Zepbound vs. Ozempic: 5 Differences Between These Weekly Injections

Zepbound (tirzepatide) and Ozempic (semaglutide) belong to a growing group of medications known as incretin mimetics. Because of how they work, incretin mimetics have a variety of proven and potential uses — from Type 2 diabetes and weight loss to obstructive sleep apnea and chronic kidney disease.

While Zepbound and Ozempic work in similar ways, they’re not exactly the same. In fact, the FDA approved the two medications for different uses. Below, we cover five key differences between Zepbound and Ozempic.

1. Zepbound and Ozempic have different approved uses

One of the main differences between Zepbound and Ozempic is that they’re approved for different uses. Zepbound is approved for weight loss and moderate-to-severe obstructive sleep apnea (OSA) in adults with a larger body size. Ozempic is approved for Type 2 diabetes in adults. It can also lower the risk of serious cardiovascular and kidney problems in certain people.

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Unlike Ozempic, Zepbound’s cardiovascular benefits haven’t been confirmed yet. A phase 3 clinical trial studying this is expected to wrap up in 2027.

Good to know: Tirzepatide, the main ingredient in Zepbound, is also available under the brand name Mounjaro for Type 2 diabetes. And semaglutide, the main ingredient in Ozempic, is also available as a higher-dose version for weight loss called Wegovy.

2. Zepbound and Ozempic work in similar, but slightly different ways

Zepbound and Ozempic both work by mimicking the effects of natural gut hormones called incretins. Incretins are involved in regulating digestion, blood glucose, and appetite. Ozempic mimics one incretin, while Zepbound mimics two incretins.

Ozempic belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class. It works by mimicking an incretin called GLP-1. Ozempic’s effects include telling the pancreas to release insulin after you eat, reducing glucose production in the liver, and slowing the movement of food out of the stomach. It’s also thought to target areas of the brain that help regulate your appetite.

Zepbound is the first and only weight-loss medication in its class: dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonists. Zepbound mimics GLP-1, similar to Ozempic. But it also acts like a second incretin called GIP. GIP is thought to work together with GLP-1 in certain ways to have an even greater effect.

3. Zepbound may result in greater weight loss compared to Ozempic

As mentioned above, Zepbound is FDA approved for weight loss. Ozempic isn’t approved for weight loss, but people taking it tend to lose weight. Based on individual and comparison studies of their active ingredients, Zepbound may result in greater weight loss compared to Ozempic.

Tirzepatide and semaglutide have been compared directly in people with Type 2 diabetes. During a 40-week (9-month) trial, the highest tirzepatide dose (15 mg) resulted in an average weight loss of nearly 25 lbs. This was compared to 12.5 lbs with semaglutide (1 mg). The highest Ozempic dose (2 mg) wasn’t included in the study. But it has been shown to result in an average weight loss of 15 lbs.

Tirzepatide and semaglutide (as Wegovy) have also been compared in a clinical study for weight loss in people without diabetes. After 72 weeks, people receiving Zepbound lost about 50 lbs, while people receiving Wegovy lost about 33 lbs.

EXPERT PICKS: WHAT TO READ NEXT

• Savings guide: Glucagon-like peptide-1 (GLP-1) medications don’t have to break the bank. Explore this savings guide for information on how to save on GLP-1s.

• Zepbound vs. Wegovy: Zepbound (tirzepatide) and Wegovy (semaglutide) are both FDA-approved once-weekly injections for weight loss. Here are the key differences between them.

• Knowing the risks: Compounded products can help people access certain medications that are in shortage. But before giving compounded weight-loss injections a try, it’s a good idea to understand the potential risks.

4. Zepbound and Ozempic injection pens work differently

Another difference between Zepbound and Ozempic is how their injection pens work. Zepbound comes in a prefilled single-use pen. That means each pen contains one dose and should be thrown away after use. Ozempic pens contain multiple doses. So you’ll need to store the pen properly while it’s still in use.

You don’t need to attach a needle to the Zepbound pen. Each Zepbound pen already has a needle attached, hidden inside the clear base. Since each Ozempic pen is used more than once, you need to attach a fresh needle for each dose. Each carton contains one Ozempic pen and four to six needles.

After using an Ozempic pen for the first time, you can store it in the refrigerator or at room temperature for up to 56 days. With Zepbound, you’ll only need to worry about properly storing new pens since they’re used one time. A new Zepbound pen lasts longest in the refrigerator, but you can also keep it at room temperature for up to 21 days.

Good to know: Zepbound is also available as single-use vials through LillyDirect. If you’re having difficulty affording Zepbound injection pens, the vials can be a lower-cost alternative.

5. Zepbound and Ozempic may be covered differently under your insurance plan

Since Ozempic is approved for Type 2 diabetes, it’s usually covered by insurance for this purpose. However, your plan may require a prior authorization before Ozempic is covered. In some cases, you may need to try other Type 2 diabetes medications first.

Zepbound is approved for weight loss and OSA in certain people. Many insurance plans do not cover weight-loss medications when they’re used for weight loss alone. But you can confirm if Zepbound is covered under your plan by reaching out to your insurance company. If you also have OSA, your plan may be more likely to cover Zepbound. But if you have Type 2 diabetes, however, there’s a better chance that your insurance plan may cover Mounjaro instead.

Can you use Zepbound and Ozempic together?

No, you can’t use both Zepbound and Ozempic. The two work in similar ways, so it’s recommended to take one or the other — not both. Taking Zepbound and Ozempic together may increase your risk of side effects.

If you’re not getting the results you want from either medication, reach out to your healthcare team. They may consider increasing your dose, adding another medication, or switching you to a different treatment.

Can you switch from Ozempic to Zepbound?

If you’re using Ozempic for Type 2 diabetes, your prescriber may switch you to Mounjaro. Mounjaro is similar to Zepbound, but it’s specifically approved for Type 2 diabetes. As mentioned above, there’s also a higher likelihood that your insurance plan would cover Mounjaro over Zepbound.

Sometimes, people without diabetes may use Ozempic off-label for weight loss. In this case, your prescriber may decide to switch you from Ozempic to Zepbound if you need more help managing your body weight.

When switching from Ozempic to Zepbound, your prescriber may have you start with a lower Zepbound dose and work your way up. This can help manage side effects and allow you to find the right dose.

How to save on Zepbound and Ozempic

The best way to save on Zepbound and Ozempic is to use your insurance. Ozempic is usually covered if you have Type 2 diabetes. But Zepbound might only be covered for weight loss if you have another health condition, such as OSA. Reach out to your insurer to learn more.

But if your plan doesn’t cover Zepbound or Ozempic, your copay is too high, or if you don’t have insurance, there are ways to save on your prescription:

• Manufacturer copay cards: If your commercial insurance plan covers Zepbound, you could pay as little as $25 for a 1- or 3-month supply with a manufacturer copay card. If it’s not covered, you may be eligible to pay $650 for a 30-day supply. If you have commercial insurance, you could pay as little as $25 for a 1-, 2-, or 3-month supply of Ozempic.

• Lower-cost vials: You can access lower-cost single-dose Zebound vials through LillyDirect for $340 (2.5 mg) and $499 (5 mg, 7.5 mg, and 10 mg) per month.

• Patient assistance programs: If you’re eligible, you could get Ozempic free of charge through a patient assistance program.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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