Tirzepatide vs Ozempic: Trial Results, Side Effects, Price
Tirzepatide and Ozempic (semaglutide) are both GLP-1 medicines, each a weekly injection. They were tested against each other in SURPASS-2. Self-pay starts at $299 per month for Tirzepatide and $199 per month for Ozempic.
- Tested head to head
- SURPASS-2
A quick look at Zepbound and Ozempic
Tirzepatide and Ozempic side by side
| Tirzepatide | Ozempic | |
|---|---|---|
| Medicine | tirzepatide |  Ozempic |
| Active ingredient | tirzepatide | semaglutide |
| Manufacturer | Eli Lilly | Novo Nordisk |
| How it is taken | Weekly injection | Weekly injection |
| Approved for | For Type 2 diabetes, and also for weight loss, sleep apnea, and heart risk | Type 2 diabetes itself, plus kidney disease in type 2 diabetes and heart risk |
| First FDA approval | 2022 | 2017 |
| Average weight loss in trials | 20.9% (SURMOUNT-1, 72 weeks) | Not listed |
| Most common side effect | Nausea 18% vs 4% on placebo | Nausea 20.3% vs 6.1% on placebo |
| List price | $1,112.16 per fill | $1,027.51 per pen |
| Self-pay from | $299 per month | $199 per month |
| Medicare GLP-1 Bridge | $50 per month, eligible Part D | Not listed |
| FDA shortage | Resolved December 19, 2024 | Resolved February 21, 2025 |
Sources: FDA label, FDA label (DailyMed), pricinginfo.lilly.com, Novo Nordisk pricing.
Weight loss compared head to head
SURPASS-2 assigned Tirzepatide to one group and Ozempic to another, so these numbers can be compared directly.
| Trial | Who took part | Length | Group | A1C change |
|---|---|---|---|---|
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 5 mg weekly | -2.01 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 10 mg weekly | -2.24 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Tirzepatide 15 mg weekly | -2.3 percentage points (mean HbA1c change) |
| SURPASS-2 | Adults with type 2 diabetes on metformin | 40 weeks | Semaglutide 1 mg weekly | -1.86 percentage points (mean HbA1c change) |
Trial sources: SURPASS-2 (PubMed).
Side effects side by side
Each label compared that drug's participants with the placebo group for that drug, so compare each drug with its placebo first.
| Side effect | Mounjaro | Placebo (Mounjaro trials) | Ozempic | Placebo (Ozempic trials) |
|---|---|---|---|---|
| Nausea | 18% | 4% | 20.3% | 6.1% |
| Diarrhea | 17% | 9% | 8.8% | 1.9% |
| Decreased Appetite | 11% | 1% | Not listed | Not listed |
| Vomiting | 9% | 2% | 9.2% | 2.3% |
| Dyspepsia | 8% | 3% | Not listed | Not listed |
| Constipation | 7% | 1% | 5% | 1.5% |
| Abdominal Pain | 6% | 4% | 7.3% | 4.6% |
Price 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 |
 Zepbound | List price before insurance | $499 to $1,086 per fill |
| Zepbound | Zepbound Savings Program (insured) | from $25 for up to a 3-month fill |
| Zepbound | Self-pay: LillyDirect vial or KwikPen 2.5 mg | $299 per month |
| Zepbound | Commercial plan that does not cover it | $299 per month |
| Zepbound | Medicare GLP-1 Bridge (Zepbound KwikPen, eligible Part D) | $50 per month |
| Ozempic | List price before insurance | $1,027.51 per pen |
| Ozempic | Ozempic Savings Offer (insured) | starting at $25 each month, for up to 3 months of coverage |
| Ozempic | Self-pay: Ozempic pill (from 1.5 mg) | $149 per month |
Prices checked November 2026 (8)
mounjaro.lilly.com, zepbound.lilly.com, Eli Lilly, CMS, Novo Nordisk pricing, and NovoCare, with pricinginfo.lilly.com 1 2.
Who should pick which?
- Tirzepatide alone is approved for weight loss when you do not have diabetes.
- Tirzepatide is approved to treat sleep apnea.
- For kidney disease in Type 2 diabetes, Ozempic has approval.
- Tirzepatide is approved for certain children under 18.
- Tirzepatide is listed under Medicare GLP-1 Bridge.
- Ozempic's lower starting price is $199 per month for cash payments.
The prescriber reviews coverage, other medicines, and your health history.