Is Zepbound the same as Ozempic?
What is the difference between Ozempic and Zepbound, and which is better?
No. Ozempic is semaglutide from Novo Nordisk, labeled for type 2 diabetes. Zepbound is tirzepatide from Eli Lilly, labeled for weight management and for obstructive sleep apnea in adults with obesity. In SURMOUNT-5, tirzepatide cut body weight 20.2% at 72 weeks and semaglutide 13.7%. That trial used Wegovy doses of semaglutide, up to 2.4 mg, which is above Ozempic's 2 mg maximum.[1][2][3]
Zepbound vs Ozempic at a glance
Prices checked October 3, 2026.
| Attribute | HIGHLIGHTED Ozempicsemaglutide | Zepbound tirzepatide |
|---|---|---|
| Active ingredient | semaglutide | tirzepatide |
| Manufacturer | Novo Nordisk | Eli Lilly |
| Drug class | GLP-1 receptor agonist | Dual GIP / GLP-1 receptor agonist |
| FDA approved | December 2017 | November 2023 |
| Indication | Type 2 diabetes (adults). Also lowers heart and kidney risks in type 2 diabetes with heart or kidney disease[2] | Chronic weight management (adults) and moderate to severe obstructive sleep apnea in adults with obesity[3] |
| Dose schedule | Subcutaneous injection · Once weekly[2] | Subcutaneous injection · Once weekly[3] |
| Available doses | 0.25 mg · 0.5 mg · 1 mg · 2 mg[2] | 2.5 mg · 5 mg · 7.5 mg · 10 mg · 12.5 mg · 15 mg[3] |
| Mechanism | Semaglutide is a GLP-1 analog with 94% homology to native human GLP-1. It binds the GLP-1 receptor, augmenting glucose-dependent insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite via central nervous system pathways. | Tirzepatide is a first-in-class single molecule that activates both the GIP and GLP-1 receptors. The dual incretin action slows gastric emptying and reduces appetite via central nervous system pathways while improving glucose handling. It produces larger average weight loss than single GLP-1 agonists in its obesity trials. |
| Common side effects | Nausea (15.8 to 20.3%), diarrhea (8.5 to 8.8%), vomiting (5 to 9.2%) at 0.5 mg and 1 mg. Most reports came during dose escalation[2] | Nausea (25 to 29%), diarrhea (19 to 23%), vomiting (8 to 13%) at 5 mg to 15 mg. Most reports came during dose escalation[3] |
| Cost range | List price $1,027.51 a month. Self-pay pen $349 to $499 through Novo Nordisk. As little as $25 with commercial insurance and the savings card[5][6] | List price $1,086.37 a month. Self-pay KwikPen $299 to $699 by dose through Lilly, vial from $299. As little as $25 with commercial insurance and the savings card[7][8] |
This comparison is for education only and is not medical advice. Ozempic and Zepbound are prescription medicines with distinct FDA-approved indications. Whether either is appropriate for you, and at what dose, is a decision for a licensed clinician.
What is the difference between Ozempic and Zepbound?
Ozempic acts on one gut-hormone receptor, GLP-1. Zepbound acts on two, GIP and GLP-1. Ozempic is approved to lower blood sugar in adults with type 2 diabetes. It also lowers heart and kidney risks in adults with type 2 diabetes who have heart disease or chronic kidney disease. Zepbound is approved for long-term weight management in adults and for moderate to severe obstructive sleep apnea in adults with obesity.[2][3]
Which is better, Ozempic or Zepbound?
It depends on what the drug is treating. For weight loss, SURMOUNT-5 favored tirzepatide over semaglutide. For blood sugar in type 2 diabetes, SURPASS-2 compared tirzepatide with Ozempic's 1 mg dose over 40 weeks. HbA1c fell 2.01 to 2.30 points on tirzepatide and 1.86 points on semaglutide. Weight loss was 1.9 to 5.5 kg greater on tirzepatide. SURPASS-2 used tirzepatide as Mounjaro, the diabetes brand, compared in Mounjaro vs Ozempic.[1][4]
Is Zepbound better for weight loss than Ozempic?
Zepbound is approved for weight loss and Ozempic is not. In SURMOUNT-1, adults with obesity lost 15.0% to 20.9% of their body weight at 72 weeks on tirzepatide 5 mg to 15 mg, versus 3.1% on placebo. Ozempic's label reports weight loss of 5.6 kg on 1 mg and 6.4 kg on 2 mg over 40 weeks in adults with type 2 diabetes. Those trials enrolled different people. The Zepbound weight loss calculator and the Ozempic weight loss calculator chart average loss week by week from trial data.[9][2]
Does Zepbound have fewer side effects than Ozempic?
