What’s the Difference Between Zepbound® and Ozempic®?


Injectable weight loss medications drew inspiration from diabetes medications. Some medications used to manage diabetes – such as GLP-1 receptor agonists – were found to have the side effect of promoting weight loss. This observation led researchers to explore their potential in treating obesity specifically.

You’ve probably heard of Ozempic, which is often referred to as a leading injectable weight loss medication. But, that may not be entirely true. There are many more injectable weight loss medications – including Zepbound – that are equally or more effective in treating chronic weight management. And, they’re even FDA-approved for weight loss.

In this article, we’ll point out the key differences between Ozempic and Zepbound, including their main ingredient, FDA-approval status, cost differences, and side effects.

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How Do Injectable Weight Loss Medications Work?

Injectable weight loss medications like semaglutide and tirzepatide belong to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. They work by mimicking the action of the GLP-1 hormone released in the gastrointestinal tract after a meal. One of GLP-1's functions is to stimulate insulin production, leading to decreased blood glucose levels. For this reason, it became a drug to treat type 2 diabetes.

Studies of the effects of semaglutide in the body found that it also promotes weight loss, as higher amounts of GLP-1 interact with the brain to suppress appetite and induce a sensation of fullness.

As drug developers realized that GLP-1s could help manage weight in those with obesity and weight-related comorbidities, new injectable variations of these medications.

The increasing prevalence of obesity and its associated health risks created a significant unmet need for effective weight loss treatments. Traditional lifestyle interventions and oral weight loss medications were not always successful in achieving and maintaining weight loss for many individuals. Injectable medications offered a new approach, providing an alternative option that could potentially yield more substantial and sustained weight loss results.

As the efficacy and safety of injectable weight loss medications became more evident through clinical trials and real-world use, healthcare providers began to incorporate them into their treatment plans for patients struggling with obesity. Patient demand for effective weight loss solutions also played a role in the popularity of injectable medications, as people began to seek options beyond diet and exercise alone.

Eligibility for Zepbound vs. Ozempic for Weight Management

As of November 2023, Zepbound is FDA-approved for chronic weight management. Tirzepatide is the main ingredient in Zepbound.

Tirzepatide is a dual agonist of GLP-1 and GIP (glucose-dependent insulinotropic polypeptides). Semaglutide is the main ingredient in Ozempic. It is not a dual agonist, as it is only a GLP-1.

Health experts suggest that tirzepatide may be a more holistic choice when it comes to managing weight, as this medication presents advantages that go beyond regulating blood sugar levels.

Ozempic is not FDA-approved for chronic weight management or weight loss. It was originally designed for type 2 diabetes patients. However, some healthcare providers do prescribe it for weight loss.

This being said, there is a semaglutide medication that has been FDA-approved for weight loss called Wegovy.

Safety and Side Effects

Those who have taken tirzepatide or semaglutide have experienced similar side effects, likely due to their comparable mechanisms of action.

  • Common side effects shared by both medications include:

  • Constipation or diarrhea

  • Upset stomach and nausea

  • Vomiting

  • Headaches

  • Abdominal pain

  • Fatigue

  • Low blood sugar (hypoglycemia)

In more severe cases, both tirzepatide and semaglutide have been linked to potential side effects including vision changes, pancreatitis, kidney failure, gallbladder problems, and allergic reactions.

Duration of Action and Dosage

Tirzepatide is undergoing research for both weekly and daily dosing regimens, suggesting potential variations in its duration of action.

At present, the recommended starting dose of tirzepatide is 2.5 mg, administered subcutaneously once a week. Subcutaneously refers to the injection of the medication into the layer of tissue just beneath the skin.

After four weeks, the dosage should be raised to 5 mg. If additional dose adjustment is necessary, it can be increased in 2.5 mg increments after at least four weeks on the current dose. The maintenance dose typically ranges from 5 mg to 15 mg, to be injected once weekly.

Similarly, semaglutide dosing also increases gradually to help patients adjust to the medication. Ozempic should be administered once weekly, always on the same day each week. It can be taken at any time of the day, with or without meals. The maximum recommended dosage is 2 mg, to be taken once weekly. If needed, the day of weekly administration can be changed, as long as there is a minimum of 2 days (more than 48 hours) between doses.

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Cost of Zepbound vs. Cost of Ozempic

Zepbound, developed by Eli Lilly, is anticipated to be available in the U.S. by the end of 2023, with a list price of approximately $1,060. However, the list price does not reflect the typical out-of-pocket expenses after insurance coverage and discounts.

Eli Lilly intends to provide a savings card to minimize out-of-pocket costs for Zepbound among those with commercial insurance. With insurance coverage for Zepbound, the price could be reduced to as low as $25 for a one to three-month supply.

For individuals without insurance coverage for Zepbound, the cost would be around $550 for a one-month supply.

The price of Ozempic is subject to variability based on factors such as the dosage prescribed, the quantity of pens required, and the specific pharmacy selected by an individual. Typically, the cost ranges from $915-$1,000 per injection pen.

