Zepbound vs Mounjaro: What is the Difference?

If you have type 2 diabetes or are interested in losing weight, you’ve probably seen the names of different GLP-1 medications thrown around as ways to manage symptoms effectively. Zepbound and Mounjaro are often compared to each other because they both use tirzepatide as their active ingredient. But what’s the difference between the two? The main difference is that Zepbound is FDA-approved for weight management and sleep apnea, while Mounjaro is approved for type 2 diabetes.

If you’re considering starting a GLP-1 medication and are interested in trying tirzepatide, here is what you need to know about the differences and similarities between Mounjaro and Zepbound.

What is Zepbound?

Zepbound is a once-weekly injectable prescription medication designed to help people lose weight more effectively than with just diet and exercise alone. It’s made by the manufacturer Eli Lilly and was approved for weight loss by the FDA in 2023. FDA approved Zepbound is indicated for chronic weight management in adults with obesity or overweight who have at least one weight related condition or weight-related health condition. In addition to weight loss, Zepbound is also FDA approved to treat obstructive sleep apnea, specifically moderate-to-severe or severe obstructive sleep apnea in adults with obesity.

Zepbound comes in six different dosage strengths:

• 2.5 mg
• 5 mg
• 7.5 mg
• 10 mg
• 12.5 mg
• 15 mg

If you are prescribed Zepbound, your doctor will likely start you on the lowest dose and increase it gradually to find the ideal dosage for your body’s needs. Zepbound is intended to be used alongside a reduced-calorie diet and increased physical activity for optimal results.

What is Mounjaro?

Mounjaro is a once-weekly injectable medication designed to help people with type 2 diabetes lose weight and manage their diabetes more effectively by improving blood sugar control. Mounjaro is a prescription medication specifically used to treat diabetes. It works to lower blood sugar and improve insulin sensitivity in people with type 2 diabetes. Like Zepbound, it’s produced by the manufacturer Eli Lilly, and it was FDA-approved in 2022, one year before Zepbound.

Mounjaro is also available in six different dosage options:

• 2.5 mg
• 5 mg
• 7.5 mg
• 10 mg
• 12.5 mg
• 15 mg

The maximum dose for Mounjaro is 15 mg weekly.

Like with Zepbound, your doctor will likely want to start on the lowest dose before gradually working up to find the ideal place for your body’s needs.

Insurance coverage for Mounjaro may vary depending on your insurance company and plan, and it often requires prior authorization.

What are GLP-1 Medications?

Zepbound and Mounjaro are both what are known as GLP-1 receptor agonists, also known as GLP-1 RAs. These are medications that mimic natural GLP-1s that the body produces when you eat. GLP-1s are essential for blood sugar control, insulin production, and feeling full after you’ve eaten. GLP-1 RAs do the same thing natural GLP-1s do in your body. Tirzepatide, the active ingredient in Zepbound and Mounjaro, also acts on the dependent insulinotropic polypeptide (GIP) pathway, making it a dual-agonist drug that targets both GLP-1 and GIP receptors.

GLP-1 RAs were originally developed for type 2 diabetes management, as blood sugar control is essential for people with diabetes to stay healthy. However, in recent years, the medications have become popular as weight loss drugs due to their ability to reduce appetite and decrease food intake, which contributes to their effectiveness. Now, people can be prescribed GLP-1 RAs both for diabetes management and for general weight loss.

GLP-1 RAs are a class of weight loss drugs, and Zepbound is a recently approved weight loss drug.

Similarities Between Zepbound and Mounjaro

There are a lot of similarities between Zepbound and Mounjaro, and these similarities include:

• Both medications have the same dosage size options, ranging from 2.5 mg to 15 mg, with increases of 2.5 mg between each size.
• Both medications are injectables that can be used on the stomach, thighs, or upper arms.
• Both medications are taken once per week.
• Both medications are produced by the same manufacturer, Eli Lilly.
• Both medications use the active ingredient tirzepatide.
• Both medications can help you lose body weight.
• Both medications have some similar side effects, such as nausea, diarrhea, and abdominal pain, and others.
• Both medications have FDA approval.
• Both medications are GLP-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide (GIPs).
• Both Zepbound and Mounjaro are prescription medications that must be prescribed by healthcare providers.
• Both medications are commonly used as part of medical weight loss programs.

