Four brand names, two medicines. Ozempic® and Wegovy® both contain semaglutide. Mounjaro® and Zepbound® both contain tirzepatide. The differences come down to what the FDA approved each one for and the doses it comes in.
Ozempic is FDA-approved, alongside diet and exercise, to improve blood sugar in adults with type 2 diabetes, and to lower the risk of heart attack, stroke, and cardiovascular death in adults with type 2 diabetes and heart disease. Wegovy is approved for chronic weight management in adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. It is also approved to lower the risk of major cardiovascular events in adults with heart disease and obesity or overweight. Wegovy's standard maintenance dose, 2.4 mg a week, is higher than Ozempic's top labeled dose of 2 mg.
Mounjaro is approved, alongside diet and exercise, to improve blood sugar in adults with type 2 diabetes. Zepbound is approved for chronic weight management using the same BMI criteria as Wegovy, and for moderate to severe obstructive sleep apnea in adults with obesity. The two share the same dose steps, starting at 2.5 mg and going up to a maximum of 15 mg once a week.
In the STEP 1 trial (NEJM, 2021), adults without diabetes on semaglutide 2.4 mg lost an average of 14.9% of body weight over 68 weeks, compared with 2.4% on placebo. In SURMOUNT-1 (NEJM, 2022), adults on the highest tirzepatide dose, 15 mg, lost an average of 20.9% over 72 weeks, compared with 3.1% on placebo. Both trials paired the medication with diet and activity counseling, and averages hide a wide range: some people lose much less.
All four carry an FDA boxed warning about thyroid C-cell tumors seen in rodent studies, and none should be used by anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Labeling also warns about pancreatitis, gallbladder problems, kidney injury from dehydration, serious allergic reactions, and low blood sugar when combined with insulin or sulfonylureas. Get care right away for severe stomach pain that won't go away, with or without vomiting, or signs of an allergic reaction. None of them should be combined with another GLP-1 medication. If you're starting one, our guide on keeping muscle on a GLP-1 is worth reading.
Osirius offers all four brands as well as compounded semaglutide and tirzepatide. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety or effectiveness; our guide to compounded vs. brand-name GLP-1s explains the difference. Which brand fits usually follows your diagnosis: the diabetes-labeled versions for type 2 diabetes, the weight-management versions when that is the goal. Because the approved uses differ, an insurance plan may cover one and not the other, so check your own plan. A licensed provider reviews your history and decides what, if anything, is appropriate.
This guide explains general information and is not medical advice. It doesn't replace a licensed provider reviewing your own history.
