Ozempic by Novo Nordisk. 


What’s the difference between Zepbound, Wegovy, Mounjaro, and Ozempic?

Brand Name

Zepbound

Wegovy

Mounjaro

Ozempic

Manufacturer

Lilly

Novo Nordisk

Lilly

Novo Nordisk

Generic Name

Tirzepatide

Semaglutide

Tirzepatide

Semaglutide

Indication

Adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obesity) or

  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition

Chronic weight management in addition to physical activity and calorie-reduced diet for adults who are overweight or obese


Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.


Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.


FDA approved for chronic weight management?

YES

YES

NO

NO

Age requirement

18 years or older

12 years or older

18 years or older

18 years or older

How does this drug work?

Glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist

Glucagon-like peptide-1 (GLP-1) receptor agonist 

  • Increases glucose-dependent insulin secretion

  • Decreases inappropriate glucagon secretion

  • Helps delay gastric emptying, control appetite/food intake

Glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist

Glucagon-like peptide-1 (GLP-1) receptor agonist 

  • Increases glucose-dependent insulin secretion

  • Decreases inappropriate glucagon secretion

  • Helps delay gastric emptying, control appetite/food intake

Dosage forms

Prefilled single-use injection pen delivering doses of either 2.5mg/0.5mL, 5mg/0.5mL, 7.5mg/0.5mL, 10mg/0.5mL, 12.5mg/0.5mL, or 15mg/0.5mL

​Prefilled single-use injection pen delivering doses of either 0.25mg/0.5mL, 0.5mg/0.5mL, 1mg/0.5mL, 1.7 mg/0.75mL, or 2.4mg/0.75mL

Prefilled single-use injection pen delivering doses of either 2.5mg/0.5mL, 5mg/0.5mL, 7.5mg/0.5mL, 10mg/0.5mL, 12.5mg/0.5mL, or 15mg/0.5mL

Prefilled single-use injection pen delivering doses of either 0.68mg/mL, 1.34mg/mL, or 2.68mg/mL

Administration

Inject subcutaneously once weekly on the same day, at any time, with or without food (rotate injection site with each injection). Start at 2.5 mg, increase every 4 weeks up to 15mg. 

​Inject subcutaneously once weekly on the same day, at any time, with or without food (rotate injection site with each injection). Start at 0.25 mg, increase every 4 weeks up to 2.4mg (adults and pediatrics) or 1.7mg (alternative for adults).

​Inject subcutaneously once weekly on the same day, at any time, with or without food (rotate injection site with each injection). Start at 2.5 mg, increase every 4 weeks up to 15mg.

Inject subcutaneously once weekly on the same day, at any time, with or without food (rotate injection site with each injection). Start at 0.25 mg, increase every 4 weeks up to 2 mg.

Side effects

Common side effects (occurred in at least 5% of patients):

  • Stomach/GI discomfort

  • Nausea/Vomiting 

  • Diarrhea

  • Injection site reactions

  • Fatigue

  • Hypersensitivity reactions

  • Hair loss

Common side effects (occurred in at least 10% of adult patients): 


  • Nausea, Vomiting

  • Diarrhea

  • Constipation

  • Stomach/GI discomfort

  • Headache

  • Fatigue


Common side effects (occurred in at least 10% of patients):

  • Stomach/GI discomfort

  • Nausea

  • Diarrhea

  • Decreased appetite

Common side effects (occurred in at least 5% of patients):

  • Nausea, vomiting

  • Diarrhea

  • Abdominal pain

  • Constipation

Warnings

​Serious warnings:


  • Risk of thyroid C-cell tumors, Multiple Endocrine Neoplasm Syndrome Type 2 (MEN 2) 

  • Acute pancreatitis 

  • Low glucose levels with concomitant use of insulin secretagogues or insulin 

  • Hypersensitivity reactions 

  • Acute kidney injury 

  • Severe gastrointestinal disease 

  • Diabetic retinopathy complications 

  • Acute gallbladder disease 

  • Suicidal behavior and ideation

  • Fetal harm (caution if breastfeeding)

Serious warnings:


  • Risk of thyroid C-cell tumors, Multiple Endocrine Neoplasm Syndrome Type 2 (MEN 2) 

