Saxenda vs. Mounjaro: how are they different?

GLP-1 medications have been making headlines lately. If you don’t recognize the term GLP-1, you probably know these medications by their brand names instead: Ozempic, Wegovy, Saxenda, and Mounjaro (side note: as a dual GLP-1/GIP agonist, Mounjaro differs slightly from other GLP-1 drugs — more on that below).

GLP-1 medications are all part of the same drug class, and they typically treat type 2 diabetes or obesity. Saxenda and Mounjaro are two such medications, both of which can lead to weight loss.

If you’re interested in Saxenda or Mounjaro, read on. We’ll break down the key differences between these two medications.

Saxenda and Mounjaro are prescription medications that you inject under the skin in your upper arm, thigh, or abdomen. Both drugs are meant to be taken in combination with lifestyle changes like diet and exercise. Some of their key differences include being FDA approved for different conditions, and having different active ingredients and dosing schedules. Let’s explore.

Saxenda (liraglutide) is approved for chronic weight management in people with obesity (BMI of 30 or higher) or with overweight (BMI of 27 or higher) and a weight-related health condition, such as type 2 diabetes, high blood pressure, or high cholesterol. The recommended dose of Saxenda is 3 mg, injected daily. When you start taking Saxenda, your health provider will have you begin with a starting dose of 0.6 mg daily for one week. You’ll slowly increase your dosage each week until you reach the recommended maintenance dose of 3 mg daily. Saxenda is not FDA-approved to treat type 2 diabetes. 

Mounjaro (tirzepatide) is approved to treat type 2 diabetes by improving blood sugar control. Mounjaro differs from Saxenda in that it is a once-weekly injection, as opposed to daily. It comes in several strengths, ranging from a starting dose of 2.5 mg to a maximum maintenance dosage of 15 mg. Also, each pen of Mounjaro contains a single weekly dose of the medication—a single-use pen—while a Saxenda pen contains multiple doses. The Mounjaro pen includes an integrated needle. But, for Saxenda, you’ll need to purchase needles separately (each box of 100 NovoFine or NovoTwist needles costs about $60, or 60 cents per needle).

Both medications work on the glucagon-like peptide-1 (GLP-1) receptor. Their active ingredients, liraglutide and tirzepatide, mimic the GLP-1 hormone naturally produced by your body. In doing so, these medications help encourage insulin release, limit glucagon production, slow down digestion, and increase satiety (fullness) signals in your brain. As a result, people taking Saxenda and Mounjaro experience lower blood sugar levels, reduced appetite, and weight loss.

A key difference between Mounjaro and Saxenda is that Mounjaro works on an additional receptor. Mounjaro mimics the glucose-dependent insulinotropic polypeptide (GIP) hormone in addition to GLP-1. Being a dual GLP-1/GIP agonist may make Mounjaro more effective at weight loss than other GLP-1 agonists like Saxenda, Ozempic, and Wegovy.

Both Saxenda and Mounjaro can lead to significant weight loss, when combined with diet and exercise, but Mounjaro has been proven to be more effective. Overall, the higher 10 mg and 15 mg doses of Mounjaro produce more weight loss than Saxenda. 

On average, people taking Saxenda lose around 9% of their body weight in one year. In one study, nearly two-thirds of people taking Saxenda lost at least 5% of their body weight in about a year, while one-third of people lost more than 10%. This amount of weight loss is significant enough to improve other cardiometabolic health measures, such as cholesterol and blood pressure. It has also been shown to delay the development of type 2 diabetes in people with prediabetes.

While Mounjaro is not yet approved for weight loss (more on this in a bit), clinical trials show that it leads to much more weight loss than other GLP-1 medications, including Saxenda. In one study, people taking the highest 15 mg dose of Mounjaro lost nearly 21% of their body weight in about a year and a half. This study demonstrated that the weight loss with Mounjaro is dose-dependent, meaning that people taking higher doses tend to lose more weight. For comparison, people taking a 10 mg dosage of Mounjaro lost 19.5% of their body weight, and those taking the 5 mg dose lost 15%. 

Currently, only Saxenda is approved for weight loss. Mounjaro is only FDA-approved for controlling blood sugar in type 2 diabetes, not weight loss. But health providers can prescribe Mounjaro off-label for weight loss if they determine it best fits their patients. 

That may change soon, though. The maker of Mounjaro, Eli Lilly, is currently conducting clinical trials of tirzepatide for weight loss in people without type 2 diabetes. The FDA has granted them a “Fast Track” designation to accelerate the process. The trials are expected to be finished later in 2023, which means tirzepatide could be officially approved for weight loss later this year.

Saxenda and Mounjaro can cause similar gastrointestinal side effects. These may include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Upset stomach or indigestion

Some side effects — including nausea, diarrhea, constipation, and vomiting — are reported more commonly in people taking Saxenda vs. Mounjaro. For example, up to 40% of people taking 3 mg of daily Saxenda report experiencing nausea, while 12% to 18% of people taking Mounjaro report nausea. 

Either way, these side effects tend to be mild to moderate, and people generally find them manageable. Side effects are usually more common at the beginning of treatment, and often go away with time as your body gets used to the medication.

Additional side effects of Saxenda listed by the manufacturer may include injection site reactions, headache, fatigue, dizziness, fever, stomach flu, and increased lipase (a potential warning sign of acute pancreatitis). 

