Ozempic alternatives: 9 options to consider

Maybe there’s a drug shortage. Or perhaps your insurance doesn’t cover it. Whatever the case may be, if you’re considering Ozempic (semaglutide), you may be wondering if there are any Ozempic alternatives that can also help manage blood sugar and encourage weight loss. 

The good news is that Ozempic is not the only medication in its class. There are several other drugs that are similar to Ozempic and can produce similar effects, especially when combined with a healthy diet and exercise. It’s important to note, however, that most of the Ozempic alternatives are, like Ozempic, approved by the US Food and Drug Administration (FDA) to control blood sugar in those with type 2 diabetes. And while a few have received FDA approval for chronic weight management, others may be prescribed off-label for weight loss. 

Ahead, we break down nine Ozempic alternatives, including options for diabetes as well as weight loss. But remember: When considering medications, it’s best to consult a healthcare practitioner. So, consider this dive into Ozempic alternatives as a prep course, if you will, for a forthcoming discussion on your best option(s) with your provider.

As mentioned above, many Ozempic alternatives are glucagon-like peptide-1 (GLP-1) receptor agonists, just like Ozempic. These medications work by directing the pancreas to release more insulin when blood glucose levels get too high. This helps bring blood sugar levels back down. At the same time, GLP-1 receptor agonists also limit the release of glucagon, a hormone that raises your blood glucose levels. Together, these effects are what make GLP-1s so effective at stabilizing blood glucose in people with type 2 diabetes. 

What’s more, GLP-1 receptor agonists slow down digestion. Since it takes longer for your stomach to empty, you feel full longer, which may lead you to eat less food and experience weight loss. In addition to decreasing appetite, GLP-1s also tell the brain you’re full after eating, which adds another layer of appetite regulation. It’s because of these impacts that Ozempic and many of its alternatives are often prescribed off-label for weight loss. 

Since several of the Ozempic alternatives in this article work in similar ways, they tend to share side effects with Ozempic, including nausea, vomiting, abdominal pain, diarrhea or constipation, and injection site reactions (e.g. pain or skin irritation). In general, these symptoms are most common when you start using the medications and as you increase your dose. 

And one more point of note before diving into the Ozempic alternatives: All of the options below work best—be it for addressing diabetes or weight—when used in tandem with lifestyle changes, such as following a well-balanced diet and keeping up with adequate exercise. 

1. Mounjaro (tirzepatide)

While Mounjaro (tirzepatide) is part of the more prominent GLP-1 drug family, it differs slightly from other GLP-1 agonists like Ozempic. That’s because Mounjaro is a dual GLP-1/GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, which works on two different receptors. This may make it more effective at controlling blood sugar levels and subsequent weight loss. 

Like Ozempic, Mounjaro is injected on a weekly basis. Unlike Ozempic, however, it’s available in six dosage strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. While Mounjaro itself is currently only FDA-approved to help control blood sugar levels, the active ingredient in the medication, tirzepatide, has been approved for weight loss under a different name. (More on that in the next section.)

Cost: According to the manufacturer, Eli Lilly, Mounjaro costs $1,069.08 for a month’s supply (four pre-filled pens) without insurance. Depending on your eligibility, however, you might be able to cut this price down to $25 for a one-month or three-month supply of the medication with the Mounjaro Savings Card. 

Current availability: While tirzepatide (the active ingredient in Mounjaro) is categorized as “currently in shortage,” all dosage strengths of Mounjaro are available, per the Drug Shortages database managed by the FDA.

2. Trulicity (dulaglutide)

Trulicity (dulaglutide) is another injectable medication that helps improve blood sugar levels and weight loss. It should be injected weekly and prescribed in addition to lifestyle changes like diet and exercise. 

Like Ozempic, Trulicity is often prescribed to people with type 2 diabetes who have not found other treatments successful. The drug works by encouraging your pancreas to make more insulin when your body senses that you’ve eaten glucose or carbohydrates. Trulicity also reduces the risk that people with type 2 diabetes—both with and without heart disease—will experience a major cardiac event such as stroke, heart attack, or death.

Cost: While Trulicity is also produced by Eli Lilly, this Ozempic alternative costs slightly less than Mounjaro, coming in at $977.42 per month without insurance. Still, you might be able to pay as little as $25 for 12 Trulicity pens with the Trulicity Savings Card—that is, of course, if you’re eligible. 

Current availability: While dulaglutide (the active ingredient in Trulicity) is categorized as “currently in shortage,” all dosage strengths of Trulicity are available, per the FDA. 

3. Rybelsus (semaglutide)

Rybelsus has the same active ingredient as Ozempic: semaglutide. You usually take Rybelsus once a day in the morning and at least 30 minutes before you eat or drink anything. Rybelsus and Ozempic are both brand names of the same drug, semaglutide, but the biggest difference is that you take Rybelsus, which is available in 3 mg, 7 mg, and 14 mg tablets, by mouth, whereas Ozempic is an injection.

