Zepbound vs. Ozempic: Differences & similarities explained

In this article:

• Key differences
• Conditions treated
• Is Zepbound better than Ozempic?
• Coverage and cost comparison
• Side effects
• Drug interactions
• Drug warnings
• FAQs

In this article

• Key differences
• Conditions treated
• Is Zepbound better than Ozempic?
• Coverage and cost comparison
• Side effects
• Drug interactions
• Drug warnings
• FAQs

Zepbound (tirzepatide) and Ozempic (semaglutide) are two brand-name medications that are commonly used for weight loss. Zepbound is classified as a glucose-dependent insulinotropic polypeptide receptor and glucagon-like peptide-1 receptor agonist (GIP/GLP-1 receptor agonist), while Ozempic is classified as a GLP-1 receptor agonist. For weight loss, they work by slowing gastric emptying and increasing satiety, which helps decrease cravings and regulate food intake. While these medicines share some similarities, they have many differences as well. 

Zepbound vs. Ozempic: Key differences

Zepbound and Ozempic are typically used as long-term treatments, and both drugs are FDA approved for use in adults only. Both drugs are available in brand name with no generic available. Zepbound is made by Eli Lilly and Company and contains the active ingredient tirzepatide, while Ozempic is made by Novo Nordisk and contains the active ingredient semaglutide. Although they work in a similar way, Zepbound targets an additional pathway, which may enhance weight loss.

Compare key differences
	Zepbound	Ozempic
Drug class	GIP/GLP-1 receptor agonist	GLP-1 receptor agonist
Brand/generic status	Brand	Brand
What is the generic name?	The active ingredient is tirzepatide, but there is no generic available.	The active ingredient is semaglutide, but there is no generic available.
What form(s) does the drug come in?	Injection	Injection
What is the standard dosage?	Starting dose is 2.5 mg injected subcutaneously every week. The healthcare provider will gradually increase the dose to a maximum of 15 mg weekly.	Starting dose is 0.25 mg injected subcutaneously every week. The healthcare provider will gradually increase the dose to a maximum of 2 mg weekly.
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults	Adults

 

Zepbound vs. Ozempic: Conditions treated

Zepbound is approved by the Food and Drug Administration (FDA) for weight loss and long-term weight management in adults with obesity or who are overweight with at least one weight-related health condition, such as high blood pressure or high cholesterol. Zepbound is also FDA approved to treat moderate to severe obstructive sleep apnea in adults with obesity. 

Ozempic is FDA approved to manage blood sugar levels in adults with Type 2 diabetes. It is also used to lower the risk of major adverse cardiovascular events (heart attack, stroke, and cardiovascular death) in adults with Type 2 diabetes and heart disease. Ozempic is also FDA approved in adults with Type 2 diabetes and chronic kidney disease. In this population, it can help reduce the risk of further kidney damage and cardiovascular death. Ozempic is not FDA pproved for weight loss, but it is frequently prescribed off-label (for a non-FDA-approved use) for weight loss. The active ingredient in Ozempic, semaglutide, is also found in Wegovy, which is FDA approved for weight loss and long-term weight management. 

Both Zepbound and Ozempic are typically recommended in combination with lifestyle changes, including a reduced-calorie diet and increased physical activity. 

Compare conditions treated
Condition	Zepbound	Ozempic
Weight loss and weight management	Yes	Off-label
Obstructive sleep apnea	Yes	No
Type 2 diabetes	No	Yes
Cardiovascular risk reduction	No	Yes
Kidney disease	No	Yes

 

Is Zepbound better than Ozempic?

Either drug can be very effective—both drugs have gone through extensive clinical trials to prove safety and efficacy. Until recently, there was little data comparing the drugs directly. In December 2024, the results of the SURMOUNT-5 study comparing Zepbound and Wegovy were published. (Wegovy contains the same active ingredient as Ozempic, which is called semaglutide.) In this 72-week study, researchers found that people who used Zepbound lost 20.2% of body weight, compared to 13.7% in people who used Wegovy. It’s important to note that the higher doses of Wegovy are slightly higher than the highest doses of Ozempic. In this study, participants were gradually increased to doses of 1.7 or 2.4 mg of Wegovy, while the maximum dose of Ozempic is 2 mg. 

Although Zepbound showed better results, this does not necessarily mean it is the best choice for everyone. Consult your healthcare provider for more information and medical advice about Zepbound and Ozempic. The best drug for you can only be determined by your healthcare provider, who can take many individual factors into consideration. 

Zepbound vs. Ozempic: Insurance coverage and cost comparison

Without insurance, a one-month supply of Zepbound can cost about $1,496. However, a free SingleCare coupon can bring the price down to as low as $947 per month.

The out-of-pocket price for a one-month supply of Ozempic is about $1,370. However, a free SingleCare coupon can bring the price down to as low as $811 per month.

Insurance coverage for Zepbound and Ozempic varies by plan. The best way to find out if your insurance company provides coverage for these drugs is to check with your insurance provider for the most up-to-date pricing estimates and coverage information. You can also check the manufacturers’ websites for insurance look-up tools and additional savings options. 

These drugs may require prior authorization, and in some cases, they may or may not be covered depending on what you are using the drug for. For example, an insurance company may cover Ozempic for Type 2 diabetes, but not for weight loss. Similarly, an insurance plan that does not cover weight loss medicine may cover Zepbound for obstructive sleep apnea but not for weight loss. 

Your plan provider, whether commercial or through Medicare, can give you more information on your benefits for these drugs.

