Wegovy vs. Mounjaro

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

Key Takeaways

  • Wegovy is FDA-approved for chronic weight management and to lower cardiovascular risk, while Mounjaro is FDA-approved for type 2 diabetes and used off-label for weight loss.

  • Mounjaro acts on two gut hormone receptors (GIP and GLP-1) instead of one, which is linked to greater average weight loss in trials than semaglutide alone.

  • Wegovy causes gastrointestinal side effects like nausea and diarrhea at notably higher rates than Mounjaro, based on each drug's own FDA label.

Wegovy vs. Mounjaro Drug Summary

Wegovy

Wegovy (semaglutide) is a GLP-1 receptor agonist FDA-approved for chronic weight management and to lower cardiovascular risk in adults with obesity or overweight and existing heart disease. It's given as a once-weekly injection, starting low and increasing gradually to a 2.4 mg maintenance dose over about four months.

Mounjaro

Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist FDA-approved to control blood sugar in adults and children 10 and older with type 2 diabetes, alongside diet and exercise. It is not FDA-approved for weight loss, but many doctors prescribe it off-label for that purpose because of the significant weight loss seen in clinical trials.

Wegovy vs. Mounjaro Side Effects

Wegovy

Most common
Nausea (up to 44%)
Diarrhea (up to 30%)
Constipation (up to 24%)
Vomiting (up to 24%)

Mounjaro

Most common
Nausea (12-18%)
Diarrhea (12-17%)
Constipation (5-7%)
Vomiting (5-9%)

Wegovy vs. Mounjaro Dosage

Wegovy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.25 mg once weekly Weeks 1-4
Maximum dose 2.4 mg once weekly Week 17 onward
Dose changes 4 increases Every 4 weeks

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

Wegovy vs. Mounjaro Indications

Wegovy

Wegovy is FDA-approved for chronic weight management in adults and adolescents 12 and older who have obesity, or are overweight with a weight-related condition, alongside diet and exercise. It's also approved to reduce the risk of major cardiovascular events in adults with obesity or overweight who already have cardiovascular disease.

  • Chronic weight management in adults and teens 12+

  • Reduces risk of heart attack, stroke, and cardiovascular death in adults with existing heart disease

  • Prescribed alongside diet and exercise changes

  • Not approved for type 1 or type 2 diabetes

Mounjaro

Mounjaro is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes, alongside diet and exercise. It is not FDA-approved for weight loss, but many doctors prescribe it off-label for that purpose because of the significant weight loss seen in clinical trials.

  • Blood sugar control in adults with type 2 diabetes

  • Blood sugar control in children 10 and older with type 2 diabetes

  • Off-label use for weight loss in people without diabetes

  • Not approved for type 1 diabetes

Wegovy vs. Mounjaro Pros and Cons

Wegovy

Wegovy has an FDA approval specifically for weight management and is the only GLP-1 shown to reduce major cardiovascular events in people with obesity and heart disease. It causes more gastrointestinal side effects on average than Mounjaro, based on each drug's own label data.

Pros

  • FDA-approved specifically for weight management, not just diabetes

  • Only GLP-1 medication proven to lower cardiovascular event risk in people with obesity

  • Approved for adolescents 12 and older

  • Well-established track record since its 2021 approval

Cons

  • Higher rates of nausea, vomiting, and GI side effects than Mounjaro

  • Slower titration schedule, taking about 4 months to reach full dose

  • Only one maintenance dose (2.4 mg), with no higher option if weight loss plateaus

Mounjaro

Mounjaro's dual-hormone mechanism has produced larger average weight loss in trials than semaglutide alone, though its FDA approval covers diabetes rather than obesity. Its lower rates of GI side effects come from head-to-head label comparisons, but using it for weight loss still requires an off-label prescription.

Pros

  • Targets two gut hormone receptors (GIP and GLP-1), linked to greater weight loss in trials

  • Lower rates of nausea, vomiting, and other GI side effects than Wegovy

  • More maintenance dose options (5 mg to 15 mg) if weight loss plateaus

  • Also sold as Zepbound, an on-label option for weight loss with the same active ingredient

Cons

  • Not FDA-approved for weight loss; using Mounjaro itself for that purpose is off-label

  • Longer titration schedule, taking about 20 weeks to reach the top dose

  • Not approved for use in adolescents under 18

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