According to Statistics Canada, about 7.3% of Canadians over the age of 12 are suffering from Diabetes. In response to this growing health concern, Novo Nordisk has pioneered Ozempic (semaglutide), a pharmaceutical breakthrough that has rapidly gained momentum in recent years due to its remarkable efficacy in both diabetes management and weight loss. However, Eli Lilly and Co. has introduced a formidable competitor named Mounjaro (Tirzepatide), which may potentially provide more advantages than Ozempic. So which one stands out?
How does Ozempic and Mounjaro work?
Both Ozempic and Mounjaro are classified as incretin mimetics. These types of drugs mimic the effects of naturally occurring hormones that are released after meals. Ozempic acts as a GLP-1 agonist, slowing down gastric emptying while making you feel fuller. In addition to a GLP-1 agonist, Mounjaro is a glucose-dependent insulinotropic polypeptide (GIP) agonist that stimulates insulin production, controls appetite, and reduces blood glucose levels. It’s worth noting that Mounjaro is the very first diabetic drug that simultaneously activates two receptors.
Mounjaro comes in single-dose prefilled pens, while Ozempic comes in multi-dose prefilled pens. This means that when using Ozempic pens, you will need to add a new needle before every injection and switch the dial to the correct dose. Both drugs should be stored in the refrigerator between 36? to 46?.
Ozempic and Mounjaro are administered once a week by subcutaneous injections. Initially, they are given at a low dose to reduce the risk of side effects, and after four weeks, the dose is increased. The medicine can be injected into your thighs, stomach or arms.
The starting dose for Ozempic is 0.25mg weekly, which is then increased to 0.5mg weekly. Mounjaro treatment begins at a higher dose of 2.5mg weekly, then increases to 5mg.
After four weeks, your physician will assess your progress on the medication and may decide to increase the dose further. The maximum dose per week for Ozempic and Mounjaro are 2mg and 15mg, respectively.
Which one is better (Ozempic vs. Mounjaro)?
In a phase 3 clinical trial, researchers studied the effects of different doses of Mounjaro versus Ozempic on the change in A1C levels. A1C levels measure the percentage of glycated hemoglobin, the portion of sugar molecules bound to red blood cells. Glycated hemoglobin is normal in healthy individuals; however, someone with Diabetes would have an abundance of sugar molecules entering the bloodstream, resulting in high A1C levels.
This study's sample size consisted of 1879 adults with Type-2 Diabetes. These patients' diabetes was not effectively controlled with Metformin. Over a 40-week period, patients were administered 5mg, 10mg, or 15 mg doses of Mounjaro or 1mg of Ozempic once a week. Initially, participants had an average A1C of 8.28% and weighed 93.7kg. For reference, normal A1C levels in healthy individuals are below 5.7%.
It was found that participants who were administered 5mg, 10mg, or 15mg of Mounjaro experienced a reduction of A1C levels by 2.01, 2.24, and 2.31 percentage points, respectively. Those who were given 1mg of Ozempic had A1C levels reduced by only 1.86. Furthermore, more drastic weight loss was observed in those on Mounjaro compared to Ozempic. The patients on Ozempic lost an average of 5.7kg, but those on Mounjaro lost 7.6kg, 9.3kg, and 11.2 kg on 5mg, 10mg and 15mg, respectively.
Despite these telling results, this trial did not examine the same doses between both Ozempic and Mounjaro or higher doses of Ozempic. In addition, certain minorities made up only a small percentage of participants and so, results cannot be extrapolated to the general population. Considering that Mounjaro acts as a dual agonist and targets two different receptors, experts hypothesize that Mounjaro is a more effective option than Ozempic.
As mentioned in the above trial, weight changes of patients on Ozempic and Mounjaro were tracked. Since results are promising, both drugs are being prescribed off-label for weight loss in individuals without diabetes. To stress, Ozempic and Mounjaro have not been officially approved by health authorities for the use of weight loss.
As with any medication, there is a risk of side effects. Everyone reacts differently to medications and can have the tendency to develop more side effects than others. Ozempic and Mounjaro have comparable side effects but patients on Mounjaro tend to report more..
Mild side effects from both drugs include diarrhea, constipation, nausea, vomiting, indigestion, abdominal pain, flatulence, and burping while Mounjaro may also cause abdominal bloating and inappetence. More severe side effects are acute gallbladder conditions, low blood sugar, pancreatitis, and severe digestive problems. To add to that, Ozempic may have a risk for diabetic retinopathy.
Before beginning any new medication, you should first consult with your physician. People respond to medications in various ways, so neither Ozempic nor Mounjaro may be the right fit for you. If your physician approves using either of these drugs for treating type 2 diabetes, then it seems that Mounjaro is the winner for its dual functionality in managing the disease. Ultimately, the decision is up to the individual and the health care professional.