What you’ll learn:
- Mounjaro® and Rybelsus® are both GLP-1 receptor agonists that are FDA-approved for type 2 diabetes, but can be prescribed off-label for weight loss.
- Mounjaro® is taken as a weekly injection, while Rybelsus® is a daily pill.
- Mounjaro® will likely lead to more weight loss, but your choice will depend on your body’s response, price, and side effect tolerance.
In recent years, there’s been a significant shift in how we approach medical support for weight loss. GLP-1 medications, like Ozempic®, have taken center stage, changing the game not just for diabetes management but for weight loss too (off-label). And Ozempic® isn’t the only one making waves.
Rybelsus® and Mounjaro® are two other medications in this growing category of GLP-1 therapies. Like Ozempic®, they’re FDA-approved to treat type 2 diabetes, but doctors increasingly prescribe them off-label to support weight loss. While they share some similarities—such as appetite suppression and blood sugar regulation—they work in different ways and deliver different results.
Rybelsus® is the first and only oral GLP-1 medication currently available, making it a needle-free option. It also contains semaglutide, the same active ingredient as in Ozempic®. Mounjaro®, on the other hand, contains tirzepatide, which has been shown in clinical trials to be one of the most effective weight loss medications.
So, how do they stack up against each other—and against Ozempic®? We’ll break down how Rybelsus® and Mounjaro® work, what the research says about their effectiveness, what they cost, and how to talk with your doctor about whether one of them could be a good fit for your goals.
Mounjaro® vs. Rybelsus®: How do they work?
Rybelsus® and Mounjaro® are made from drugs that help with weight loss and blood sugar control by working with your body’s natural hormones.
The semaglutide in Rybelsus® works by activating GLP-1 receptors, which lowers appetite, slows down digestion, and regulates blood sugar. Even though it’s taken by mouth (and less of the medication gets absorbed compared to the shot versions), it still works the same way as Ozempic® and Wegovy®.
The tirzepatide in Mounjaro® targets two hormones—GLP-1 and another called GIP. This dual action may give it an extra edge in helping control blood sugar and reduce appetite. Some research shows that people may lose more weight with tirzepatide than with single-hormone medications like semaglutide, but results depend on the person.
Both Mounjaro® and Rybelsus® come in several dose levels, and your doctor will start you low and increase it over time to minimize side effects.
Up next, we’ll look at how these medications compare in terms of cost, side effects, and results.
Mounjaro® vs. Rybelsus®: What are the differences?
Although they have similarities, there are notable differences, plus different actions and structures between the two. Let’s explore some key differences between Rybelsus® and Mounjaro® that might help you figure out which one could be a better fit for you:
How you take them
Mounjaro® is a once-a-week injection, while Rybelsus® is a daily pill. If you have strong feelings on daily versus weekly dosing, or taking something as a pill versus an injection, this may be important to you. Be aware, though, that while Rybelsus® comes as a pill, it also has very specific instructions on how to take it: You need to take it first thing in the morning with a small sip of water and wait 30 minutes before eating or drinking anything else. Mounjaro® will be taken just once a week on your chosen day.
They are made by different companies
Rybelsus® is made by Novo Nordisk, the same company behind Ozempic® and Wegovy®. Mounjaro® comes from Eli Lilly, which also makes Zepbound®. Zepbound® contains tirzepatide in the same doses as Mounjaro®, but it is approved for weight loss.
You’ll probably lose more weight with Mounjaro®
Studies have shown that Mounjaro® leads to more weight loss than Rybelsus®. People on the highest dose of Mounjaro® lost an average of 21% of their body weight, while those on Rybelsus® lost an average of 4 to 5%. This difference likely comes down to two things: Mounjaro®’s dual-action formula (it targets both GLP-1 and GIP hormones) and the fact that injections generally deliver medication more effectively than pills.
What are the similarities?
While both medications have several key differences, they also share some similarities, such as:
They are both FDA-approved for diabetes
Both Mounjaro® and Rybelsus® are FDA-approved for managing type 2 diabetes, which may make them eligible for insurance coverage for that purpose. If they are prescribed for weight loss, they are unlikely to be covered.
