7 Mounjaro alternatives: other options to consider

Mounjaro (tirzepatide) is part of a family of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists, but it sets itself apart as a so-called dual-action GLP-1/GIP (more on that below). GLP-1 medications help people with type 2 diabetes control their blood sugar, and can help people with obesity or overweight lose weight. While Mounjaro is one such medication, there are several alternatives, including Ozempic, Wegovy, and others. 

Mounjaro (tirzepatide) is a prescription injectable medication that was approved by the U.S. Food and Drug Administration (FDA) in 2022 to control blood sugar levels in people with type 2 diabetes, when used in combination with diet and exercise. The FDA is expected to approve Mounjaro for weight loss sometime in 2023 once new data from tirzepatide weight loss trials are available. Until then, health providers may prescribe the drug off-label for weight loss. 

While Mounjaro is part of the bigger GLP-1 drug family, it’s actually a bit different from other medications that are GLP-1 agonists, like Ozempic and Wegovy. That’s because Mounjaro is a dual GLP-1/GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, meaning it works on two different receptors. This dual capability may make Mounjaro more effective at weight loss and glycemic control than similar GLP-1 medications that target only one receptor. 

Mounjaro works by activating GLP-1 and GIP receptors in the brain and the pancreas. GLP-1 and GIP are two peptide hormones that play a role in insulin secretion, appetite regulation, and gastric emptying (the process in which food leaves your stomach and enters the small intestine). Mounjaro effectively regulates insulin secretion from the pancreas after you eat, helping control blood sugar levels. It also slows down gastric emptying and sends signals to your brain that you’re full, so you eat less and lose weight.

Mounjaro is injected once a week, under the skin of the upper arm, thigh, or abdomen. Each pen of Mounjaro contains one dose.  To minimize side effects, providers typically prescribe a starting dosage of 2.5 mg, and titrate the dose up every four weeks, until the maximum effective dosage is reached. Dosage strengths of Mounjaro include 2.5 mg, 5 mg, 10 mg, 12.5 mg and 15 mg. 

The most common side effects of Mounjaro may include:

• Nausea

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Upset stomach or indigestion

• Abdominal pain

If you’re interested in how other diabetes and weight loss medications compare against Mounjaro, read on. Here are seven other GLP-1 medications that may be prescribed to manage blood sugar levels or help with weight loss.

1. Ozempic

Ozempic (semaglutide) is a once-weekly injectable medication that helps control blood sugar levels in type 2 diabetes. In addition to helping control blood glucose, Ozempic also reduces the risk of experiencing a major cardiovascular event — like heart attack, stroke, or death — in people who have both type 2 diabetes and heart disease.

In a study comparing Ozempic and Mounjaro directly, all three dosages of Mounjaro (5 mg, 10 mg, and 15 mg) outperformed the 1 mg dosage of Ozempic. Blood sugar control was improved to a larger extent on Mounjaro and people lost more weight. For example, those taking the 15 mg dose of Mounjaro lost nearly twice as much body weight as those taking Ozempic. However, people taking Ozempic experienced fewer gastrointestinal side effects, including less nausea, diarrhea, and vomiting. People taking Mounjaro were also more likely to experience serious side effects like hypoglycemia.

Another study compared the highest maximum dose of Ozempic (2 mg) vs. the three doses of Mounjaro. At both weight loss and glycemic control, the higher 2 mg dose of Ozempic was comparable to the 5 mg dose Mounjaro. However, people still lost more weight, and experienced larger improvements in their blood sugar, on the higher 10 mg and 15 mg doses of Mounjaro than those taking 2 mg of Ozempic.

2. Wegovy

Wegovy (semaglutide) contains the same active ingredient as Ozempic, but is FDA-approved for weight management instead of type 2 diabetes. In addition to a reduced-calorie diet and increased exercise, Wegovy may be prescribed to people with a body mass index (BMI) of 30 and higher, or 27 and above if they have a weight-related health condition like type 2 diabetes, high cholesterol, or high blood pressure. Wegovy also differs from Mounjaro in that it is approved to treat children ages 12 and older in addition to adults.

