Ozempic alternatives: 9 options to consider

Raagini Yedidi, MD - Contributor Avatar

Reviewed by Raagini Yedidi, MD, 

Written by Amelia Willson 

Raagini Yedidi, MD - Contributor Avatar

Reviewed by Raagini Yedidi, MD, 

Written by Amelia Willson 

last updated: May 06, 2024

8 min read

Key takeaways

  • If there’s a drug shortage or your insurance doesn’t cover Ozempic, there are other medications available that might be good for weight loss or type 2 diabetes. 

  • These Ozempic alternatives include other GLP-1 agonists, including those that are FDA-approved to treat type 2 diabetes (e.g. Mounjaro, Trulicity) and for chronic weight management (e.g. Wegovy, Zepbound).

  • Oral medications, such as Metformin, Qsymia, Contrave, Xenical, and Alli may also be prescribed as Ozempic alternatives, though they have different ways of working.

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 medications 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, FDA-approved 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.

Ozempic Important Safety Information: Read more about serious warnings and safety info.

9 Ozempic alternatives

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

Ozempic alternatives for type 2 diabetes

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

Mounjaro Important Safety Information: Read more about serious warnings and safety info.

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. 

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 $935.77 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.

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? 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). 

Ozempic alternatives for weight loss

5. Wegovy (semaglutide)

Wegovy and Ozempic are brand-name injectable prescription drugs containing the same active ingredient, semaglutide. So Wegovy works the same way as Ozempic does. 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. It is often prescribed to people with a body mass index (BMI) of 30 or higher (defined as “obesity”) or to people with a BMI of 27 or higher (defined as “overweight”) who also have a weight-related health condition, such as high blood pressure, high cholesterol, or 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 savings program. With the savings card, 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. The offer applies to up to 13 fills and is subject to a maximum savings of $225 per 28-day supply. If your insurance doesn’t cover Wegovy, the savings offer can still save up to $500 for a 28-day supply. 

Wegovy Important Safety Information: Read more about serious warnings and safety info.

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 .6 mg to 3 mg. Weight loss on Saxenda is less profound compared to that on other Ozempic alternatives that are approved for weight loss, such as Wegovy and Zepbound (more on the latter in a second). 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 for a 30-day supply without insurance, and you might have to pay for disposable needles, too. 

Saxenda Important Safety Information: Read more about serious warnings and safety info.

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 one-month 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 $550 for a one-month supply of Zepbound, depending on your insurance.

Zepbound Important Safety Information: Read more about serious warnings and safety info.

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8. Compounded GLP-1

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 from the drug manufacturer out of pocket if your insurance doesn’t cover it. If you qualify, Ro offers compounded semaglutide and ongoing support from a licensed practitioner to help you meet your weight loss and health goals. 

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 or Alli (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 or Alli (orlistat) lost an average of almost 6 pounds.

Cost: The exact price varies depending on the medication. For example, Contrave costs $668 for 120 tablets without insurance, while the generic orlistat costs $673 for 90 capsules. Of course, prices can change depending on which pharmacy you visit. 

What Ozempic alternative is right for me?

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.

DISCLAIMER

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.


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.

Current version

May 06, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD


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