  • Acute pancreatitis

  • Low glucose levels with concomitant use of insulin secretagogues or insulin

  • Hypersensitivity reactions

  • Acute kidney injury 

  • Severe gastrointestinal disease

  • Diabetic retinopathy complications

  • Acute gallbladder disease

  • Heart rate increase

  • Suicidal behavior and ideation

  • Fetal harm (caution if breastfeeding)

Serious warnings:


  • Risk of thyroid C-cell tumors, Multiple Endocrine Neoplasm Syndrome Type 2 (MEN 2) 

  • Acute pancreatitis 

  • Low glucose levels with concomitant use of insulin secretagogues or insulin 

  • Hypersensitivity reactions 

  • Acute kidney injury 

  • Severe gastrointestinal disease 

  • Diabetic retinopathy complications 

  • Acute gallbladder disease 

  • Heart rate increase

  • Fetal harm (caution if breastfeeding) 


Serious warnings:


  • Risk of thyroid C-cell tumors, Multiple Endocrine Neoplasm Syndrome Type 2 (MEN 2) 

  • Acute pancreatitis

  • Low glucose levels with concomitant use of insulin secretagogues or insulin 

  • Hypersensitivity reactions 

  • Acute kidney injury 

  • Diabetic retinopathy complications

  • Acute gallbladder disease

Ingredients

Active medicinal ingredient: Tirzepatide


Inactive agents: sodium chloride, sodium phosphate dibasic heptahydrate, and water for injection. Hydrochloric acid solution and/or sodium hydroxide solution may have been added to adjust the pH.


Active medicinal ingredient: Semaglutide


Inactive agents: disodium phosphate dihydrate, sodium chloride, water for injection. Hydrochloric acid or sodium hydroxide may be added to adjust pH.


Active medicinal ingredient: Tirzepatide


Inactive agents: sodium chloride, sodium phosphate dibasic heptahydrate, and water for injection. Hydrochloric acid solution and/or sodium hydroxide solution may have been added to adjust the pH.


Active medicinal ingredient: Semaglutide


Inactive agents:

Disodium phosphate dihydrate, propylene glycol, phenol and water for injection.

Animal-Free?

LIKELY

LIKELY

YES

YES

Certified Animal-Free?

NO

NO

NO

NO

Why choosing a Certified Animal-Free Medications Matters

Opting for animal-free medications is safer, ethically inclusive and environmentally conscious! Why would one pick anything other than an animal-free medication when the price, safety and efficacy are all equal? Deaths in patients with the red-meat allergy (Alpha-gal Syndrome) have been reported (e.g. Cetuximab) due to the use of CHO (Chinese Hamster Ovary) cell lines; many patients end up going to the emergency room or having a serious allergic reaction. Also, many patients have religious or animal cruelty related preferences and choosing animal-free medications is hence inclusive of all preferences. This approach ensures that individuals from diverse backgrounds have access to treatments that align with their values and beliefs.


Conclusion

In the Super Bowl of weight loss medications, Lilly and Novo Nordisk are going head-to-head with their latest offerings: Zepbound, Mounjaro, Wegovy, and Ozempic. While all four medications have shown promise in helping patients shed excess pounds and improve their health, the choice between them may ultimately come down to individual patient preferences, tolerability, and dosing convenience.


As with any medication, it's important for patients to discuss their options with their healthcare provider to determine the best course of treatment based on their unique needs and medical history.


Co-author: Shaan Ashraf, PharmD


 

Disclaimer: The product and/or information provided on VeganMed is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We do not lab test the products to confirm that they are free from animal ingredients, and it is possible that the formulation and ingredients could have changed. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or product. The information provided in this post is accurate and up to date as of the date it was written. However, please note that circumstances and facts may change over time, and new information may become available that could alter the accuracy or relevance of the content. We encourage readers to verify and cross-reference any information provided here with trusted sources or consult relevant professionals for the most current and accurate updates.


 

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Thank you for your awareness and concern for animal-derived ingredients!


As a reminder, please comment on our FDA Citizen Petition, requesting clear labeling of animal-derived ingredients in medications. Together, we can make a difference.


If you have any further questions about ingredients in your medicines and supplements, feel free to reach out to the VeganMed team!


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