Mounjaro vs Orforglipron: Weight Loss, Side Effects, Price
Mounjaro (tirzepatide) and orforglipron are both GLP-1 medicines, weekly injection versus daily tablet. Orforglipron self-pay starts at $149 per month.
Foundayo and Mounjaro: a quick look
Orforglipron and Mounjaro side by side
| Mounjaro | Orforglipron | |
|---|---|---|
| Medicine | Mounjaro |  orforglipron |
| Active ingredient | tirzepatide | orforglipron |
| Manufacturer | Eli Lilly | Eli Lilly |
| How it is taken | Weekly injection | Daily tablet |
| Approved for | Type 2 diabetes and heart risk | Weight loss |
| First FDA approval | 2022 | 2026 |
| Average weight loss in trials | Not listed | 11.1% (ATTAIN-1, 72 weeks) |
| Most common side effect | Nausea 18% vs 4% on placebo | Nausea 35% vs 10% on placebo |
| List price | $1,112.16 per fill | $649 per month |
| Self-pay from | Not listed | $149 per month |
| Medicare GLP-1 Bridge | Not listed | $50 per month, eligible Part D |
| FDA shortage | Resolved December 19, 2024 | Not listed |
Sources: FDA label, FDA label (DailyMed), pricinginfo.lilly.com, Eli Lilly.
Weight loss compared side by side
No trial has compared these drugs directly. The results come from separate trials that used different groups and lasted different lengths.
| Trial | Who took part | Length | Group | Average weight loss | Placebo | A1C change |
|---|---|---|---|---|---|---|
| SURPASS-1 | Adults with type 2 diabetes who relied only on diet and exercise | 40 weeks | Tirzepatide 5 mg weekly | Not listed | Not listed | -1.87 percentage points (mean HbA1c change) |
| SURPASS-1 | Adults with type 2 diabetes who relied only on diet and exercise | 40 weeks | Tirzepatide 10 mg weekly | Not listed | Not listed | -1.89 percentage points (mean HbA1c change) |
| SURPASS-1 | Adults with type 2 diabetes who relied only on diet and exercise | 40 weeks | Tirzepatide 15 mg weekly | Not listed | Not listed | -2.07 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults with early type 2 diabetes who relied only on diet and exercise | 40 weeks | Orforglipron 3 mg daily (publication dose name) | Not listed | Not listed | -1.24 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults with early type 2 diabetes who relied only on diet and exercise | 40 weeks | Orforglipron 12 mg daily (publication dose name) | Not listed | Not listed | -1.47 percentage points (mean HbA1c change) |
| ACHIEVE-1 | Adults with early type 2 diabetes who relied only on diet and exercise | 40 weeks | Orforglipron 36 mg daily (publication dose name) | Not listed | Not listed | -1.48 percentage points (mean HbA1c change) |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 5.5 mg daily | 7.4% | 2.1% | Not listed |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 9 mg daily | 8.3% | 2.1% | Not listed |
| ATTAIN-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Foundayo 17.2 mg daily | 11.1% | 2.1% | Not listed |
| ATTAIN-2 | Adults with obesity or overweight and type 2 diabetes | 72 weeks | Foundayo 5.5 mg daily | 5.1% | 2.5% | Not listed |
| ATTAIN-2 | Adults with obesity or overweight and type 2 diabetes | 72 weeks | Foundayo 9 mg daily | 7% | 2.5% | Not listed |
| ATTAIN-2 | Adults with obesity or overweight and type 2 diabetes | 72 weeks | Foundayo 17.2 mg daily | 9.6% | 2.5% | Not listed |
Trial sources: SURPASS-1 (PubMed), ACHIEVE-1 (PubMed), ATTAIN-1 (FDA label (DailyMed)).
Side effects compared
Compare each drug with its placebo first, because each label tested its own group against its own placebo group.
| Side effect | Mounjaro | Placebo (Mounjaro trials) | Foundayo | Placebo (Foundayo trials) |
|---|---|---|---|---|
| Nausea | 18% | 4% | 35% | 10% |
| Diarrhea | 17% | 9% | 25% | 11% |
| Decreased Appetite | 11% | 1% | Not listed | Not listed |
| Vomiting | 9% | 2% | 24% | 4% |
| Dyspepsia | 8% | 3% | 16% | 4% |
| Constipation | 7% | 1% | 27% | 9% |
| Abdominal Pain | 6% | 4% | 14% | 7% |
| Headache | Not listed | Not listed | 9% | 7% |
| Abdominal distension | Not listed | Not listed | 9% | 3% |
Prices and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Mounjaro | List price before insurance | $1,112.16 per fill |
| Mounjaro | Mounjaro Savings Card (insured) | from $25 for up to a 3-month fill |
| Mounjaro | Commercial plan that does not cover it | $499 per month |
| Foundayo | List price before insurance | $649 per month |
| Foundayo | Foundayo Savings Card (insured) | from $25 per month |
| Foundayo | Self-pay: LillyDirect 0.8 mg and 2.5 mg | $149 per month |
| Foundayo | Self-pay: LillyDirect 5.5 mg | $199 per month |
| Foundayo | Self-pay: LillyDirect 9 mg | $299 per month |
| Foundayo | Self-pay through LillyDirect: 14.5 mg and 17.2 mg, with a refill within 45 days | $299 per month |
| Foundayo | Medicare GLP-1 Bridge (Foundayo, eligible Part D) | $50 per month |
Price checks were done in November 2026: pricinginfo.lilly.com 1 2, mounjaro.lilly.com, foundayo.lilly.com, Eli Lilly, CMS.
Who should pick which?
- If you want to avoid needles, Orforglipron is a tablet. Mounjaro needs a weekly injection.
- For weight loss without diabetes, Orforglipron is the only one approved.
- If you have type 2 diabetes, Mounjaro alone has approval for diabetes.
- For heart risk, Mounjaro is approved to lower the risk of heart attack and stroke.
- For children under 18, Mounjaro is approved for some of them.
- The Medicare GLP-1 Bridge list includes Orforglipron.
- If you pay cash, Orforglipron has a published self-pay price of $149 per month
Your prescriber weighs three factors: your medical history, other medicines, and coverage.