They share similar side effects
Both Mounjaro® and Rybelsus® share similar side effects, such as nausea, vomiting, and gastrointestinal issues. We’ll dive into these side effects in more detail below.
Can you switch between Mounjaro® and Rybelsus®?
You can switch between Mounjaro® and Rybelsus®, but there are a few important things to consider first. While both are part of the GLP-1 medication family, they’re not created equal in terms of weight loss results.
- Mounjaro® targets both GLP-1 and GIP receptors, which may lead to greater appetite suppression and more significant weight loss.
- Rybelsus® tends to produce more modest outcomes. If you’re switching from Mounjaro® to Rybelsus®, it’s important to know that the effectiveness might not be the same.
Still, there are valid reasons why someone might consider switching from one to the other, including:
- Cost and insurance coverage: Both medications can be expensive, especially for weight loss. If your plan doesn’t cover it or you lose coverage, another medication might be a more affordable alternative.
- Needle aversion: Some people simply prefer pills over injections. Rybelsus® is currently the only GLP-1 medication in pill form.
- Side effects or tolerability: If you’ve had trouble managing side effects with one medication, switching may offer some relief.
If you and your doctor decide a switch makes sense, the process usually starts with stopping your current medication and starting the new one at the lowest dose to minimize side effects. Your provider will help you taper off if needed and monitor your progress closely to ensure the new medication is working for you.
Mounjaro® vs. Rybelsus®: Which is better for weight loss?
Both medications can help with weight loss when prescribed off-label, but Mounjaro® will likely work better. That said, Rybelsus® is still an option for those who prefer a pill. Let’s take a look at the amount of weight loss you can expect with both:
How much weight can you lose on Mounjaro® vs. Rybelsus®?
If you’re exploring Mounjaro® or Rybelsus® as part of your weight loss journey, it’s helpful to know what the research says. Weight loss outcomes in clinical trials show some clear differences.
- Mounjaro® (tirzepatide): People taking Mounjaro® lost an average of 21% of their body weight over 72 weeks.
- Rybelsus® (semaglutide): Clinical trials have shown an average weight loss of around 5% with the current maximum approved dose of Rybelsus® (14 mg) over 52 weeks.
- In a trial with higher doses, people taking a 50 mg dose of Rybelsus® lost an average of 15.1% of their body weight, nearly on par with the injectable version, Wegovy®. This could be an effective option in the future.
How long does it take to see results?
While everyone’s body responds differently and lifestyle changes will have a big effect, there are some general timelines we can look at. Here’s what you can expect in terms of the average percentage of body weight lost over the course of a year.
Short-term results (3 months)
Continued progress (6 months)
Long-term results (12+ months)
Who can take Mounjaro® or Rybelsus® for weight loss?
Eligibility for both medications for weight loss depends on BMI and any related health issues. Your doctor will also look at your overall health and medical history.
You may be eligible if:
- You have a body mass index (BMI) of 30 or higher
or
- You have a BMI of 27 or higher, along with a weight-related condition such as high blood pressure or high cholesterol.
Your healthcare provider will walk you through the decision and help figure out if this medication is a good fit for you. If it is, they’ll work with you to find the right dose and build a support plan that fits your goals. Medications like this work best when you pair them with long-term habits, like eating well, staying active, and tuning into what your body needs.
Who can’t take Mounjaro® or Rybelsus® for weight loss?
While Mounjaro® and Rybelsus® are safe and effective for many people, they’re not right for everyone. Your safety is always the top priority, so it’s important to understand who shouldn’t use these medications.
You can’t take Mounjaro® or Rybelsus® if you:
- Have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Are allergic to any of the ingredients in Mounjaro® or Rybelsus®
Talk to your doctor about your eligibility if you:
- Have had pancreatitis or are at high risk for developing it
- You have severe gastrointestinal disease, such as gastroparesis
You also can’t take either medication if you’re pregnant, planning to become pregnant, or are currently breastfeeding. You’ll also have to stop GLP-1 medications at least two months before trying to conceive.
