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Hello Clare,
How is Ozempic different than Mounjaro with regards to how it works. The mechanism or pathways that these 2 different drugs use for glycemic control and weight loss.
What's the difference if both drugs are GLP-1 other than the brand name ?
Thank you.
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Great question! Both GLP-1 and SGLT2 medications are used to treat type 2 diabetes, but they work in different ways.
GLP-1 medications (like Ozempic or Trulicity) are usually given as weekly injections. They help your body release more insulin when you eat, slow down how quickly food leaves your stomach, and can help you feel full longer—which often leads to some weight loss. Many people find these medications helpful for both blood sugar control and weight management, but they can sometimes cause nausea or stomach upset.
SGLT2 medications (like Jardiance or Farxiga) are taken as daily pills. They work by helping your kidneys get rid of extra sugar through your urine. This not only lowers blood sugar, but can also help protect your heart and kidneys. The main side effects are needing to pee more often and, in some cases, a higher risk of urinary tract infections.
GLP-1s are mostly…
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Hi Geminiwin87,
Great question!
It's common, but not entirely accurate, to refer to both Ozempic and Mounjaro as GLP-1 medications in everyday conversation, media, and even some clinical settings. But let me explain why it's not completely correct.
Although both Ozempic (semaglutide) and Mounjaro (tirzepatide) help lower blood sugar and support weight loss, they work in different ways. Ozempic acts like a natural hormone in your body called GLP-1, which helps your pancreas release insulin when your blood sugar rises. It also slows down how quickly food moves through your stomach, so you feel full longer and eat less. This combination supports both better blood sugar control and weight reduction.
Mounjaro, on the other hand, takes it a step further. It mimics two hormones, GLP-1 and another one called GIP (glucose-dependent insulinotropic polypeptide). GIP also helps your body release insulin and may improve how your body uses it, especially in fat tissue. So it's a dual GIP/GLP-1 receptor agonist (also called a twincretin). When these two hormones work together, they seem to have a stronger impact, not just on blood sugar, but also on appetite control and fat metabolism. In fact, a large clinical trial found that people taking tirzepatide lost significantly more weight and had greater improvements in A1C compared to those taking semaglutide.
So, while both medications are effective, the key difference is that Mounjaro targets two hormonal pathways instead of one. This often leads to better results, especially when it comes to weight loss. Everyone responds differently, so it’s always a good idea to talk with your healthcare team about which option might be right for you.
If you're interested in the data, like I am 😊, there were some interesting trials, one comparing the two.
In the SURPASS-2 trial (published in The New England Journal of Medicine), Mounjaro outperformed Ozempic in both A1C reduction and weight loss. Participants on the highest dose of tirzepatide lost an average of 11.2 kg (~25 lbs) compared to 5.7 kg (~12.5 lbs) on semaglutide, and A1C dropped by up to 2.46% vs 1.86% with semaglutide (Frías et al., NEJM, 2021).
Another study, SURMOUNT-1, looked specifically at tirzepatide for people with obesity without diabetes and found average weight loss of up to 22.5% of body weight over 72 weeks (Jastreboff et al., NEJM, 2022).
You may also be wondering, why not just take Mounjaro if it's more effective? Well cost does play a role.
From what I can see, in Canada, the cost of Ozempic (semaglutide) typically ranges from around CAD 200 to CAD 300 per month for a standard dose of four injections, depending on the pharmacy and province. Ozempic is covered under provincial drug plans only for type 2 diabetes, not for weight loss, so you may need to pay out of pocket unless you qualify for public or private insurance.
By contrast, Mounjaro (tirzepatide) is more expensive if paid entirely out of pocket, costing about CAD 100 per week, or roughly CAD 400–530 per month depending on dosage and the pharmacy's markup. Some providers report pricing starting at around CAD 342 per month, with slight variation across pharmacies.
So, if you're managing costs yourself, Ozempic tends to be cheaper compared to Mounjaro. This means deciding between them may come down not only to how your body responds, but also to how much you're willing or able to spend.
I hope that helps to understand the difference a little more and the factors that play a role in prescibing!
Here are the links to the cited literature.
Frias et al: note this study was funded by Eli Lilly: https://www.nejm.org/doi/full/10.1056/NEJMoa2107519
Jastreboff et al: again funded by Eli Lilly: https://www.nejm.org/doi/full/10.1056/NEJMoa2206038