Zepbound vs. Mounjaro: what is the difference?

If you’re looking to manage your type 2 diabetes or lose weight (or both), your healthcare provider may have suggested Mounjaro or Zepbound as potential treatment options. Both medications are made by the same company (Eli Lilly), contain the same active ingredient (tirzepatide), and share several side effects (nausea, vomiting, and diarrhea, among others). So, what’s the difference between Zepbound and Mounjaro?

The main difference is that they are approved by the US Food and Drug Administration (FDA) to treat different health conditions: weight loss and sleep apnea in the case of Zepbound and type 2 diabetes in the case of Mounjaro. 

One medication may be a better fit for you than the other, depending on your personal health situation, insurance coverage, and other considerations. Read on as we break down the differences and similarities between Mounjaro versus Zepbound.

Zepbound (tirzepatide) is a once-weekly injectable prescription medication that’s FDA-approved for weight loss and management in people with obesity or with overweight and at least one weight-related health condition (such as high blood pressure or cholesterol). It’s intended to be used with diet and exercise. It is also approved for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity. Zepbound is made by Eli Lilly and was approved by the FDA in 2023. 

Zepbound is injected once a week subcutaneously (under the skin) of the stomach, thigh, or upper arm. It is available in six dosage strengths ranging from 2.5 mg to 15 mg, with 5 mg, 10 mg, and 15 mg being the maintenance dosages. Providers typically prescribe a starting dosage of 2.5 mg before gradually increasing the dosage over a period of weeks to months until an effective dosage is reached. This titration schedule helps keep side effects manageable while your body gets used to the medication.

Mounjaro (tirzepatide) is a once-weekly injectable prescription medication for type 2 diabetes. In combination with diet and exercise, Mounjaro treats type 2 diabetes by improving blood sugar control. It is made by Eli Lilly and was FDA-approved in 2022. 

Mounjaro is injected once a week under the skin of the stomach, thigh, or upper arm. It is available in the same six dosage strengths as Zepbound, including the 5 mg, 10 mg, and 15 mg maintenance dosages. To keep side effects manageable, health providers typically start at a dosage of 2.5 mg before gradually increasing the dosage over several weeks until blood sugar levels are adequately controlled. 

Mounjaro and Zepbound both contain the same active ingredient, tirzepatide. Tirzepatide works by mimicking two hormones produced naturally in your gut: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). 

GLP-1 slows down digestion by moving food more slowly from your stomach to your intestine after you eat (a process called gastric emptying). At the same time, it boosts the release of insulin and inhibits the release of glucagon. GIP enhances these insulin-boosting and glucagon-lowering effects and is thought to help your body burn fat better. Together, these effects help lower blood sugar levels while also making you feel full sooner, which may cause you to eat less and lose weight as a result. Additionally, research suggests that both GLP-1 and GIP have effects on your brain that influence your appetite and satiety. 

When Mounjaro was approved, it became the first drug to target both the GLP-1 and GIP receptors, making it unique among other injectable medications for type 2 diabetes or weight loss, such as Ozempic (semaglutide) or Wegovy (semaglutide), which only target a single receptor, GLP-1. This unique ability to target two receptors may explain why tirzepatide can be more effective than other GLP-1 medications at both improving blood sugar levels and weight loss.

No, Zepbound is not the same as Mounjaro. Zepbound and Mounjaro contain the same active ingredient, but they’re different brand-name medications that are FDA-approved for different indications. Zepbound is approved for weight loss and sleep apnea, while Mounjaro is approved for type 2 diabetes. 

In sum, while the two drugs share many similarities, it’s not accurate to say that Zepbound and Mounjaro are the same. 

Zepbound and Mounjaro share a similar list of gastrointestinal side effects, which usually range from mild to moderate. Common Mounjaro side effects include:

• Nausea

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Upset stomach or indigestion

• Abdominal pain

Additional common Zepbound side effects may include injection site reactions (e.g. bruising, rash, or irritation at the injection site), fatigue, skin reactions (typically rash and itching), belching, flatulence, dizziness, hair loss, and acid reflux.

