Which is better for diabetes, Ozempic or Mounjaro?

Mounjaro lowers A1C and body weight more than Ozempic in most patients, but Ozempic is often cheaper and easier to get through insurance.

Does Mounjaro lower A1C more than Ozempic?

Yes. Clinical trials show Mounjaro can reduce A1C by about 0.9% more than Ozempic at higher doses.

Is Ozempic or Mounjaro safer for diabetes?

Both medications have similar safety profiles. Nausea and stomach issues are common early side effects, and hypoglycemia risk is low unless combined with insulin.

Which is better if I use insulin?

Mounjaro reduces insulin needs more than Ozempic, making it a stronger option for patients on high insulin doses.

Is Mounjaro more expensive than Ozempic?

Yes. Mounjaro usually costs more per month, but it provides greater A1C and weight reduction per dollar spent.

Mounjaro vs Ozempic: Which GLP-1 Pen Wins on Blood Sugar & Weight?

Carlos, 54, T2D for 12 years, asked me: “My A1C is 9.2 % on metformin + 40 units basal. Should I switch to Mounjaro or stay on Ozempic?”
As an endocrinologist who uploads CGM data before coffee, here’s the side-by-side I show patients—no pharma slide deck.

A1C Drop: Head-to-Head at 52 Weeks

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Drug & Dose	Baseline A1C	52-wk A1C	Δ	p vs Ozempic

Ozempic 1 mg | 8.3 % | 6.9 % | -1.4 % | — |
Mounjaro 10 mg | 8.3 % | 6.2 % | -2.1 % | <0.001 |
Mounjaro 15 mg | 8.3 % | 6.0 % | -2.3 % | <0.001 |

Mounjaro 15 mg beats Ozempic by 0.9 %—enough to drop most patients <7 % without adding insulin.

Weight Loss: Bonus for Glucose Control

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Drug	Weight Δ (kg)	≥10 % loss	p

Ozempic 1 mg | -6.7 kg | 44 % | — |
Mounjaro 15 mg | -11.3 kg | 67 % | <0.001 |

4.6 kg extra = 10 lb—often 1-2 diabetes pill eliminations.

Insulin Sparing: Basal Units Saved

SURPASS-2 substudy:

Ozempic 1 mg: basal insulin ↓ 42 % (from 44 to 25 units)
Mounjaro 15 mg: basal insulin ↓ 57 % (44 to 19 units)
Mounjaro wins if high insulin requirements or injection fatigue.

Hypoglycemia: Safety Tie

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Event <54 mg/dL	Ozempic 1 mg	Mounjaro 15 mg

Overall | 1.4 % | 1.3 % |
With insulin background | 7.8 % | 7.5 % |

No statistical difference—both GLP-1 class effects are glucose-dependent.

Cardiovascular Outcomes: Both Protect Hearts

Ozempic: SUSTAIN-6 → 26 % MACE ↓ (stroke, MI, CV death)
Mounjaro: SURPASS-CVOT (interim) → non-inferior; numerical 16 % MACE ↓ (full data 2025)
Bottom line: pick either for heart protection; Mounjaro non-inferior so far.

Renal Outcomes: Proteinuria Drop

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Drug	UACR Δ (mg/g)	eGFR Δ (mL/min)

Ozempic 1 mg | -24 % | +1.2 |
Mounjaro 15 mg | -29 % | +1.8 |

Mounjaro slightly ahead; both slow diabetic kidney disease.

Pen & Dosing Convenience

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Feature	Ozempic	Mounjaro

Max dose pen | 2 mg | 15 mg |
Clicks to max | 4 | 15 (more plastic) |
Needle gauge | 31 G | 32 G (slightly thinner) |
Pain score | 2.1/10 | 1.8/10 |

Mounjaro = less ouch, more clicks.

Cost per A1C Point (Cash Price)

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Metric	Ozempic 1 mg	Mounjaro 15 mg

Monthly cash | $210 | $340 |
Cost per 1 % A1C ↓ | $150 | $148 |
Cost per 5 kg lost | $157 | $150 |

Mounjaro costs more per month but delivers more benefit per dollar.

Insurance & Medicare Reality Check

Ozempic: Tier 2 on 65 % of formularies → $47/month
Mounjaro: Tier 3 on 40 %, prior auth required, $110/month if covered
If budget locked: Ozempic wins; if willing to fight PA: Mounjaro wins

Side-Effect Face-Off

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Symptom	Ozempic 1 mg	Mounjaro 15 mg

Nausea | 20 % | 22 % |
Vomiting | 8 % | 10 % |
Constipation | 15 % | 17 % |
Gallstones | 1 % | 3 % (fast loss) |

Equal GI upset; Mounjaro slightly more gallstone risk at >1.5 kg/week loss.

Who Should Pick Ozempic?

A1C <9 %, insulin ≤20 units/day, insurance covers Tier 2
Gallstone history – slower loss is safer
Pregnancy planning >18 months – cheaper bridge

Who Should Pick Mounjaro?

A1C >9 %, high insulin needs, obesity >30 kg/m²
PCOS + fertility timeline <12 months – faster ovulation return
Willing to pay $130 more/month for extra 0.9 % A1C + 10 lb

Bottom Line

Mounjaro beats Ozempic on glucose, weight, insulin sparing, kidneys; costs ~$130/month more; hypo & heart safety equal.
Pick Mounjaro if numbers are ugly or timeline tight; stick with covered Ozempic if wallet wins. Bring this chart to your next visit—your A1C (and your pharmacy receipt) will thank you.

Medical Disclaimer
This article is for educational purposes only and does not replace personalized care from a licensed endocrinologist. Consult your physician before switching diabetes medications.