Compare cost and coverage
	Zepbound	Ozempic
Typically covered by insurance?	Varies	Varies
Typically covered by Medicare Part D?	Varies	Varies
Quantity	1 box of 4 single-use pens	1 box of 1 multiple-use injection pen
Typical Medicare copay	Varies	Varies
SingleCare cost	$946 and up	$811 and up

 

Zepbound vs. Ozempic side effects

The most common side effects of both drugs are gastrointestinal—nausea, vomiting, stomach pain, and diarrhea or constipation. The table below shows some of the more common side effects of both drugs, with the frequency varying by dose. While taking Zepbound or Ozempic, tell your healthcare provider if you have any side effects that bother you or do not go away. 

If you have symptoms of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, get emergency medical help right away. 

Compare side effects
	Zepbound		Ozempic
Side effect	Applicable?	Frequency	Applicable?	Frequency
Nausea	Yes	25%–29%	Yes	16%–20%
Vomiting	Yes	8%–13%	Yes	5%–9%
Diarrhea	Yes	19%–23%	Yes	8%–9%
Stomach pain	Yes	9%–10%	Yes	5%–7%
Constipation	Yes	11%–17%	Yes	3%–5%
Indigestion	Yes	9%–10%	Yes	3%–4%
Injection site reactions	Yes	6%–8%	Yes	0.2%
Fatigue	Yes	5%–7%	Yes	>0.4%
Hair loss	Yes	4%–5%	No	N/A
Bloating	Yes	3%–4%	No	N/A
Allergic reactions	Yes	5%	Yes	% not reported

Source: Zepbound (DailyMed), Ozempic (DailyMed)

Zepbound and Ozempic drug interactions

Before you take Zepbound or Ozempic, tell your healthcare provider about all the medications you take. This includes prescription medications, over-the-counter drugs, vitamins, and supplements. Because both Zepbound and Ozempic lower blood sugar, there is a risk of hypoglycemia (low blood sugar) when taken with insulin or certain diabetes medications. Your healthcare provider may recommend close monitoring and a possible dose adjustment. 

While both drugs affect stomach emptying, there is a potential to affect how medicines are absorbed if taken around the same time. Your healthcare provider can advise you if you need to make any adjustments to your schedule or regimen. This may affect drugs that require careful monitoring, such as the blood thinner warfarin. 

The prescribing information for Zepbound (but not Ozempic) notes that if you are taking a birth control pill, you will need to switch to a non-oral method of birth control—or add a barrier method of birth control, such as a condom—for four weeks after starting Zepbound and for four weeks after each dose increase. Consult your healthcare provider for more information and medical advice about birth control. 

Compare drug interactions
Drug	Drug Class	Interacts with Zepbound?	Interacts with Ozempic?
Lantus  Levemir Tresiba	Insulin	Yes	Yes
Glimepiride Glipizide Glyburide	Sulfonylureas	Yes	Yes
Oral medications	Oral medications	See above	See above

 

Zepbound and Ozempic drug warnings

Before beginning your weight loss journey with Zepbound or Ozempic, tell your healthcare provider about all of your medical conditions and medical and family history. 

Zepbound and Ozempic share many of the same warnings. Both drugs have a black box warning, the most serious warning required by the FDA. In animal studies, these drugs have caused thyroid tumors. It is not known whether Zepbound or Ozempic can cause cancer in humans. However, people with a personal or family history of medullary thyroid carcinoma (MTC), and people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should never take Zepbound or Ozempic. Also, anyone who takes Zepbound or Ozempic should be alert to symptoms of thyroid cancer, such as a lump in the neck, difficulty breathing or swallowing, or hoarseness. 

Other possible serious side effects of both drugs are listed below, which require immediate or urgent medical attention. You can discuss with your healthcare provider what symptoms to look for and what to do if you experience them: 

• Severe gastrointestinal problems
• Kidney injury
• Gallbladder disease
• Pancreatitis (inflammation of the pancreas)
• Allergic reactions
• Low blood sugar 
• Diabetic retinopathy
• Pulmonary aspiration during general anesthesia or deep sedation

Additionally, the Zepbound prescribing information notes that people who use this drug may experience suicidal thoughts and behaviors. People with a history of suicidal thoughts or attempts should not use Zepbound. People using Zepbound should be closely monitored for a worsening of depression symptoms, changes in mood and behavior, and suicidal thoughts or behaviors. If you are using Zepbound and you or a close friend, family member, or caregiver notice any of these changes, call your healthcare provider right away. For urgent or emergency situations, call 911 and go to the emergency room or call or text 988 for the 988 Suicide & Crisis Lifeline.

Frequently asked questions about Zepbound vs. Ozempic

Which is better, Zepbound or Ozempic?

In the SURMOUNT-5 study, people who used Zepbound lost 20.2% of body weight over 72 weeks, compared to 13.7% loss in those who used Wegovy (which contains the same active ingredient as Ozempic but at a slightly higher maximum dose). However, the best drug may not be the same for everyone. Consult your healthcare provider for more information on the best drug for you. 

Why is Zepbound so hard to get?

Zepbound (as well as other similar weight loss drugs) was affected by periodic shortages for some time. However, as of October 2024, the FDA reports that the Zepbound shortage has been resolved. There should not be supply issues with Zepbound at this time. You can check with your local pharmacy for supply questions.

Is Zepbound more expensive than Ozempic?

Zepbound may be slightly more expensive than Ozempic if you are paying out of pocket. However, your cost will vary based on your insurance coverage. Contact your health insurance plan for more information on your costs for Zepbound or Ozempic. You can also check the manufacturers’ websites for both drugs to explore other savings options.