Cost: According to Novo Nordisk, the company that produces the drug, if you don’t have insurance, you could have to pay $968.52 for Rybelsus. But you might be able to slash that price and only pay $10 for one-, two-, or three-month prescriptions if you’re eligible for a Savings Card.

Current availability: As of publication, there is no drug shortage affecting Rybelsus. 

4. Metformin

Metformin, also known by its brand name, Glucophage, is FDA-approved as a diabetes medication and shares some side effects with Ozempic. But that’s where their similarities stop. 

Metformin is available as a tablet, liquid, or in an extended-release (ER) dosage form, and depending on the formulation, the dosage strengths and how often you take the medication differ. For example, the immediate-release tablets and liquids are often taken twice a day and come in 500 mg, 850 mg, and 1,000 mg whereas the ER version—which is available in 500 mg, 750 mg, and 1,000 mg—tends to be just once a day. 

So, how does metformin work? Metformin increases your body’s own production of GLP-1, potentially mimicking some of the effect of GLP-1 receptor agonists. The drug lowers the amount of glucose in your blood by blocking glucose production by the liver (aka gluconeogenesis). According to research, metformin might also decrease blood sugar by enhancing muscle tissue’s ability to remove glucose from the bloodstream and use it for energy. Additionally, metformin stimulates bacteria in your gut to use more glucose, thus decreasing blood sugar levels. And, last but certainly not least, the medication increases your body’s insulin sensitivity (i.e. your body’s ability to use insulin). 

Cost: When it comes to Ozempic alternatives, Metformin might be the most budget-friendly; without insurance, the medication can cost anywhere from $4 to $40 for a pack of 60 500 mg tablets (~one month supply if the prescription is to take 1 tablet twice a day), according to GoodRx. 

Current availability: As of publication, there is no drug shortage affecting metformin. 

5. Wegovy (semaglutide)

Wegovy and Ozempic are brand-name injectable prescription drugs containing the same active ingredient, semaglutide. So the way in which Wegovy works is the same as Ozempic. By ramping up the body’s levels of GLP-1, Wegovy keeps food in the stomach for longer and sends signals to the brain, letting it know you’re full. All of that helps regulate your appetite, and leads to significant weight loss.

While Ozempic is only approved for blood sugar management, Wegovy is FDA-approved for weight loss and management in adults and children ages 12+ with obesity as well as adults with obesity or overweight who have at least one weight-related health condition (e.g. high blood pressure, diabetes). It can also be prescribed to lower the risk of major cardiovascular problems (e.g. heart attack, stroke) in adults with heart disease and obesity or overweight, even without type 2 diabetes. In one clinical trial on Wegovy, participants who took Wegovy combined with lifestyle changes lost an average of 15% of their body weight by the end of the 68-week trial.

Cost: While the list price of Wegovy is $1,349.02 per month, you might be able to bring the cost down with the WeGoTogether savings program. Through this offer, you can pay as little as $0 for a 28-day supply of the medication if you have private or commercial insurance with prescription drug coverage. If your insurance doesn’t cover Wegovy, you can save up to $500 for a 28-day supply. Because of the manufacturer’s coupon at the time of publication, no one—no matter their insurance coverage or lack thereof—should pay more than $650 for a month’s supply of Wegovy, at least initially. 

Current availability: As of publication, the 0.25 mg dose of Wegovy is currently in shortage until “TBD,” according to the FDA. 

6. Saxenda (liraglutide)

Saxenda (liraglutide) is FDA-approved for chronic weight management. It also improves blood sugar control, although it is not FDA-approved to treat type 2 diabetes. Unlike Ozempic, Saxenda is a daily injection for weight loss whose dosage strengths range from 0.6 mg to 3 mg. Weight loss on Saxenda tends to be less profound compared to that on other Ozempic alternatives that are approved for weight loss, such as Wegovy and Zepbound. But the effects are still impressive: In a clinical trial, the majority of participants lost 5-10% of their body weight while on Saxenda over the course of one year, and some people even lost greater than 10%. 

Cost: Saxenda costs $1,349.02 per month without insurance, and you might have to pay for disposable needles, too. With the manufacturer’s savings card, you can pay as little as $25 for a 28-day supply of the medication if you have private or commercial insurance. If your insurance doesn’t cover Saxenda, the savings offer brings the cost down by $200 per 30-day supply for as long as the offer is valid.

Current availability: Saxenda is currently in shortage until “TBD,” according to the FDA. 

7. Zepbound (tirzepatide)

The latest weight loss drug to join the party, so to speak, is Zepbound: the brand name of tirzepatide, a medication that was previously only marketed under the brand name Mounjaro. Being that it has the same active ingredient as Mounjaro, the two medications share many similarities. Both are GIP/GLP-1 receptor agonists, injected on a weekly basis, available in the same range of dosage strengths, and have similar side effects. What is the key difference between the two Ozempic alternatives? Mounjaro is FDA-approved to treat type 2 diabetes while Zepbound is FDA-approved for chronic weight management. 

