Four brand names, two molecules. Ozempic and Wegovy are both semaglutide. Mounjaro and Zepbound are both tirzepatide. Within each pair the active ingredient is the same; what differs is what the FDA approved each product to treat. Ozempic and Mounjaro are approved for type 2 diabetes, Wegovy and Zepbound for weight management. Indication is the main difference but not the only one: the products also differ in the forms they come in, the dose ranges attached to each approved use, the ages they cover, and the coverage and manufacturer programmes that follow from all of that.
| Brand | Molecule | Approved for | Weekly injection dose, adults |
|---|---|---|---|
| Ozempic | Semaglutide | Type 2 diabetes; cardiovascular risk and kidney outcomes in type 2 diabetes | Maintenance 0.5, 1 or 2 mg |
| Wegovy | Semaglutide | Weight reduction and long-term maintenance; cardiovascular risk; MASH with moderate to advanced fibrosis | Recommended maintenance 2.4 mg; for adult weight reduction only, up to 7.2 mg where 2.4 mg is tolerated and further reduction is clinically indicated |
| Mounjaro | Tirzepatide | Type 2 diabetes, adults and children 10 and older; cardiovascular risk in high-risk type 2 diabetes | Maximum 15 mg; maximum 10 mg in children 10 and older |
| Zepbound | Tirzepatide | Weight reduction and long-term maintenance; moderate to severe obstructive sleep apnea in adults with obesity | Maintenance 5, 10 or 15 mg |
The column covers the weekly injection for adults, because that is the form all four share. Wegovy and Ozempic also have oral versions on different dose scales, set out further down. Each brand links to its current FDA label.
Why one molecule carries two names
A manufacturer runs separate trials for separate uses, and each approval gets its own application, its own label and, usually, its own brand. Novo Nordisk studied semaglutide for glycemic control in type 2 diabetes and sells that as Ozempic; it studied a higher dose for weight management and sells that as Wegovy. Eli Lilly did the same with tirzepatide, as Mounjaro and Zepbound.
The practical consequences are ordinary rather than mysterious. Insurance often covers the diabetes brand for a diabetes diagnosis and declines the weight-management brand, because coverage follows indication. Prescribing the diabetes brand for weight loss is off-label use, which is legal and common but sits outside what the label supports. And the manufacturer support programmes differ by brand, because they are attached to the product rather than to the molecule.
One thing that is not a general rule: the weight-management brand does not always titrate higher. It does for semaglutide, where Wegovy goes above Ozempic’s 2 mg ceiling. It does not for tirzepatide, where Mounjaro and Zepbound both top out at 15 mg weekly in adults. The tirzepatide pair differs by indication and by what each programme covers, not by dose range.
What each label actually says
Ozempic is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes, to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to reduce the risk of sustained kidney function decline, end-stage kidney disease and cardiovascular death in type 2 diabetes with chronic kidney disease. Dosing starts at 0.25 mg weekly, with maintenance at 0.5 mg, 1 mg or 2 mg.
Wegovy is indicated to reduce cardiovascular risk in adults with established cardiovascular disease and obesity or overweight, to reduce excess body weight and maintain that reduction in adults and children 12 and older with obesity or adults with overweight plus a weight-related condition, and for noncirrhotic MASH with moderate to advanced liver fibrosis. The injection titrates from 0.25 mg to a recommended maintenance of 2.4 mg weekly for adults. The label adds that for adults who tolerate 2.4 mg for at least four weeks and for whom further weight reduction is clinically indicated, the dose may go to a maximum of 7.2 mg weekly. Children aged 12 and older have their own maintenance dosing, and the 7.2 mg strength has not been established in them.
Mounjaro is indicated for glycemic control in adults and children 10 and older with type 2 diabetes, and to reduce cardiovascular risk in adults with type 2 diabetes at high risk. It starts at 2.5 mg weekly and increases in 2.5 mg steps, no sooner than every four weeks, to a maximum of 15 mg in adults. For children aged 10 and older the label caps the dose at 10 mg weekly.