Differences Between Mounjaro and Zepbound

When considering Mounjaro vs Zepbound, there are a lot of similarities between the two medications, but also some important differences.

• Mounjaro is approved for type 2 diabetes, while Zepbound is the only medication currently FDA-approved for both weight management and sleep apnea treatment in adults with obesity. Zepbound is indicated for obesity treatment and weight management.
• Side effects may differ. For instance, Zepbound tends to have more common injection site reactions than Mounjaro does.

Because Mounjaro and Zepbound use the same active ingredient and are produced by the same manufacturer, they have a lot more similarities than differences, but they aren’t the same drug.

Zepbound vs. Mounjaro: Side Effects

Side effects are one of the areas where Zepbound and Mounjaro are the most different, but there are still a lot of side effects that are common between the two. It is also important to discuss potential drug interactions with your healthcare provider, especially if you are taking other medications, including prescription drugs, over-the-counter medicines, or herbal supplements, when starting Zepbound or Mounjaro.

Similar Side Effects Between Mounjaro and Zepbound

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Constipation
• Indigestion
• Stomach pain
• Hair loss
• Pancreatitis
• Injection site reactions (more common in Zepbound)
• Gallbladder problems
• Depression

Different Side Effects Between Mounjaro and Zepbound

Zepbound

• Low blood sugar (hypoglycemia)
• Changes in vision
• Kidney problems
• Acute kidney injury

Certain conditions, such as severe gastrointestinal disease, can affect normal movement within the gastrointestinal tract and may impact the safety of these medications.

Mounjaro

• Acid reflux
• Anaphylaxis
• Angioedema (swelling of deep skin layers)

Mental Health and Mood Changes

Both Zepbound and Mounjaro can influence mood and mental health, though individual experiences vary. Some users report improvements in mood and reduced anxiety, possibly due to better blood sugar control and weight loss. However, others have experienced negative effects such as depression, irritability, and fatigue. These mood changes may be linked to fluctuations in blood sugar levels, the drug’s impact on brain chemistry, or psychological responses to weight loss.

Eli Lilly, the manufacturer, advises monitoring for any new or worsening mood symptoms, including depression or suicidal thoughts, and recommends discontinuing the medication if such symptoms occur. While some studies suggest that GLP-1 RA medications like tirzepatide may reduce the risk of depression in individuals with type 2 diabetes, the effects on mood in individuals without diabetes are less clear.

If you notice significant mood changes while taking Zepbound or Mounjaro, it’s crucial to consult your healthcare provider promptly. They can assess whether the medication is contributing to these changes and discuss alternative treatment options if necessary.

Effectiveness of Zepbound and Mounjaro

In a clinical trial sponsored by the manufacturer Eli Lilly, researchers aimed to discover how effective tirzepatide (the active ingredient in both Zepbound and Mounjaro) was for adults with BMI ratings over 27. Body mass index is used to determine eligibility for these medications. The trial divided participants into four different groups, each one receiving a different dosage strength of tirzepatide: 5 mg, 10 mg, 15 mg, and a placebo for the control group.

The study lasted for 72 weeks and included a 20-week de-escalation period. After the study concluded, the average weight loss was

• Placebo: 3.1% of starting weight
• 5 mg: 15% of starting weight
• 10 mg: 19.5% of starting weight
• 15 mg: 20.9% of starting weight

These results provide insight into how much weight people can expect to lose with these medications, depending on the dosage. Tirzepatide helps promote weight loss and lower blood sugar levels in people with obesity or type 2 diabetes. These medications are especially beneficial for individuals with a weight-related health condition or other health conditions such as heart disease, high blood pressure, or high cholesterol. These results showed that tirzepatide was effective in helping the study participants achieve steady weight loss over the 72-week span of using the medication.