When it comes to weight loss, the higher the dose of Zepbound, the more weight you’re likely to lose, according to research. In clinical trials, for example, patients taking 5 mg of Zepbound lost 15% of their body weight, patients taking 10 mg of Zepbound lost 19.5% of their body weight, and patients taking 15 mg of Zepbound lost 20.9% of their body weight after a 72 week period. 

Cost: Zepbound costs $1,059.87 for a month's supply, but insurance and discount cards may bring the price down. For example, the Zepbound Savings Card can make it so you only have to pay between $25 and $650 for a month of Zepbound, depending on your insurance. Additionally, the manufacturer recently developed a direct-to-patient program called LillyDirect that provides Zepbound for $400 per month for the 2.5 mg dose or $550 per month for the 5 mg dose. 

Current availability: As of publication, the FDA is still determining if tirzepatide is in shortage.

8. Compounded semaglutide

In case you’re unfamiliar, compounded medications are custom-made pharmaceutical products by licensed pharmacists to meet the unique needs of an individual patient when a commercially available drug cannot, according to the American Pharmacists Association. Although compounded drugs are permitted to be prescribed under federal law, they are not FDA-approved and do not undergo safety, effectiveness, or manufacturing review. That being said, a provider may prescribe compounded medications, namely compounded GLP-1, if you’re looking for Ozempic alternatives and you’re facing a shortage or insurance denial. 

Compounded semaglutide features the same active ingredient as Ozempic and Wegovy and, like these brand-name versions, is a weekly injection that requires a prescription from a healthcare provider. If you and your practitioner decide that compounded semaglutide might be the best Ozempic alternative for you, it’s important to ensure that the medication is prepared by a reputable compounding pharmacy that adheres to strict quality control measures. 

Cost: Compounded medications are not typically covered by insurance, but they can be more affordable than paying for Ozempic out-of-pocket if you don’t have insurance or your insurance doesn’t cover the drug. If you qualify, Ro offers compounded semaglutide starting at $249 for the first month; from there, the medication costs $299 monthly. 

Current availability: Compounded semaglutide through Ro is currently available. But availability of the drug may differ if you fill the Rx elsewhere.  

9. Non GLP-1s

With the skyrocketing popularity of GLP-1s for weight loss, it can often feel like every other headline is talking about the short supply of these medications. The good news? There are other drugs that are also FDA-approved for weight loss that don’t seem to be in such limited availability. These include Qsymia (phentermine/topiramate), Contrave (naltrexone/bupropion) and Xenical (orlistat)—all of which are oral medications that you take once a day. Similar to GLP-1s, these Ozempic alternatives may cause gastrointestinal distress as well as other digestive side effects. And, depending on the specific medication, people taking these medications might also experience headaches, insomnia, dizziness, tingling sensations, anxiety, and irritability. 

In clinical trials, the three weight loss pills have been shown to be effective. In one year, people taking Qsymia (phentermine/topiramate) lost an average of 19 pounds, Contrave (naltrexone/bupropion) lost an average of 11 pounds, and Xenical (orlistat) lost an average of almost 6 pounds.

Cost: The exact price varies depending on the medication. For example, Contrave can cost around $668 for 120 tablets without insurance, while Xenical can cost around $466 for 90 capsules and Qsymia can cost around $211 for 30 capsules, according to Drugs.com. Of course, prices can change depending on which pharmacy you visit—as is the case for any of these Ozempic alternatives. There are savings cards for both Contrave and Qsymia, which can bring the cost down to $99 or $75, at first, respectively, for those who are eligible.

Current availability: As of publication, there is no drug shortage affecting Contrave, Qsymia, or Xenical. 

Short answer: It depends. 

If Ozempic isn’t available to you, either because of a shortage or because your insurance doesn’t cover it, your healthcare provider will help you find the right Ozempic alternative, factoring in your age, health situation, treatment goals, and personal preferences. 

If you’re interested in switching from Ozempic to an alternative medication, make an appointment with a healthcare provider. They can determine which Ozempic alternative (if any) could be a good option for you, and offer guidance on how to switch from one drug to the other. Your healthcare provider may recommend slowly tapering off of Ozempic before starting you on the new medication in order to minimize side effects. Follow their medical advice to ease the transition from Ozempic to the alternative.

If you’ve been struggling to find Ozempic during a drug shortage or if your insurance doesn’t cover it, you may want to consider an Ozempic alternative. Whether you are taking Ozempic for type 2 diabetes or weight loss, there are other treatment options for both conditions, including injectable GLP-1 medications as well as oral tablets and capsules. Talk to your healthcare provider about your options and whether switching to an Ozempic alternative could be the right move for you.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

October 02, 2024

Written by

Amelia Willson

Fact checked by

Beverly Tchang, MD and Raagini Yedidi, MD

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About the medical reviewers

Beverly Tchang, MD

Beverly Tchang, MD, is an Obesity Medicine Advisor for Ro. She is also an assistant professor of Clinical Medicine at Weill Cornell Medicine in New York and triple board-certified in Internal Medicine, Endocrinology, and Obesity Medicine.

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.