While rare, serious side effects can occur with either medication. These may include:

• Severe gastrointestinal problems that may lead to dehydration

• Acute kidney injury

• Acute gallbladder disease, such as gallstones

• Acute pancreatitis

• Serious allergic reaction

• Pulmonary aspiration during general anesthesia

• Hypoglycemia (low blood sugar) in people also taking insulin or insulin secretagogues

• Worsening diabetic retinopathy (vision damage or changes) in people with type 2 diabetes

Depression, suicidal behavior, or ideation have also been reported with Zepbound.

Providing your healthcare provider with a full personal and family medical history, along with a list of any drugs or supplements you are taking, can help them ensure Zepbound or Mounjaro will be safe for you. Taking the medication as prescribed may help reduce the digestive side effects common to either medication. So can dietary changes such as:

• Drinking lots of water and other healthy liquids to stay hydrated

• Eating easily digestible foods or bland foods like toast, crackers, or rice

• Avoiding spices, fried foods, alcohol, and fatty foods

• Eating smaller meals more frequently vs. larger meals less often

• No longer eating once you feel full

The FDA first approved tirzepatide to treat type 2 diabetes in May 2022. Marketed under the brand name Mounjaro, the drug is a second-line treatment for type 2 diabetes, recommended for people whose blood sugar levels did not adequately improve with diet and exercise alone or with other diabetes treatments. Mounjaro should be used in combination with diet and exercise. It is not FDA-approved for weight loss, though some providers may prescribe it off-label for this purpose. 

In clinical trials, researchers found Mounjaro to be even more effective than other GLP-1 medications dulaglutide and semaglutide 1.0 mg in controlling blood sugar levels. It was also found to be highly effective in producing weight loss, leading healthcare providers to prescribe the medication off-label for obesity. 

In November 2023, the FDA approved Zepbound as a treatment for weight loss and management in people with obesity or with overweight and a weight-related health condition. Like Mounjaro, it is also meant to be used in combination with a reduced-calorie diet and increased physical activity.

In December 2024, the FDA approved Zepbound for another indication: to treat moderate-to-severe obstructive sleep apnea in adults with obesity. Obstructive sleep apnea (OSA) happens when a person’s airway becomes blocked, resulting in interruptions in breathing during sleep. OSA is more common in people with obesity. Zepbound works for OSA by reducing body weight, as demonstrated by clinical trials showing its effectiveness for reducing or eliminating symptoms of OSA.

As of publication, all dosage strengths of  Mounjaro and Zepbound are available, according to the Drug Shortages database managed by the FDA. Because of local variability, though, patients prescribed either drug may experience delays in filling their Rx at their local pharmacy.

Both Mounjaro and Zepbound have experienced drug shortages since their initial approval and release. The demand for both medications is unprecedented, and although Eli Lilly continues to ramp up production, ongoing shortages may still occur. 

There is about a $10 cost difference between Mounjaro and Zepbound. These are the list prices of both drugs (i.e. the price at which a drug manufacturer sells its drugs to a wholesaler), according to the manufacturer: 

• Mounjaro: $1,079.77 per month

• Zepbound: $1,086.37 per month 

The price you pay at the pharmacy to fill your prescription of Mounjaro or Zepbound may be higher or lower, depending on factors such as insurance coverage (if any), pharmacy, and location. 

It can also vary depending on whether you’re prescribed a pre-filled pen or a single-dose vial of the medication. Through Ro, for example, Zepbound single-dose vials are available for the following cash-pay prices:

• 2.5 mg dose: $399/month 

• 5 mg dose: $549/month

Higher doses of Zepbound single-dose vials, 7.5 mg and 10 mg, are also available at discounted prices through the LillyDirect Self Pay program. Restrictions apply.

Eli Lilly also offers savings programs for both drugs outside of the LillyDirect program, which may bring down the price of either medication. Neither program is available to people with insurance through a state or federal program like Medicaid, Medicare, Medigap, DoD, VA, or TRICARE or those who are uninsured. 

