What is the Equivalent of Zepbound? Comparing Mounjaro, Wegovy, and Other Options

October 9, 2025 •

3 min read

According to a recent study published by FAIR Health, more than 2% of U.S. adults took a GLP-1 medication for weight loss in 2024, leading to increased interest in the class of drugs and questions like, "what is the equivalent of Zepbound?". While its direct, molecular equivalent is the diabetes drug Mounjaro, several other effective prescription medications exist for weight management, each with unique characteristics.

Quick Summary

Zepbound's direct equivalent is Mounjaro, containing the same active ingredient, tirzepatide, but with different FDA-approved indications. Other alternatives for weight management include injectable Wegovy and oral medications, offering varying levels of effectiveness, mechanisms, and suitability for different patient profiles.

Key Points

Direct Equivalent: Mounjaro contains the same active ingredient, tirzepatide, as Zepbound, but is only FDA-approved for Type 2 diabetes.
Different FDA Indications: While Zepbound is approved for chronic weight management, Mounjaro is approved for diabetes; this affects insurance coverage.
Alternative Injectable: Wegovy (semaglutide) is an FDA-approved weekly injectable for weight loss that acts as a single GLP-1 agonist, potentially leading to less weight loss than Zepbound.
Other Injectables: Saxenda (liraglutide) is an older, daily injectable option for weight management that is generally less effective than Zepbound and Wegovy.
Oral Options: For those avoiding injections, oral medications like Contrave, Qsymia, and Xenical are available, though they typically offer more modest weight loss results.
Cost and Insurance: Costs and coverage vary significantly; Mounjaro may be covered for diabetes, while Zepbound for weight loss may face coverage hurdles, depending on the plan.
Prescription Only: All effective equivalents and alternatives require a prescription and should be used under a doctor's supervision.

Zepbound, with the active ingredient tirzepatide, is a once-weekly injectable approved by the FDA for chronic weight management in adults with obesity or those overweight with at least one weight-related condition. It also recently received FDA approval for treating obstructive sleep apnea (OSA) in adults with obesity.

Tirzepatide is a dual-receptor agonist, mimicking GLP-1 and GIP hormones to regulate blood sugar, reduce appetite, and promote fullness, leading to significant weight loss.

The Direct Equivalent: Mounjaro (Tirzepatide)

Pharmacologically, Mounjaro is the direct equivalent of Zepbound as both contain tirzepatide and are made by Eli Lilly. However, their FDA-approved uses differ:

Mounjaro: Approved for treating type 2 diabetes in adults.
Zepbound: Approved for chronic weight management and obstructive sleep apnea.

This distinction in indication impacts insurance coverage. While Mounjaro is covered by many plans for diabetes, Zepbound's coverage for weight loss is less consistent. Mounjaro may be prescribed off-label for weight loss, but this can affect insurance. It is crucial not to use both concurrently due to the risk of overdose.

Other Injectable Alternatives: Semaglutide and Liraglutide

Other injectable weight management options include medications containing semaglutide and liraglutide, which work similarly but have differences in effectiveness.

Wegovy (Semaglutide)

Contains semaglutide, a GLP-1 receptor agonist from Novo Nordisk.
FDA-approved for chronic weight management in adults and adolescents aged 12 and older.
Showed less weight loss (around 14%) compared to Zepbound (around 20%) in a clinical trial over 72 weeks.
Also approved to reduce the risk of major cardiovascular events in certain adults.

Saxenda (Liraglutide)

Contains liraglutide, another GLP-1 receptor agonist approved for weight management.
Administered as a daily injection.
Generally results in less weight loss than Zepbound or Wegovy.

Oral Alternatives for Weight Management

Oral options are available for those who prefer not to inject, although they typically lead to less weight loss than injectable GLP-1 and GIP agonists.

Contrave (naltrexone/bupropion): A combination pill to reduce appetite and cravings, generally less effective than injectables.
Qsymia (phentermine/topiramate ER): A once-daily pill combining an appetite suppressant and anti-seizure medication.
Xenical (orlistat): Blocks dietary fat absorption and can cause gastrointestinal side effects. A lower dose is available over-the-counter as Alli.

Comparison Table: Zepbound and Key Alternatives


Feature	Zepbound (Tirzepatide)	Mounjaro (Tirzepatide)	Wegovy (Semaglutide)	Saxenda (Liraglutide)
Active Ingredient	Tirzepatide	Tirzepatide	Semaglutide	Liraglutide
Mechanism	Dual GIP/GLP-1 agonist	Dual GIP/GLP-1 agonist	Single GLP-1 agonist	Single GLP-1 agonist
FDA-Approved for	Chronic weight management, OSA	Type 2 Diabetes	Chronic weight management, Cardiovascular risk reduction	Chronic weight management
Approval Age	Adults (18+)	Adults (18+)	Adults and adolescents (12+)	Adults and adolescents (12+)
Dosing Frequency	Once weekly	Once weekly	Once weekly	Once daily
Typical Weight Loss	Up to 22.5%	Up to 22.5%	Up to 15%	~8%

Choosing the Right Equivalent

Selecting the best equivalent for Zepbound depends on individual health needs, medical history, and insurance coverage. While Mounjaro is the molecular match, its official use is for diabetes. Wegovy offers a different approach for weight loss with broader approvals. Oral medications are less potent alternatives. Consulting a healthcare provider is essential for determining the most suitable medication, considering that long-term use may be necessary and each drug has its own risks and side effects.

Conclusion

There is no single equivalent for Zepbound; the most appropriate alternative varies based on individual medical circumstances. Mounjaro is chemically identical but approved for diabetes. Other injectable options like Wegovy and Saxenda, along with oral medications such as Contrave and Qsymia, offer different mechanisms and efficacy. The final decision should involve a healthcare professional to ensure the chosen treatment is safe and effective and aligns with the patient's overall health and weight loss goals.

Frequently Asked Questions

Yes, Mounjaro and Zepbound contain the exact same active ingredient, tirzepatide, and are molecularly identical. The primary difference is their FDA-approved indication: Mounjaro is for type 2 diabetes, while Zepbound is for chronic weight management and obstructive sleep apnea.

You may be able to switch from Mounjaro to Zepbound, and because they are the same medication, the dosage would likely stay the same. The main reason for switching may relate to insurance coverage or the specific condition being treated, but it should always be done under a doctor's guidance.

Wegovy (semaglutide) is a clinically effective alternative to Zepbound and is also an FDA-approved injectable for weight loss. Head-to-head trials show that Zepbound may produce greater average weight loss, but Wegovy has additional approvals, such as for cardiovascular risk reduction in certain patients.

There is no direct oral equivalent of Zepbound. However, oral medications like Contrave (naltrexone/bupropion), Qsymia (phentermine/topiramate), and Xenical (orlistat) can be used for weight management, though they are generally less potent than the injectable tirzepatide and semaglutide.

Clinical trial data suggests that Zepbound (tirzepatide) may be more effective for weight loss than Wegovy (semaglutide). In a head-to-head study, average weight loss was approximately 20% with Zepbound versus 14% with Wegovy.

Because Zepbound and Mounjaro share the same active ingredient, they have similar side effects, including nausea, vomiting, diarrhea, and abdominal pain. Other injectable alternatives like Wegovy have a similar gastrointestinal side effect profile.

No, a generic version of Zepbound (tirzepatide) is not yet available. The active ingredient was temporarily allowed for compounding during a shortage but is now available as brand-name Zepbound and Mounjaro.