In rare cases, serious side effects can occur. Both medications can increase the risk of experiencing hypoglycemia (low blood sugar) in people who are also taking insulin or insulin secretagogues like sulfonylurea. You might also have an allergic reaction to Mounjaro or Saxenda, such as a rash or difficulty breathing. If this happens, stop taking Mounjaro or Saxenda and call your health provider immediately. Pancreatitis, kidney injury, and gallstones can also occur, in which case your health provider may recommend stopping treatment. 

Finally, a few serious side effects are more common with one medication over the other. The risk of experiencing severe gastrointestinal disease or diabetic retinopathy (diabetes-related vision loss or changes) is higher with Mounjaro. Increased heart rate, depression, and suicidal thoughts have been reported with Saxenda.

Saxenda costs more than Mounjaro. However, one medication may be cheaper based on your insurance coverage. Without insurance, the average price for a month’s supply of Saxenda is $1,349.02, while for Mounjaro it is $1,023.04. Neither medication has a generic version available at this time.

Ultimately, how much you’ll pay for Mounjaro or Saxenda will depend on your insurance plan and the pharmacy you use. If your insurance covers one or both medications, that will significantly reduce the cost. In some cases, you may need to work with your healthcare provider to request prior authorization before the drug will be covered by your insurance. 

Review your plan’s drug coverage and run the numbers to see how much each medication will cost based on your copays and your deductible. If you have any questions, call your insurance provider. Novo Nordisk, the maker of Saxenda, offers a hotline (1-888-809-3942) and website that helps you estimate the cost of Saxenda.

If you have private or commercial insurance, you may be eligible for the savings cards offered by the drugs’ manufacturers. Both the Mounjaro Savings Card and Saxenda Savings Card can bring the cost of a 1-month supply down to as little as $25. The cards can also be used on 2-month and 3-month refills.

Price-checking at multiple pharmacies may help you save even more on Mounjaro or Saxenda. Call local pharmacies, and expand your search to other local pharmacies that offer home delivery. Check online with online pharmacies, too, as these often have more competitive pricing and typically offer free shipping. Finally, if you can afford it, see if a 2- or 3-month supply is cheaper in the long run than a 1-month supply. 

This is one of those situations where too much of a good thing becomes a bad thing. The answer is no, Mounjaro and Saxenda should not be taken together, or combined with other GLP-1 medications. It is also not known if taking Saxenda at the same time as other weight loss medications is safe or effective.

If you have questions about combining medications, for weight loss or other conditions, talk to your healthcare provider first. Some medications, including Saxenda and Mounjaro, can affect your body’s absorption of oral medications.

Saxenda and Mounjaro have similar contraindications. You should not take either medication if you develop or have a history of: 

• Acute kidney injury

• Acute gallbladder disease

• Medullary thyroid carcinoma

• Multiple endocrine neoplasia syndrome type 2 (MEN 2)

• Pancreatitis

• An allergy to the drug’s active ingredients (liraglutide for Saxenda, tirzepatide for Monjaro) or inactive ingredients

Additionally, people who have severe gastrointestinal disease should not take Mounjaro. 

Contact your healthcare provider if you become (or plan to become) pregnant while taking Saxenda or Mounjaro. There is not enough data to know whether it is safe to take these medications while pregnant, and as of now the general recommendation is to not take Saxenda or Mounjaro if you are pregnant or plan to become pregnant.

If you are taking other medications or supplements, tell your healthcare provider before starting Mounjaro or Saxenda. Both drugs delay gastric emptying (the process when food leaves your stomach and enters the small intestine), which can affect your body’s absorption of any oral medications you may be taking. 

Also, taking certain drugs may raise the risk of experiencing side effects with Saxenda or Mounjaro. For example, if you take insulin to manage your type 2 diabetes, your blood sugar levels may drop too low if used with Mounjaro or Saxenda, both of which also lower blood sugar levels. To prevent hypoglycemia, your health provider may lower your dosage of insulin. Similarly, if you take any medications that lower your blood pressure, your health provider may recommend extra monitoring, since both Saxenda and Mounjaro can also lower blood pressure. 

Sometimes, a drug just doesn’t work for you, and that’s okay. There are several reasons you might want to switch from Saxenda to Mounjaro, or vice versa, including:

• Side effects: Saxenda and Mounjaro have similar side effects. If you are taking one of these medications and the side effects are causing you significant distress, ask your healthcare provider about switching to another GLP-1 or weight loss medication.

• Cost: Mounjaro is generally more affordable than Saxenda. Ultimately, whichever is more affordable will depend on your insurance coverage. Review your insurance plan before switching medications, and do a little research to determine if you are eligible for either drug’s savings card or patient assistance programs.

• Effectiveness: People taking higher doses of Mounjaro tend to lose more weight than people taking Saxenda. But, as with side effects, your mileage may vary. If you’ve been taking Saxenda and feel like you’re not losing enough weight, talk to your healthcare provider.

• Personal preference: Finally, convenience is a consideration. Some people may prefer the convenience of Mounjaro’s once-weekly injection, while others may find it easier to remember to inject their dose daily with Saxenda. 

If you are currently taking Saxenda or Mounjaro and would like to switch to the other one, or another medication, make an appointment with your healthcare provider before you stop taking your medication. They can walk you through your options, recommend a suitable alternative, and offer guidance on adjusting your dosage and safely switching from one medication to the other. Since Saxenda and Mounjaro are FDA approved for different uses, you might be unable to switch between the two medications. For example, if you’re taking Saxenda for weight management, you’ll probably switch to Wegovy, and not Mounjaro. And if you’re taking Mounjaro for type 2 diabetes, you might switch to Ozempic, or Victoza.

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Current version

July 06, 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.