• Mounjaro Savings Card: Available to people with commercial insurance, this offering can bring the cost of Mounjaro down to as little as $25 a month. For those with commercial insurance coverage that doesn’t include Mounjaro, the savings card can provide up to $463 off one-month Rx fill of the medication. 

• Zepbound Savings Card: Available to people with commercial insurance, this offering can lower the cost of Zepbound pens to as little as $25 a month. For those with commercial insurance coverage that doesn’t include Zepbound, the savings card can lower the cost of a one-month Rx fill to as low as $650 (based on a maximum savings of $469 per month). 

You can also find individual coupons for Zepbound or Mounjaro for different pharmacy chains on websites like GoodRx.

Insurance coverage and copays for Mounjaro vs. Zepbound can differ based on your plan. Because both drugs are newer, they may not yet be covered by your particular insurance plan. To know if Zepbound or Mounjaro is covered by your plan, review your plan’s drug formulary or contact your health insurance provider.

Insurance coverage for Zepbound

Commercial insurance plans can vary in their coverage of anti-obesity medications like Zepbound. Consult your plan’s drug formulary to see if Zepbound is covered. In some cases, your healthcare provider may need to submit a prior authorization on your behalf to request coverage. If you have commercial drug insurance—whether or not it includes coverage for Zepbound—you may be eligible for the Zepbound Savings Card program, which can bring the cost of your copay down to as little as $25 for a one-month supply.

Medicare typically does not cover anti-obesity medications like Zepbound, but some Medigap and Medicare Advantage plans do in certain situations. Similarly, other government and state or federal-funded healthcare plans may differ in their coverage of Zepbound, including Veterans Affairs, TRICARE, and Medicaid. If you have coverage through the VA, you may be able to get Zepbound covered under the MOVE! Program. Contact your VA provider or local MOVE! Coordinator to find out. If Zepbound is not covered by your plan, your healthcare provider may be able to submit an appeal on your behalf.

If you’re prescribed Zepbound for sleep apnea, your healthcare provider may be able to get a prior authorization to request coverage. In December 2024, Zepbound became the first-ever medication approved for sleep apnea, and insurance companies may still be in the process of reviewing and updating their formularies to determine coverage for this purpose. 

Insurance coverage for Mounjaro 

If you have commercial drug insurance, you may be eligible for the Mounjaro Savings Card program. This program can bring the cost of a one-month supply down to as little as $25 for a one- or three-month supply for those with coverage for Mounjaro. Consult your drug’s formulary and contact your insurance plan to understand if Mounjaro is covered and what you can expect your copay to be.

If you have insurance through a government-funded program, such as Medicare Advantage Prescription Drug Plans (MA-PD), Medicare Part D, or Medicaid, Mounjaro may be covered if it is prescribed to treat type 2 diabetes. Review your plan’s drug formulary to see if Mounjaro is covered and the associated copay. Some plans may require your healthcare provider to submit a prior authorization prior to granting coverage for Mounjaro.

As a diabetes medication, Mounjaro is more likely to be covered than Zepbound, given the exclusions plans like Medicare have regarding weight loss drugs. However, if you are taking Mounjaro off-label for weight loss, and you don’t have type 2 diabetes, you may have a tougher time getting it covered by your plan. As with Zepbound, you can ask your healthcare provider to submit an appeal or prior authorization on your behalf to your insurance company requesting that they cover it.

Mounjaro is administered as a once-weekly subcutaneous injection. That means you’ll give yourself a shot under the skin of your abdomen, inner thigh, or (if someone helps you) your upper arm. You’ll choose a different injection site each week; reusing the same exact spot can irritate or damage your skin. The medication is a clear (or slightly yellow) liquid that comes in pens or vials. Each pen or vial contains a single dose of the medication. 

You can take Mounjaro any time of day, with or without meals.

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Mounjaro dosage

Mounjaro is available in six dosage strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. The recommended starting dose of Mounjaro is 2.5 mg weekly. After at least four weeks on the 2.5 mg dose, your healthcare provider may have you increase to 5 mg. 

