Ozempic vs Mounjaro: the T2D labels of the two biggest GLP-1 drugs
Both are approved for type 2 diabetes. Different molecules, different mechanisms, meaningfully different HbA1c and weight outcomes. Here's the clinical picture.
Ozempic (semaglutide) and Mounjaro (tirzepatide) are the T2D-indicated versions of their respective molecules. Both are FDA approved for glycemic control in adults with type 2 diabetes, both are once-weekly subcutaneous injections, and both show cardiovascular benefit in T2D populations. They differ at the receptor level (single GLP-1 vs dual GIP/GLP-1) and in head-to-head HbA1c reduction.
| Field | Ozempic | Mounjaro |
|---|---|---|
| Brand names | semaglutide | tirzepatide |
| Manufacturer | Novo Nordisk | Eli Lilly |
| FDA approved | 2017 (T2D), 2020 (CV risk reduction in T2D+CVD) | 2022 (T2D) |
| Indication | Type 2 diabetes; cardiovascular risk reduction in T2D adults with established CV disease | Type 2 diabetes |
| Mechanism | GLP-1 receptor agonist | Dual GIP / GLP-1 receptor agonist |
| Delivery | Once-weekly subcutaneous injection | Once-weekly subcutaneous injection |
| Avg weight loss | ~6% at 40 weeks (SURPASS-2, 1 mg) | ~11% at 40 weeks (SURPASS-2, 15 mg) |
Primary sources
- Ozempic: SURPASS-2 (NEJM, 2021)
- Mounjaro: SURPASS-2 (NEJM, 2021)
Frequently asked
Which one lowers HbA1c more?
Mounjaro. SURPASS-2 (NEJM 2021) showed tirzepatide 15 mg produced ~2.30% HbA1c reduction at 40 weeks vs semaglutide 1 mg's ~1.86%. All three tirzepatide doses (5, 10, 15 mg) outperformed semaglutide 1 mg on both HbA1c and weight.
Which one has better cardiovascular-outcomes evidence?
Ozempic currently has more mature CV outcomes data. SUSTAIN-6 (2016) and SELECT (2023) established CV risk reduction for semaglutide. Mounjaro's cardiovascular outcomes trial (SURPASS-CVOT) is ongoing.
Is one preferred for weight loss in T2D?
For weight loss specifically, Mounjaro's efficacy is larger. SURPASS-2 reported ~11% mean weight loss at 40 weeks on 15 mg vs ~6% for Ozempic 1 mg. But for weight management specifically, Zepbound (tirzepatide) and Wegovy (semaglutide) are the labeled products — Mounjaro and Ozempic are T2D labels.
Can I get Ozempic for weight loss without diabetes?
It can be prescribed off-label but insurance coverage typically requires the T2D indication. Without diabetes, most plans won't cover Ozempic. The approved weight-loss semaglutide product is Wegovy.