Zepbound vs Ozempic: Weight Loss, Side Effects, Price
Zepbound (tirzepatide) and Ozempic (semaglutide) are both GLP-1 medicines, each a weekly injection. Self-pay starts at $299 per month for Zepbound and $199 per month for Ozempic.
Zepbound and Ozempic: A Quick Look
Side-by-side look at Ozempic and Zepbound
| Zepbound | Ozempic | |
|---|---|---|
| Medicine | Zepbound |  Ozempic |
| Active ingredient | tirzepatide | semaglutide |
| Manufacturer | Eli Lilly | Novo Nordisk |
| How it is taken | Weekly injection | Weekly injection |
| Approved for | Weight loss and sleep apnea | Uses include type 2 diabetes, heart risk, and kidney disease for type 2 diabetes patients |
| First FDA approval | 2023 | 2017 |
| Average weight loss in trials | 20.9% (SURMOUNT-1, 72 weeks) | Not listed |
| Most common side effect | Nausea 29% vs 8% on placebo | Nausea 20.3% vs 6.1% on placebo |
| List price | $499 to $1,086 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.
How weight loss compares
Since no trial has compared the two drugs directly, each result comes from a separate study, and the studies had different participants and durations.
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 5 mg weekly | 15% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 10 mg weekly | 19.5% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 15 mg weekly | 20.9% | 3.1% |
| SURMOUNT-2 | Adults with obesity or overweight, with type 2 diabetes as well | 72 weeks | Tirzepatide 10 mg weekly | 12.8% | 3.2% |
| SURMOUNT-2 | Adults with obesity or overweight, with type 2 diabetes as well | 72 weeks | Tirzepatide 15 mg weekly | 14.7% | 3.2% |
Sources for the trial data are SURMOUNT-1 (FDA label (DailyMed)) and SURMOUNT-2 (PubMed).
Comparing side effects
Every label tested a separate group of people against the placebo for that drug.
| Side effect | Zepbound | Placebo (Zepbound trials) | Ozempic | Placebo (Ozempic trials) |
|---|---|---|---|---|
| Nausea | 29% | 8% | 20.3% | 6.1% |
| Diarrhea | 23% | 8% | 8.8% | 1.9% |
| Constipation | 17% | 5% | 5% | 1.5% |
| Vomiting | 13% | 2% | 9.2% | 2.3% |
| Abdominal Pain | 10% | 5% | 7.3% | 4.6% |
| Dyspepsia | 10% | 4% | Not listed | Not listed |
| Injection Site Reactions | 8% | 2% | Not listed | Not listed |
| Fatigue | 7% | 3% | Not listed | Not listed |
Pricing and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| 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 | Commercial plan that does not cover it | $299 per month |
| Zepbound | Self-pay: LillyDirect vial or KwikPen 2.5 mg | $299 per month |
| Zepbound | Self-pay: LillyDirect vial or KwikPen 5 mg | $399 per month |
| Zepbound | Pay on your own through LillyDirect for 7.5 mg up to 15 mg, with refills within 45 days | $449 per month |
| Zepbound | If you do not refill within 45 days, you pay the regular self-pay price | the monthly rates are $499 ($7.5 mg) and $699 ($10 to $15 mg) |
| Zepbound | Self-pay via TrumpRx | $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) | the price begins at $25 per month for a period of up to 3 months |
| Ozempic | Self-pay: Ozempic pill (from 1.5 mg) | $149 per month |
| Ozempic | For the first 2 fills, the self-pay intro rate for Ozempic pens covers 0.25 mg and 0.5 mg | $199 per month |
| Ozempic | Self-pay option: Ozempic pens at 0.25 mg or 0.5 mg, or 1 mg | $349 per month |
| Ozempic | Self-pay: Ozempic pen 2 mg | $499 per month |
| Ozempic | Self-pay via TrumpRx | $199 per month |
Prices checked November 2026 (7)
sources: pricinginfo.lilly.com, zepbound.lilly.com, Eli Lilly, TrumpRx, CMS, Novo Nordisk pricing, NovoCare.
Who should pick which?
- Between the two, only Zepbound is approved for weight loss when you do not have diabetes.
- Of these two, only Ozempic has approval to treat type 2 diabetes.
- Zepbound is approved to treat sleep apnea.
- Ozempic is approved for people with type 2 diabetes who also have kidney disease.
- Ozempic has approval to lower the risk of heart attack and stroke.
- The Medicare GLP-1 Bridge list includes Zepbound.
- The lower starting cash price belongs to Ozempic, at $199 per month.
Your prescriber looks at your health history, the medicines you take, and your coverage. Only they can decide whether you should switch between the two.