Zepbound® vs Mounjaro®: A Simple Breakdown

How They’re Approved (FDA-Labeled Uses)

The FDA identifies a significant difference between Zepbound® and Mounjaro®, despite both containing the same active ingredient. Labels guide how clinicians prescribe or consider off-label use.

Zepbound®: Chronic Weight Management Indication

The FDA approved Zepbound® in November 2023 specifically to manage chronic weight issues. Adults may be eligible if they have:

• A body mass index (BMI) of 30 kg/m² or greater (obesity), or
• A BMI of 27 kg/m² or greater (overweight) with at least one weight-related medical condition 

Doctors may prescribe Zepbound® with a reduced-calorie diet and suggest increased physical activity. The SURMOUNT-1 clinical trial showed clinically significant weight reduction compared to placebo (the study formulation became Zepbound®). 

Mounjaro®: Type 2 Diabetes Indication  

The FDA approved Mounjaro® in May 2022 to improve blood glucose control in adults with type 2 diabetes. Clinical trials showed that Mounjaro® lowered A1C levels effectively when patients combined it with diet and exercise.

Note on off-label use: Because Mounjaro® and Zepbound® contain tirzepatide, clinicians may consider Mounjaro® off-label for weight management in some cases. Only a licensed prescriber can determine whether off-label use is appropriate for an individual patient.

What this means in real life:

1. Coverage may follow labeled use.
2. Each product comes with different patient information.
3. Dosing titration schedules may be similar, but your prescriber may follow the label that matches your condition and product.

While both contain tirzepatide, the key difference is their FDA-approved indications. Your clinician will recommend the option (when clinically appropriate) that fits your diagnosis, goals, coverage, and safety considerations.

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What’s Inside & How They Work

Same active ingredient but different FDA-approved uses

Zepbound® and Mounjaro® both contain tirzepatide. Tirzepatide is a dual GIP/GLP-1 receptor agonist that:

• GLP-1 receptors: slow gastric emptying, boost insulin secretion, and reduce appetite.
• GIP receptors: enhance insulin response and may further influence appetite regulation.

Why labels matter in practice

• Dosing protocols and patient education differ by indication.
• Monitoring needs can differ depending on whether the goal is diabetes management or weight management.

Delivery form and administration overview

Both are once-weekly subcutaneous injections in prefilled pens (abdomen, thigh, or upper arm).

Example dosing (for illustration purposes only; your prescriber determines each plan if clinically appropriate):

• Start: 2.5 mg once weekly for ~4 weeks
• Gradual increases: About every 4 weeks 
• Maximum dose: Up to 15 mg weekly, per product labeling

Administration tips (although not a substitute for clinical training): Inject on the same day each week, rotate sites (abdomen, thigh, or upper arm), and confirm the solution is clear and colorless.

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What the Research Shows  

Weight Management (SURMOUNT trials*):

• What they measured: Change in body weight over ~72 weeks
• What they found: At higher doses, alongside diet and physical activity, participants taking tirzepatide medication lost ~20% on average; many achieved ≥ 5%, and some reached ≥ 20%. Individual results vary.

Type 2 Diabetes (SURPASS trials*):

• What they measured:
  
  • A1C - a lab test that reflects your average blood sugar over ~3 months
  • How many people reached A1C < 7%
• What they found: Tirzepatide lowered A1C by up to ~2.4 percentage points (dose-dependent), and more people hit the target compared with study control groups. Weight also tended to go down, though these studies focused on blood sugar first.

*In SURPASS-2 (type 2 diabetes), tirzepatide (5, 10, 15 mg; brand Mounjaro®) was compared with semaglutide 1 mg (brand Ozempic® for type 2 diabetes). Wegovy® 2.4 mg was not evaluated in SURPASS-2. In SURMOUNT-1 (obesity), tirzepatide was compared with a placebo.

Why it matters:

• Trials were designed to answer different questions: weight (Zepbound®) vs blood sugar (Mounjaro®).
• Your clinician will match treatment (when clinically appropriate) to your diagnosis, goals, safety profile, and insurance coverage.

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What the Numbers Mean (And What They Don't)

Clinical trial averages are helpful, but real-world results vary. Factors like how closely you follow the plan, the dose you reach and maintain, your individual response, and coverage/costs can all change outcomes. Your clinician will help interpret the data in the context of your individual health profile.

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Safety and Monitoring

Both products contain tirzepatide and carry an FDA boxed warning (applicable to both Zepbound® and Mounjaro®) about thyroid C-cell tumors (seen in animals; it is unknown if this risk occurs in humans). Seek care for neck lumps, hoarseness, trouble swallowing, or shortness of breath. 

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Common GI effects: nausea, diarrhea, vomiting, constipation (may be dose-dependent and may improve over time, but not guaranteed).

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Do not use if you have a personal/family history of MTC, MEN 2, or a known hypersensitivity to tirzepatide. Not recommended during pregnancy; Mounjaro® isn’t for type 1 diabetes. Get urgent help for severe abdominal pain (possible pancreatitis), gallbladder symptoms, persistent vomiting/dehydration, or allergic reactions. Tell your clinician about all medicines and procedures (including anesthesia).

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Coverage & Cost

Coverage typically follows the indication:

• Zepbound® (weight management): Often excluded or tightly managed (BMI thresholds, documented lifestyle efforts, weight-related conditions).
• Mounjaro® (type 2 diabetes): More commonly covered for diabetes with diagnosis, recent A1C, and step therapy.
• List price for either can exceed $1,000/month before insurance; savings programs may lower costs for eligible commercial plans. 

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Conclusion

Zepbound® and Mounjaro® share the same active ingredient but serve different FDA-approved uses, weight management vs type 2 diabetes. The appropriate choice (if any) depends on your diagnosis, goals, safety profile, and coverage. Talk with your clinician about which option (if clinically appropriate) fits your plan and how to monitor progress over time. 

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Eden is an independent company and is not affiliated with, sponsored by, or endorsed by Eli Lilly and Company or Novo Nordisk; all trademarks are the property of their respective owners.. Names are used here for identification and educational purposes only.

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