Ozempic (semaglutide) is a brand-name prescription medication known for treating type 2 diabetes and promoting weight loss. It belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class, which mimics a natural gut hormone to help regulate appetite and blood sugar. While these medications share a core mechanism, they differ in formulation, administration, and approved uses.
The GLP-1 Receptor Agonist Family
GLP-1 receptor agonists activate GLP-1 receptors, stimulating insulin release, inhibiting glucagon, slowing gastric emptying, and reducing appetite. Other FDA-approved drugs in this class include:
- Semaglutide: Also found in Wegovy (weekly injection for weight management) and Rybelsus (daily oral tablet for type 2 diabetes).
- Dulaglutide: Marketed as Trulicity, a once-weekly injection for type 2 diabetes with cardiovascular benefits.
- Liraglutide: Available as Victoza (daily injection for type 2 diabetes and CV risk reduction) and Saxenda (higher-dose daily injection for chronic weight management).
Next-Generation Incretin Therapies
These therapies target multiple incretin receptors for enhanced effects. Tirzepatide is a dual GLP-1 and GIP receptor agonist.
- Tirzepatide: Available as Mounjaro (weekly injection for type 2 diabetes, showing superior efficacy over semaglutide) and Zepbound (for chronic weight management, showing substantial weight loss).
Older or Discontinued GLP-1 Agonists
Older options like exenatide (Byetta, Bydureon) and lixisenatide (Adlyxin) have been largely replaced by newer, more convenient alternatives.
Comparison of Incretin-Based Therapies
Choosing among these medications involves considering efficacy, administration, frequency, and cost. Below is a comparison of prominent options:
| Feature | Ozempic (semaglutide) | Rybelsus (oral semaglutide) | Trulicity (dulaglutide) | Mounjaro/Zepbound (tirzepatide) |
|---|---|---|---|---|
| Active Ingredient | Semaglutide | Semaglutide | Dulaglutide | Tirzepatide |
| Drug Class | GLP-1 Agonist | GLP-1 Agonist | GLP-1 Agonist | Dual GLP-1/GIP Agonist |
| Form & Route | Weekly subcutaneous injection | Daily oral tablet | Weekly subcutaneous injection | Weekly subcutaneous injection |
| Approved Uses | Type 2 diabetes; CV event risk reduction | Type 2 diabetes | Type 2 diabetes; CV event risk reduction | Type 2 diabetes (Mounjaro); chronic weight management (Zepbound) |
| Typical Weight Loss | Moderate (~10% of body weight) | Moderate (~8% of body weight) | Moderate (less than semaglutide) | Substantial (up to ~22% for Zepbound) |
Weighing Efficacy and Side Effects
Common side effects are gastrointestinal, including nausea, vomiting, diarrhea, and constipation, which often decrease over time. Dual-action drugs like tirzepatide may offer greater efficacy but have similar side effect profiles. All GLP-1 agonists carry an FDA boxed warning about a potential risk of thyroid C-cell tumors based on rodent studies and are contraindicated in individuals with a history of MTC or MEN2. Rare but serious side effects include pancreatitis and gallbladder issues.
Who Are These Medications For?
Initially for type 2 diabetes, these drugs are now crucial for obesity treatment. The best choice depends on goals (diabetes control, weight loss, or both), administration preference, and side effect tolerance. Cardiovascular benefits of drugs like Ozempic or Trulicity may be important for some patients.
Conclusion
Ozempic is part of a larger class of incretin-mimetic drugs. The field is advancing with dual-action therapies like Mounjaro and Zepbound providing enhanced benefits. Consulting a healthcare provider is vital to choose the right treatment based on individual needs, risks, and goals.
Visit the Obesity Medicine Association for more resources and information