If additional blood sugar control is needed, they will keep increasing your dose every four weeks (or longer) until you reach a maintenance dose that adequately controls your blood sugar levels. The maximum dose of Mounjaro is 15 mg weekly. 

Like Mounjaro, Zepbound is also administered as a once-weekly subcutaneous injection, so you’ll give yourself a shot under the skin of your abdomen, inner thigh, or (with a helper) upper arm. You’ll choose a different injection site each week. The medication is a clear (or slightly yellow) liquid that comes in pens or vials. Each pen or vial contains a single dose of Zepbound. 

You can inject Zepbound any time of day, with or without meals. 

Zepbound dosage

Zepbound comes in the same six dosage strengths as Mounjaro: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. The recommended starting dose of Zepbound is 2.5 mg weekly, and the maximum dose is 15 mg weekly. 

Your healthcare provider will have you start at 2.5 mg weekly, and increase your dose every four weeks or so until you reach a maintenance dose that is effective for you and keeps side effects tolerable. 

Mounjaro is indicated for blood sugar control in people with type 2 diabetes. Zepbound is indicated for weight loss and chronic weight management in individuals with obesity or with overweight and a weight-related health condition (e.g. type 2 diabetes, high blood pressure, sleep apnea). Zepbound is also indicated for treating obstructive sleep apnea in adults with obesity. Both Mounjaro and Zepbound should be used with diet and exercise. 

Before starting Zepbound or Mounjaro, fill your healthcare provider in on your full personal and family medical history, as well as any prescription medications or over-the-counter supplements you are taking. Because both Zepbound and Mounjaro slow down the digestive process, they may affect the absorption of any medications taken orally.

Zepbound and Mounjaro both contain a FDA boxed warning for medullary thyroid cancer, because animal studies of tirzepatide showed that it caused medullary thyroid cancer in rats. While it is not known if the drug has the same effect in humans, people with a personal or family history of medullary thyroid carcinoma or those with Multiple endocrine neoplasia syndrome type 2 (MEN2) should not take Zepbound or Mounjaro. 

People with severe gastrointestinal disease, or anyone with a known allergy to tirzepatide or any of the inactive ingredients in Zepbound or Mounjaro, should also not take these medications.

While both drugs offer a safe and effective treatment, not everyone is a good fit for Zepbound or Mounjaro. In particular, people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a personal or family history of medullary thyroid cancer, or a known allergy to tirzepatide should not take either medication. 

Additionally, some people may be at increased risk of experiencing serious side effects while taking Mounjaro or Zepbound. This includes people who have:

• A history of pancreas or kidney issues

• A history of diabetic retinopathy

• Stomach issues, including problems with digestion or gastroparesis

People who are pregnant, breastfeeding, or planning to be soon should not use Zepbound or Mounjaro. If you are planning on having surgery soon, tell your healthcare provider about all medications you are taking. 

Mounjaro and Zepbound can lower the efficacy of oral contraceptives, so if you take birth control pills, your healthcare provider may recommend using a barrier birth control method during the dose escalation period of either medication.

Tirzepatide, along with other GLP-1s like semaglutide and liraglutide, is considered a second-line treatment for diabetes. That means it’s often recommended when a first-line treatment, such as metformin, doesn’t effectively control blood sugar levels. If you’ve been taking metformin for at least three months and your HbA1c is still 7% or higher, your healthcare provider may recommend tirzepatide or another GLP-1.

Both Mounjaro and Zepbound can be effective medications for people with type 2 diabetes, obesity or overweight, or both. In a clinical trial of people with obesity but without diabetes, Zepbound led to an average weight loss of 15–21% after about a year and a half. In addition to weight loss, the participants enjoyed significant improvements in other aspects of their cardiometabolic health, including:

• Reduced waist circumference

• Lower blood pressure

• Lower cholesterol

• Improved physical functioning

In addition, over 95% of people who had prediabetes at the start of the trial had normal blood sugar levels by the end of the trial.

