Mounjaro vs. Qsymia

See how Mounjaro and Qsymia compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Mounjaro is a once-weekly injectable dual GIP/GLP-1 agonist approved for type 2 diabetes, while Qsymia is a once-daily oral combination pill approved for chronic weight management.

  • Mounjaro carries a boxed warning for thyroid tumors, while Qsymia is a controlled substance with its own REMS program for pregnancy risk.

  • Qsymia typically costs far less out of pocket than Mounjaro, though insurance coverage varies for both drugs.

Mounjaro vs. Qsymia Drug Summary

Mounjaro

Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist injected once a week. It's FDA-approved to control blood sugar in adults and children 10 and older with type 2 diabetes, and it's also used off-label for weight loss in people without diabetes.

Qsymia

Qsymia combines phentermine, a stimulant appetite suppressant, with topiramate, an anticonvulsant, in a once-daily extended-release capsule. It's FDA-approved for chronic weight management in adults and adolescents 12 and older with obesity or weight-related conditions.

Mounjaro vs. Qsymia Side Effects

Mounjaro

Most common
Nausea (12-18%)
Diarrhea (12-17%)
Decreased appetite (8-11%)
Vomiting (5-9%)

Qsymia

Most common
Paresthesia (up to 21%)
Dry mouth (up to 19%)
Constipation (up to 16%)
Insomnia (up to 11%)

Mounjaro vs. Qsymia Dosage

Mounjaro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mg once weekly Weeks 1-4
Maximum dose 15 mg once weekly Week 21 onward
Dose changes 5 increases Every 4 weeks

Qsymia

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 3.75 mg/23 mg once daily Days 1-14
Maximum dose 15 mg/92 mg once daily Week 17 onward
Dose changes 3 increases As tolerated

Mounjaro vs. Qsymia Indications

Mounjaro

Mounjaro is approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, used alongside diet and exercise. It is not approved for type 1 diabetes. Many prescribers also use it off-label for weight loss in people without diabetes.

  • Blood sugar control in adults with type 2 diabetes

  • Approved for pediatric patients 10 years and older with type 2 diabetes

  • Off-label use for weight loss without diabetes

  • Not approved for type 1 diabetes

Qsymia

Qsymia is approved for chronic weight management in adults with obesity or who are overweight with a weight-related condition like high blood pressure. It is also approved for adolescents 12 and older with obesity. It is not approved for diabetes treatment.

  • Chronic weight management in adults with obesity

  • Weight management in adults who are overweight with a related condition

  • Approved for adolescents 12 and older with obesity

  • Not approved for diabetes or blood sugar control

Mounjaro vs. Qsymia Pros and Cons

Mounjaro

Mounjaro's dual incretin action has shown substantial weight loss and blood sugar improvement in clinical trials, and its weekly injection means fewer doses to remember. It carries a boxed warning for thyroid C-cell tumors and requires ongoing injections, which some patients find less convenient than a pill.

Pros

  • Once-weekly dosing means just one injection per week

  • Directly treats blood sugar as well as weight

  • Not a controlled substance

  • No REMS program or pregnancy testing requirement

Cons

  • Requires self-injection rather than a pill

  • Boxed warning for thyroid C-cell tumors

  • Common GI side effects like nausea and diarrhea

  • Typically costs more out of pocket, roughly $1,000 to $1,300 per month before savings programs

Qsymia

Qsymia is taken as a once-daily oral capsule, which some patients prefer over an injection. As a Schedule IV controlled substance combining a stimulant and an anticonvulsant, it requires REMS enrollment, monthly pregnancy testing, and monitoring for mood or cognitive side effects.

Pros

  • Oral capsule instead of an injection

  • Long track record since its 2012 approval

  • Roughly $200 to $350 per month before savings programs, well below Mounjaro's list price

  • Approved for adolescents as young as 12

Cons

  • Schedule IV controlled substance with abuse potential

  • Requires REMS enrollment and certified pharmacy dispensing

  • Not safe in pregnancy; requires monthly pregnancy testing

  • Stimulant-related effects like insomnia and increased heart rate

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