What Drug Is Most Like Mounjaro?: Comparing Zepbound, Ozempic, and Other Alternatives

According to a comparative study published in JAMA Internal Medicine, individuals with overweight or obesity who were treated with tirzepatide (the active ingredient in Mounjaro) achieved significantly greater weight loss compared to those taking semaglutide (Ozempic/Wegovy). For those seeking an equivalent medication or alternative, the question arises, what drug is most like Mounjaro?

Quick Summary

Zepbound is the most similar medication to Mounjaro, as both contain the same active ingredient, tirzepatide. This article compares Mounjaro and Zepbound to other alternatives like Ozempic, Wegovy, and Trulicity, detailing their mechanisms, uses, and efficacy.

Key Points

• Zepbound is Mounjaro's Closest Relative: Zepbound contains the exact same active ingredient, tirzepatide, and works identically to Mounjaro, with the primary difference being FDA approval for weight management versus diabetes.

• Mounjaro is a Dual Agonist: Unlike most alternatives, Mounjaro (tirzepatide) uniquely mimics two intestinal hormones, GIP and GLP-1, to regulate blood sugar, delay gastric emptying, and suppress appetite.

• Semaglutide is a Single Agonist: Medications like Ozempic and Wegovy use semaglutide, which acts only as a GLP-1 agonist, making it highly effective but generally resulting in less weight loss than tirzepatide.

• Dosing and Frequency Vary: While Mounjaro and Zepbound are once-weekly injections, alternatives like Victoza are daily, and oral options like Rybelsus are daily tablets.

• Efficacy Differences Exist: Head-to-head clinical trials and real-world studies show that tirzepatide leads to greater reductions in both A1C and body weight compared to semaglutide.

• Side Effect Profiles Overlap: Common side effects for Mounjaro, Zepbound, and semaglutide-based drugs include nausea, diarrhea, and constipation, which often subside over time or with a lower dose.

Mounjaro (tirzepatide) is a groundbreaking once-weekly injectable medication that has revolutionized the treatment landscape for type 2 diabetes and, off-label, for weight loss. Its unique effectiveness stems from its action as a dual agonist, mimicking both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) hormones. While many new and older medications exist for these conditions, few replicate Mounjaro's dual-hormone approach.

The Closest Match: Zepbound

The most straightforward and direct answer to the question "what drug is most like Mounjaro?" is Zepbound. Zepbound (tirzepatide) is, in fact, the same medication as Mounjaro, containing the identical active ingredient: tirzepatide. The critical difference lies in their FDA-approved indications, not their chemical makeup or biological function. Eli Lilly, the manufacturer of both, markets them for different purposes:

• Mounjaro (tirzepatide): FDA-approved for the treatment of type 2 diabetes in adults.
• Zepbound (tirzepatide): FDA-approved for chronic weight management in adults with obesity, or those with overweight who have at least one weight-related medical condition. It is also approved for obstructive sleep apnea in adults with obesity.

Because they are chemically the same, they share the same mechanism of action, dose strengths, dosage schedule (once-weekly injection), injection pen design, and side effect profile. The choice between Mounjaro and Zepbound is typically determined by a patient's primary diagnosis and insurance coverage.

How Tirzepatide Works

As a dual GIP and GLP-1 receptor agonist, tirzepatide works by:

• Enhancing Insulin Secretion: It signals the pancreas to release more insulin in response to food intake, particularly after a meal.
• Reducing Glucagon Production: It suppresses the release of glucagon, a hormone that causes the liver to release stored glucose, thereby lowering blood sugar levels.
• Delaying Gastric Emptying: By slowing the movement of food from the stomach, it helps patients feel fuller for longer and better manages post-meal blood sugar spikes.
• Regulating Appetite: It acts on appetite centers in the brain to reduce cravings and decrease overall food intake.

Other Injectable GLP-1 Alternatives

While no other medication currently offers the dual-agonist approach of tirzepatide, several other once-weekly injectables are effective alternatives. These medications, often referred to as GLP-1 receptor agonists, mimic only one of the two hormones that tirzepatide targets.

Semaglutide: Ozempic and Wegovy

Semaglutide is the active ingredient in both Ozempic and Wegovy, made by Novo Nordisk. Both are once-weekly injectable GLP-1 receptor agonists.

• Ozempic (semaglutide): FDA-approved for type 2 diabetes and for reducing the risk of major cardiovascular events in patients with both type 2 diabetes and established cardiovascular disease.
• Wegovy (semaglutide): FDA-approved for chronic weight management. It is available at higher doses than Ozempic to maximize weight loss.

Studies comparing tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy) indicate that tirzepatide generally results in greater weight loss and A1C reduction due to its dual-action mechanism. However, some individuals may tolerate semaglutide better, and Wegovy has proven cardiovascular benefits that Mounjaro is still investigating.

Dulaglutide: Trulicity

Trulicity (dulaglutide), also made by Eli Lilly, is another once-weekly injectable GLP-1 receptor agonist. It is FDA-approved for adults and children aged 10 and older with type 2 diabetes and is also approved for reducing cardiovascular risk in certain patients. While effective, clinical trials show that Mounjaro provides greater A1C reduction and weight loss compared to Trulicity.

Oral and Daily Injectable Alternatives

For patients who prefer not to use a once-weekly injectable or require different treatment parameters, other options exist.

Oral Semaglutide: Rybelsus

Rybelsus is an oral tablet formulation of semaglutide, the same active ingredient as Ozempic and Wegovy. It is taken once daily and offers an injection-free alternative for managing type 2 diabetes. Its efficacy and side effect profile are similar to other GLP-1 agonists, but it requires careful timing around meals.