Research comparing the maximum 2.4 mg dose of Wegovy vs. the maximum 15 mg dose of Mounjaro found that Mounjaro was more effective at both weight loss and blood sugar control. However, both medications are highly effective at producing weight loss. People taking the highest dose of Mounjaro may lose up to 13% of their body weight while those taking Wegovy may lose nearly 10% in the same time period. 

Gastrointestinal side effects like nausea and diarrhea are common to both Wegovy and Mounjaro, but people taking Wegovy may be more likely to experience additional side effects such as:

• Headache

• Fatigue

• Bloating 

• Burping

• Flatulence

• Acid reflux

• Hypoglycemia (in people who have type 2 diabetes)

• Common cold

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3. Saxenda

Saxenda (liraglutide) is another GLP-1 medication that is FDA-approved for weight loss. Like Wegovy, Saxenda may be prescribed to adults and children with obesity, as well as adults who are overweight and have at least one weight-related health condition. Unlike Mounjaro, Saxenda is not approved to treat type 2 diabetes. It also differs from Mounjaro in that it is injected daily, not weekly.

When compared to Mounjaro, Saxenda's highest dose of 3mg produces less weight loss than either of the two highest doses of Mounjaro (10 mg or 15 mg). In clinical trials, people taking Saxenda lost between 5% to 7.5% of their body weight in about a year, while those taking Mounjaro lost more — 6% to 8% of their body weight — in less time. Side effects like nausea, diarrhea, constipation, and vomiting are also more common with Saxenda than Mounjaro.

Here are the differences between Saxenda and Mounjaro.

4. Victoza

Victoza (liraglutide) shares the same active ingredient as Saxenda. Like Mounjaro, it is approved to treat type 2 diabetes in adults. However, Victoza differs from Mounjaro in that it is a daily injection, as opposed to weekly, and it can also lower the risk of heart attack, stroke, or death in people with type 2 diabetes and heart disease. Additionally, Victoza is approved to treat children ages 10 and older.

While Victoza can lead to some weight loss, the results are less noticeable than with Mounjaro. People taking Victoza may lose a little over 2% of their body weight in one year, while those taking Mounjaro lose three to four times as much (6% to 8%) in a shorter time period. However, side effects are significantly less common with Victoza than Mounjaro.

5. Byetta or Bydureon BCise

Byetta and Bydureon BCise are two diabetes medications with the same active ingredient, exenatide. Like Mounjaro, they treat type 2 diabetes by improving blood sugar control. Byetta is a twice-daily injection, while Bydureon BCise is a weekly injection like Mounjaro.

Both versions of exenatide can lead to weight loss, although their impact on weight loss and glycemic control is to a lesser extent than Mounjaro. While nausea is common to all three medications, people taking Byetta and Bydureon BCise may be more likely to experience additional side effects such as injection site reactions or feeling jittery.

6. Trulicity

Trulicity (dulaglutide) is a weekly injection like Mounjaro, and is also approved to treat type 2 diabetes by improving blood sugar control. It also reduces the risk of heart attack, death, and stroke in people with type 2 diabetes and cardiovascular disease.

In a clinical trial, all maintenance doses of Mounjaro produced greater improvements in blood sugar levels and weight loss than Trulicity. However, people taking Trulicity experienced fewer side effects, including less nausea and constipation.

7. Rybelsus

The above GLP-1 receptor agonists are all injectable medications, but there is also an oral option. Rybelsus (semaglutide) is a once-daily oral GLP-1 medication that treats type 2 diabetes, in combination with lifestyle changes like diet and exercise.

Like Ozempic and Mounjaro, Rybelsus is effective at improving blood sugar levels, but people taking Rybelsus may experience fewer side effects than those taking Ozempic or Mounjaro.

Different diabetes and weight loss drugs may cause different side effects in different people, and they can have varying levels of insurance coverage. GLP-1s may not be prescribed to people with certain health conditions, like a history of thyroid cancer or pancreatitis. In addition to these Mounjaro alternatives, there are other weight-loss prescription drugs, including Qsymia, Contrave, or Xenical. Talk to your healthcare provider about the right option for you.

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Current version

June 05, 2023

Written by

Amelia Willson

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.