Zepbound is indicated to reduce excess body weight and maintain that reduction in adults with obesity or overweight plus a weight-related condition, and to treat moderate to severe obstructive sleep apnea in adults with obesity. Maintenance is 5 mg, 10 mg or 15 mg weekly, with 10 mg or 15 mg for sleep apnea. Its safety and effectiveness in children have not been established.
The part most comparisons are now out of date on
These are no longer injection-only franchises. Wegovy’s current label covers both an injection and a tablet, with the tablet maintenance dose at 25 mg once daily for cardiovascular risk reduction and weight reduction in adults. On the semaglutide side for diabetes, Ozempic tablets share a label with Rybelsus, the original oral semaglutide product, and the label sets out how to switch between them.
If a comparison you are reading says semaglutide is only available as a weekly shot, it was written before those changes. Check the label date on anything you rely on.
Side effects and warnings
Gastrointestinal effects dominate every one of these labels: nausea, diarrhea, vomiting, constipation and abdominal pain appear across all four. Beyond that shared core the lists are not identical, and they are not interchangeable between products, so read the label for the product you are actually prescribed rather than a molecule-level summary. Each label is linked in the table above.
All four carry a boxed warning about thyroid C-cell tumours observed in rodents, where the human relevance has not been determined. All four are contraindicated for anyone with a personal or family history of medullary thyroid carcinoma, or with multiple endocrine neoplasia syndrome type 2. Those are contraindications, not cautions.
Each label also contraindicates hypersensitivity, but in its own words rather than a shared formula: Wegovy’s is “known hypersensitivity to semaglutide or any of the excipients”, while Ozempic, Zepbound and Mounjaro each specify a serious hypersensitivity reaction to their active ingredient or excipients. Wegovy’s is the broader wording of the four, so take the contraindication from the label for the product in front of you rather than from a summary of the class.
All four currently warn about severe gastrointestinal adverse reactions, though the labels picked that section up at different times: Wegovy’s own recent-changes listing dates it 10/2025, Mounjaro’s 12/2025 and Zepbound’s 02/2026. Wegovy and Zepbound also record the removal of a suicidal behaviour and ideation warning, Wegovy’s dated 01/2026 and Zepbound’s 02/2026. A recent-changes entry marks when a section last changed rather than when a warning first appeared, so treat those dates as label history, not as the date a risk was discovered.
Where compounded medication fits
Compounded semaglutide and compounded tirzepatide are a separate category from all four products above. They are not FDA-approved, and they are not generic or equivalent versions of Ozempic, Wegovy, Mounjaro or Zepbound. A generic is an approved copy that has demonstrated equivalence to a specific product; no such approval exists here. The preparations we offer are made by state-licensed pharmacies for an individual patient under section 503A, and the trial results attached to the brand names above were generated with the brand products.
That distinction is also why price comparisons mislead when they put all of it in one column. At Gentle Health, compounded semaglutide starts at $112 a month for oral drops and $135 for the injection, and compounded tirzepatide starts at $169 a month, every tier published in advance. How the brands, the manufacturers’ direct programs and compounded options price out against each other is set out at tirzepatide cost per month and semaglutide cost without insurance.
The molecule-level question behind the brand names - whether tirzepatide or semaglutide produces more weight loss, and what the one direct trial does and does not establish - is a separate subject with its own page in the GLP-1 question library.
Frequently asked questions
Are Ozempic and Wegovy the same drug? Both contain semaglutide. They differ in approved indication and in how high the dose goes: Ozempic is approved for type 2 diabetes with a 2 mg weekly injection maximum, Wegovy for weight management with a recommended maintenance of 2.4 mg weekly and a 7.2 mg maximum for adults who tolerate 2.4 mg and need further weight reduction.
Is Zepbound just Mounjaro under another name? Both are tirzepatide, and in adults both top out at 15 mg weekly. Zepbound is approved for weight management and obstructive sleep apnea; Mounjaro is approved for type 2 diabetes, in adults and in children aged 10 and older, where the label caps the dose at 10 mg.
Is compounded medication the generic version of these? No. A generic is an approved product shown to be equivalent to a specific brand, and none exists for these. Compounded semaglutide and tirzepatide are not FDA-approved - the wider pricing picture is at Why Do GLP-1 Prices Vary So Much?, and the full question library is at GLP-1 questions.
Dr. James Simmons, MD