Demographics That Should Not Use Zepbound or Mounjaro

Tirzepatide-based medications aren’t right for everyone, and you may have a condition that could increase the risk of adverse effects while taking one of these medications. Groups who are not recommended to take these medications include

• People with a personal or family history of medullary thyroid cancer
• People with a personal or family history of multiple endocrine neoplasia syndrome (MEN2)
• People with severe gastrointestinal disease
• People who are pregnant or nursing
• People with a history of a serious reaction to Zepbound, Mounjaro, or any of the non-medical ingredients used in the medications

These medications are contraindicated in people with a personal or family history of medullary thyroid carcinoma or thyroid C cell tumors, due to the increased risk observed in animal studies. If you experience severe or life-threatening side effects, such as signs of an allergic reaction or kidney problems, seek immediate medical attention.

Access to Medications

To get either medication, you must first have a prescription from a licensed healthcare provider, either through an in-person visit with your primary care physician or via telehealth services. For Zepbound, Eli Lilly offers the LillyDirect self-pay option, where you can buy pens or vials without insurance, or use your insurance if accepted, often at reduced cost.

When considering Mounjaro or Zepbound, it’s important to know that insurance plans and insurance companies have different coverage criteria for these medications. Your insurance plan may require prior authorization or have specific eligibility requirements, which can affect your access and out-of-pocket costs.

For Mounjaro, you need to be evaluated by a provider for type 2 diabetes (or qualifying weight-related conditions), and they’ll submit a prescription to a local or mail-order pharmacy. Telehealth clinics can walk you through this process, too.

In many cases, you’ll need to complete medical screening or lab testing before the prescription is finalized.

How Does Tirzepatide Differ From Other GLP-1 RAs?

Both Zepbound and Mounjaro use the active ingredient tirzepatide, which is one of several different GLP-1 RA medications currently on the market. Other well-known GLP-1 RAs, like Ozempic and Victoza, use different active ingredients, such as semaglutide and liraglutide. So, is there a reason to prefer tirzepatide over the others?

One unique quality about tirzepatide is that it acts as both a GLP-1 and a glucose-dependent insulinotropic polypeptide (GIP), and tirzepatide is currently the only GLP-1 medication that works in two ways. The FDA approves tirzepatide for specific indications, such as chronic weight management and type 2 diabetes, highlighting its regulatory status and credibility.

Zepbound or Mounjaro: Which is Right For You?

Zepbound and Mounjaro are both powerful tools for managing weight and metabolic health, but the right choice depends on your specific health needs. Working with your healthcare provider to develop a personalized treatment plan is essential for success. While they share the same active ingredient, their FDA-approved uses, insurance coverage, and potential side effects differ in meaningful ways.

If you’re considering starting a tirzepatide-based medication, it’s essential to do so as part of a comprehensive plan, not just a prescription. Both medications are often used as part of a comprehensive medical weight loss approach, which may include expert guidance from obesity medicine physicians, behavioral health support, nutrition, and physical activity. Working with a registered dietitian can help you create a sustainable approach to nutrition, manage side effects, and improve your results long-term. Nutrition counseling can help you get better results from your medication, manage side effects, and build healthy habits that last.

What are you waiting for? Sign up to talk to a registered dietitian today at no cost to you!

Zepbound vs. Mounjaro: Frequently Asked Questions (FAQ)

How Much Do Zepbound and Mounjaro Cost Without Insurance?

Without insurance, the list price for tirzepatide-based GLP-1 medications is roughly $1,080 per month. With insurance coverage, the price can vary widely depending on the specific coverage plan you have.

Can These Medications Interfere With Other Medicines I’m Taking?

Because tirzepatide slows digestion, it may impact how your body absorbs other oral medications. For example, birth control pills could be less effective soon after an injection. When talking to your doctor about starting a GLP-1 medication, always go over all your other prescription medications so your doctor is aware of how it may affect you.

How Do I Store Zepbound or Mounjaro Pens?

Keep unopened pens refrigerated at 36–46°F. Once in use, they can be stored at room temperature (up to 86°F / about 30°C) for a certain number of days, which should be listed on the pen’s label. Avoid exposure to extreme heat or cold.

Is There a Risk of Weight Regain if I Stop Taking Zepbound or Mounjaro?

Yes, stopping the medication may lead to some weight regain because the effects on appetite, metabolism, and satiety may reduce over time. Continuing healthy eating, exercise, and lifestyle support is important even after stopping medication.