Usually, the generic version of a drug is less expensive. However, the FDA has not yet approved generic semaglutide for use.

Novo Nordisk, the manufacturer of Ozempic, provides a Diabetes Savings Offer Program. However, this program is not accessible for individuals enrolled in Medicaid, Medicare, or any other federal or state health programs.

Under this offer, individuals can save up to:

  • $150 for a 1-month prescription

  • $300 for a 2-month prescription

  • $450 for a 3-month prescription

To qualify for this offer, individuals must be enrolled in a commercial insurance plan that covers a portion of the cost of Ozempic. It is important to note that this saving option is not suitable for individuals whose insurance covers the entire expense of this medication.

This savings opportunity is exclusively available for individuals diagnosed with type 2 diabetes.

Limitations of Use for Zepbound and Ozempic

While Zepbound and Ozempic are considered safe and effective in treating their respective health conditions – be it chronic weight management or type 2 diabetes – there are some limitations to these prescription medications.

Zepbound has certain limitations as indicated on its label:

  • Being a newer medication, the FDA has not yet established the safety and effectiveness of Zepbound in teens or adolescents. For this reason, its use is not recommended for anyone under 18 years of age.

  • Zepbound may pose a risk to unborn babies, so it is important for individuals to inform their healthcare provider if they become pregnant while using Zepbound. Planning a pregnancy warrants the discontinuation of Zepbound.

  • It is crucial not to use Zepbound if a serious allergic reaction has occurred to tirzepatide.

  • If an individual or any family member has a history of a type of thyroid cancer called medullary thyroid carcinoma (MTC), the use of Zepbound is contraindicated.

  • Zepbound is specifically contraindicated in patients with a personal or family history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

  • Using bexarotene concurrently with tirzepatide may increase the risk of pancreatitis, which involves inflammation of the pancreas.

  • Gatifloxacin, another medication, may impact blood glucose levels and is not recommended for use in patients with diabetes. Both hypoglycemia (low blood glucose) and, less frequently, hyperglycemia (high blood glucose) have been reported with the use of gatifloxacin.

  • Zepbound contains tirzepatide and should not be used simultaneously with other tirzepatide-containing products or any GLP-1 receptor agonist medicines.

According to Novo Nordisk, people with the following conditions should not use Ozempic:

  • Ozempic can increase the risk of pancreatitis, which is inflammation of the pancreas. Individuals with a history of pancreatitis or at an increased risk should avoid using Ozempic.

  • Ozempic is specifically indicated for individuals with type 2 diabetes. It should not be used in those with type 1 diabetes as it may not provide the desired effects for blood sugar control.

  • The safety and effectiveness of Ozempic have not been established in individuals under 18 years of age. As a result, it is not recommended for use in this age group.

  • Ozempic may harm unborn babies, and its effects while breastfeeding are not known. Therefore, individuals who are pregnant, planning a pregnancy, or breastfeeding should not use Ozempic.

  • Diabetic retinopathy is a condition that affects the eyes of individuals with diabetes. The safety and efficacy of Ozempic in individuals with diabetic retinopathy have not been established.

  • Individuals with pre-existing conditions or complications involving the pancreas or kidneys may have an increased risk of adverse effects when using Ozempic. It is important to avoid Ozempic in such cases and consult with a healthcare provider for alternative treatment options.

  • Ozempic is contraindicated in individuals with a family history of MTC, a type of thyroid cancer. This is because Ozempic may stimulate the growth of existing MTC or increase the risk of developing MTC.

  • MEN 2 is a rare genetic disorder affecting the endocrine system. Ozempic is contraindicated in individuals with a personal or family history of MEN 2 due to the potential risk of developing MTC associated with this condition.

Consult with a Healthcare Professional

It's important to note that injectable weight loss medications are typically intended for individuals with obesity or those who have difficulty losing weight through lifestyle changes alone. As with any medication, they should be prescribed and used under the guidance of a healthcare professional.

While both tirzepatide and semaglutide can be beneficial in chronic weight management, it is important to adopt a comprehensive approach for effective weight loss. At LifeMD, we offer a holistic solution that includes clinical oversight, metabolic testing, and continuous support from licensed healthcare providers, ensuring a healthier overall well-being when using GLP-1 medications.

To explore GLP-1 medications for chronic weight management, visit LifeMD and determine your eligibility for the Weight Management Program. By answering a series of questions about your medical history, weight loss goals, and current weight, you can determine if you prequalify for a GLP-1 medication. Then, you'll have a virtual appointment with a licensed medical professional to discuss if a GLP-1 medication is the right choice for you.

If prescribed weight management medication, regular follow-up appointments with healthcare professionals are vital to assess progress and determine its effectiveness. These check-ins allow for adjustments in treatment plans if needed, as well as provide the opportunity to discuss any challenges or successes throughout your weight loss journey.

Should you experience any side effects while using semaglutide or tirzepatide, a licensed medical professional will assist you in managing these changes to ensure your well-being and safety. Often, seeking guidance from a healthcare professional and seeking reassurance can provide the peace of mind needed when starting a new medication.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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