Liraglutide: Saxenda and Victoza

Liraglutide is a GLP-1 receptor agonist that is administered once daily via injection.

• Saxenda (liraglutide): FDA-approved for chronic weight management.
• Victoza (liraglutide): FDA-approved for type 2 diabetes and for reducing cardiovascular risk.

Liraglutide tends to be less effective for weight loss than tirzepatide or semaglutide, though it was the first GLP-1 approved for weight management. The need for a daily injection can also be a deterrent for some patients.

Metformin and DPP-4 Inhibitors

Older medications like metformin and DPP-4 inhibitors (e.g., Januvia) offer alternatives, particularly for managing type 2 diabetes. These have different mechanisms and are generally less potent for weight loss compared to incretin-based therapies. Metformin works by increasing insulin sensitivity, while DPP-4 inhibitors boost the body's natural incretin levels.

Comparison Table

Feature	Mounjaro (Tirzepatide)	Zepbound (Tirzepatide)	Ozempic / Wegovy (Semaglutide)	Trulicity (Dulaglutide)
Active Ingredient	Tirzepatide	Tirzepatide	Semaglutide	Dulaglutide
Mechanism of Action	Dual GIP and GLP-1 agonist	Dual GIP and GLP-1 agonist	GLP-1 agonist	GLP-1 agonist
FDA Approval (Adults)	Type 2 Diabetes	Weight Loss, OSA	Type 2 Diabetes (Ozempic), Weight Loss (Wegovy)	Type 2 Diabetes, CV Risk Reduction
Injection Frequency	Once-weekly	Once-weekly	Once-weekly	Once-weekly
Weight Loss	Significant; high average loss in trials	Significant; high average loss in trials	Highly effective; typically less than tirzepatide	Moderate; less effective than tirzepatide
Side Effects	Nausea, diarrhea, constipation, vomiting	Nausea, diarrhea, constipation, vomiting	Nausea, vomiting, diarrhea, constipation	Nausea, diarrhea, constipation
Cardiovascular Benefit	Under investigation	N/A	Proven (Ozempic/Wegovy)	Proven (Trulicity)

Conclusion

In summary, the medication most like Mounjaro is Zepbound, its sister product containing the identical active ingredient, tirzepatide. While Mounjaro is approved for type 2 diabetes and Zepbound for weight management, they function in the same dual-agonist manner. For individuals seeking alternatives, semaglutide-based drugs like Ozempic (for diabetes) and Wegovy (for weight loss) are highly effective alternatives, though they only mimic the GLP-1 hormone and generally demonstrate less weight loss. Other options like Trulicity offer once-weekly convenience, while older or more frequent medications may also be considered depending on a patient's specific health goals, tolerance for side effects, cost considerations, and insurance coverage. It is crucial for patients to consult with a healthcare provider to determine the most appropriate and effective treatment path based on their individual needs.

For more in-depth information on the mechanism of action for tirzepatide, you can refer to the National Institutes of Health.

• Tirzepatide - StatPearls - NCBI Bookshelf

Frequently Asked Questions

Are Mounjaro and Zepbound the same thing?

Yes, Mounjaro and Zepbound contain the same active ingredient, tirzepatide, and work identically in the body. They are manufactured by the same company, Eli Lilly, but are FDA-approved for different primary indications: Mounjaro for type 2 diabetes and Zepbound for chronic weight management.

Is Ozempic or Wegovy the same as Mounjaro?

No, Ozempic and Wegovy are not the same as Mounjaro. While all are injectable incretin-based medications, Ozempic/Wegovy's active ingredient is semaglutide (a GLP-1 agonist), whereas Mounjaro's is tirzepatide (a dual GIP/GLP-1 agonist). Tirzepatide's dual mechanism has shown greater efficacy in clinical trials.

What is the key difference in how Mounjaro works compared to Ozempic?

The key difference is their mechanism of action. Ozempic mimics only one gut hormone, GLP-1. Mounjaro, however, is a dual agonist that mimics both GLP-1 and GIP. This dual action provides enhanced effects on blood sugar control, appetite regulation, and weight loss.

Are there any oral medications similar to Mounjaro?

Rybelsus is an oral alternative that uses semaglutide, the same active ingredient as Ozempic and Wegovy. While it is a daily tablet, it is also a GLP-1 agonist with similar effects for type 2 diabetes, though it may be less effective for weight loss compared to Mounjaro.

Does Mounjaro or Ozempic have more side effects?

Both Mounjaro and Ozempic have similar common side effect profiles, primarily gastrointestinal issues like nausea, diarrhea, and vomiting. However, individual tolerance varies, and side effects often improve over time. Clinical data suggest Mounjaro may have a slightly lower rate of serious adverse events, but direct head-to-head comparisons are limited.

Why would someone use a different medication instead of Mounjaro?

Reasons to choose an alternative include differing insurance coverage policies, availability due to drug shortages, managing side effects, or focusing on specific health benefits. For example, some may switch to a medication with proven cardiovascular benefits like Ozempic, while others may prefer an oral option like Rybelsus to avoid injections.

Can I switch from Mounjaro to Zepbound?

Switching from Mounjaro to Zepbound is possible and should be managed by a healthcare provider. Because they are the same medication, maintaining the same dosage is an option. The main reason for switching would be based on FDA-approved indications and insurance coverage.

How do Mounjaro and Victoza compare?

Victoza (liraglutide) is a once-daily injectable GLP-1 agonist, whereas Mounjaro (tirzepatide) is a once-weekly dual agonist. Studies suggest Mounjaro offers greater A1C and weight reduction, but Victoza has proven cardiovascular benefits that Mounjaro is still studying.