In a clinical trial of people with type 2 diabetes, Mounjaro led to an average reduction in hemoglobin A1c (HbA1c) levels between 1.87–2.07%, with over 80% of people taking 15 mg of Mounjaro reaching target levels of 6.5% or less — and up to 52% of people reaching a level below 5.7% (again at the 15 mg dose). Overall, people lost 15–21 pounds after 40 weeks of taking Mounjaro, with higher doses resulting in more weight loss.

Both Mounjaro and Zepbound can be safe and effective treatment options. The choice of which one is right for you can be made with the help of a healthcare provider. Talk with your healthcare provider about your medical situation, your treatment goals, and your insurance coverage. 

Insurers are more likely to cover a medication when it is prescribed for its FDA-approved indication, so your insurance coverage may play a role in which medication can be a more affordable treatment option for you. Mounjaro is indicated for type 2 diabetes, while Zepbound is indicated for chronic weight management in people with obesity, or overweight and a related health condition. Zepbound is also indicated for sleep apnea in adults with obesity.

Your tolerance for side effects may be another consideration. Zepbound has a slightly longer list of common side effects, with side effects like belching, hair loss, and dizziness being more common, along with the possibility of serious  side effects like suicidal behavior. Even though these side effects are still relatively rare, it may be worth discussing with your healthcare provider.

Finally, availability may be a factor. Both Mounjaro and Zepbound may experience drug shortages from time to time, so you may want to consult with your pharmacy about their history of availability with either drug and consider alternative medications.

Zepbound and Mounjaro are both GLP-1 agonists, a class of medications that also includes semaglutide. Semaglutide is available under the brand names Ozempic, Wegovy, and Rybelsus, as well as compounded semaglutide. Like Mounjaro, Ozempic and Rybelsus are approved for type 2 diabetes, but may be prescribed off-label for weight loss. Wegovy is approved for weight loss, like Zepbound.

Tirzepatide, the active ingredient in Mounjaro and Zepbound, stands out among GLP-1 medications because it is the only medication that mimics two hormones—GLP-1 and GIP—as opposed to just one, like semaglutide does. This may explain why Zepbound and Mounjaro can be more effective at both weight loss and blood sugar control when compared to semaglutide. For example:

• In a 40-week trial of people with type 2 diabetes, tirzepatide lowered HbA1c levels by 2.01–2.3 percentage points, while semaglutide lowered them by 1.86. People taking tirzepatide also lost 4–12 more pounds than people taking semaglutide, depending on the dosage strength of Mounjaro or Zepbound. 

• In a 1-year study of people with obesity or overweight, people taking tirzepatide were more than twice as likely to lose at least 10% of their body weight, and more than three times as likely to lose at least 15% of their body weight, than those taking semaglutide.

Choosing between Mounjaro vs. Zepbound depends on your specific health goals, medical history, and insurance coverage. The medications have a lot in common, including sharing the same active ingredient, tirzepatide, but they also have some differences that may make one the better fit for you over the other.

• Zepbound and Mounjaro have different FDA-approved indications. 

  • Zepbound is FDA-approved for weight loss and chronic weight management in individuals with obesity or overweight and a weight-related health condition. Zepbound is also FDA-approved to treat moderate to severe obstructive sleep apnea in adults with obesity. 

  • Mounjaro is FDA-approved to improve blood sugar control in adults with type 2 diabetes, but can be prescribed off-label for weight loss.

• Both medications work in similar ways. Their active ingredient, tirzepatide, targets GLP-1 and GIP receptors to improve blood sugar control and promote weight loss.

• The drugs have different costs and insurance coverage. 

  • The list price of Zepbound is about $7 higher than Mounjaro, but the drugs may cost more or less at the pharmacy. Eli Lilly's savings programs may lower costs to as little as $25 per month for eligible individuals with commercial insurance. 

  • Mounjaro is more likely to be covered by insurance if you are taking it for type 2 diabetes, while Zepbound may face coverage limitations as is common with medications approved for weight loss.