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
Qsymia
Mounjaro vs. Qsymia Dosage
Mounjaro
Qsymia
| 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 |
| 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
| 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
| 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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