Not clearly. SURPASS-2 enrolled adults with type 2 diabetes and tested tirzepatide at the Mounjaro doses of 5, 10, and 15 mg against semaglutide 1 mg. In it, nausea hit 17 to 22% on tirzepatide and 18% on semaglutide. Diarrhea was 13 to 16% versus 12%, and vomiting 6 to 10% versus 8%. Serious adverse events were 5 to 7% on tirzepatide and 3% on semaglutide. The table below shows the rates on Zepbound's own label, from weight trials that enrolled different people. Both labels carry a boxed warning about thyroid C-cell tumors.[4][2][3]
| Side effect | Ozempic 0.5 mg and 1 mg | Zepbound 5 mg to 15 mg |
|---|---|---|
| Nausea | 15.8% to 20.3% | 25% to 29% |
| Diarrhea | 8.5% to 8.8% | 19% to 23% |
| Vomiting | 5% to 9.2% | 8% to 13% |
| Constipation | 3.1% to 5% | 11% to 17% |
| Abdominal pain | 5.7% to 7.3% | 9% to 10% |
| Stopped for stomach side effects | 3.1% to 3.8% | 1.9% to 4.3% |
Can you take Zepbound and Ozempic together?
The Zepbound label says it is not recommended with any GLP-1 receptor agonist. Ozempic is a GLP-1 receptor agonist, so the two are not meant to be combined.[3]
Which costs more, Zepbound or Ozempic?
At list price, Zepbound is $1,086.37 a month and Ozempic is $1,027.51. Paying cash through the makers, Ozempic pens cost $349 a month at 0.25 mg to 1 mg and $499 at 2 mg. Zepbound KwikPens cost $299 at 2.5 mg, $399 at 5 mg, and $499 to $699 at higher doses. From 7.5 mg up, a first purchase or a refill within 45 days costs $449. With commercial insurance that covers the drug, each savings card can bring a fill to as little as $25.[5][6][7][8]
Prices checked October 3, 2026.
| Monthly price | Ozempic | Zepbound |
|---|---|---|
| List price | $1,027.51 | $1,086.37 |
| Self-pay through the maker | $349 for 0.25 mg, 0.5 mg, or 1 mg. $499 for 2 mg | $299 for 2.5 mg, as a KwikPen or vial. KwikPen prices are $399 for 5 mg, $499 for 7.5 mg, and $699 for 10 mg, 12.5 mg, or 15 mg. A $449 price applies to 7.5 mg through 15 mg KwikPens on a first purchase and on refills within 45 days |
| Commercial insurance with the savings card | As little as $25 | As little as $25 |
Can you switch from Ozempic to Zepbound?
That is a prescriber's decision, and neither label gives a conversion between the two. Zepbound starts at 2.5 mg a week for 4 weeks and steps up by 2.5 mg after at least 4 weeks at each dose. Its label asks people on birth control pills to switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase. Both labels warn that using the drug with insulin or a sulfonylurea can raise the risk of low blood sugar.[3][2]
Is Zepbound stronger than Wegovy?
In SURMOUNT-5, the one trial that compared them, tirzepatide cut weight 20.2% and semaglutide 13.7% at 72 weeks. Wegovy is semaglutide, the same drug as Ozempic at higher doses. More in Wegovy vs Zepbound, Wegovy vs Ozempic, and semaglutide vs tirzepatide.[1]
- Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med 2025;393:26-36 (SURMOUNT-5) (NEJM)
- FDA label, Ozempic (semaglutide) injection, Novo Nordisk (DailyMed)
- FDA label, Zepbound (tirzepatide) injection, Eli Lilly (DailyMed)
- Frías JP et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med 2021;385:503-515 (SURPASS-2) (NEJM)
- Ozempic list price (wholesale acquisition cost), Novo Nordisk Pricing, May 2026 (Novo Nordisk)
- Ozempic cost and coverage: savings card and self-pay prices, read October 3, 2026 (Novo Nordisk)
- Zepbound list price and self-pay prices, Lilly pricing information, read October 3, 2026 (Eli Lilly)
- Zepbound savings card, self-pay offers, and the Medicare GLP-1 Bridge, read October 3, 2026 (Eli Lilly)
- Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022;387:205-216 (SURMOUNT-1) (NEJM)