If you take Rybelsus® or Mounjaro® to lose weight, will you need to keep taking them forever?
Rybelsus® and Mounjaro® are not quick fixes; most people stay on them for about two years. Some people remain on them indefinitely if they continue working.
Stopping GLP-1 medications can often lead to weight regain, especially without long-term lifestyle changes. Studies show that people who stopped semaglutide regained about two-thirds of the original weight loss within a year, or roughly 12% of their body weight. Those who stopped tirzepatide regained about 14%. That’s because these drugs help regulate hunger and appetite—once they’re gone, those challenges can resurface.
Here’s what can happen when you stop taking Rybelsus® or Mounjaro®:
- Appetite may increase as the medication’s appetite-suppressing effect wears off
- Weight regain is common unless healthy habits are maintained
- Blood sugar levels may fluctuate, especially for those managing diabetes
- Some side effects may subside, particularly nausea or GI issues
That’s where programs like Noom can make a big difference. By helping you build sustainable routines around food, movement, and mindset, Noom can support your weight loss goals during and after medication. Whether you stay on medication long-term or eventually taper off with your provider’s guidance, the best outcomes come from combining the medication with improved habits.
Rybelsus® vs. Mounjaro®: Costs and insurance coverage
Figuring out the cost difference between Rybelsus® and Mounjaro® can really help you decide which one fits best with your weight loss goals—and your budget. Both are effective GLP-1 medications, but they come with very different price tags and insurance rules, so it’s worth comparing before you commit.
- Rybelsus®: Without insurance, Rybelsus® costs around $998 per month. If your insurance plan includes coverage, which is unlikely when it’s prescribed for weight loss, your monthly cost could drop to as low as $25. Read more about the costs associated with Rybelsus®.
- Mounjaro®: Mounjaro® costs about $1,080 per month without insurance. Insurance coverage is usually limited to diabetes-related use. For those who are thinking about trying Mounjaro® for weight loss, Zepbound® might be a more affordable option. While the prefilled pen version of Zepbound® costs about the same as Mounjaro®, if you get the vial and syringe form through LillyDirect, you’ll pay less. Here’s a look at pricing:
- The 2.5 mg starting dose of Zepbound® costs $349 per month
- The 5, 7.5, and 10 mg doses cost $499. If you need to step up to the 12.5 and 15 mg doses to continue weight loss, you will have to pay the prefilled pen prices for Mounjaro® or Zepbound®.
Mounjaro® vs. Rybelsus®: Side effects and safety
Mounjaro® and Rybelsus® can come with some side effects, and they’re often pretty similar. Most people notice mild symptoms at the start, especially as their body adjusts to the medication or when the dose is increased. Below, we’ll walk through the common side effects you might experience, along with the rare but more serious ones you’ll want to keep an eye out for.
Common side effects
Most people experience mild to moderate side effects when starting Mounjaro® or Rybelsus®, especially as the body adjusts to the medication, including:
- Nausea
- Diarrhea
- Constipation
- Upset stomach
- Vomiting
- Bloating or gas
- Fatigue
Serious side effects and warnings
While rare, some side effects are more serious. If you experience signs of any of these conditions while taking Mounjaro® or Rybelsus®, get immediate medical attention.
Boxed warning for Rybelsus® and Mounjaro®
Both Rybelsus® and Mounjaro® carry an FDA-boxed warning (the strongest safety warning) for the potential risk of thyroid C-cell tumors. This risk has only been observed in animal studies, but it is unknown whether it applies to humans.
Get immediate medical help if you experience any of the following:
- Pancreatitis: Symptoms include severe abdominal pain that radiates to your back, with or without vomiting. Learn more about the risk of pancreatitis with semaglutide.
- Vision changes: If you notice any sudden changes in your vision while taking these, get immediate medical attention.
- Low blood sugar (hypoglycemia): Low blood sugar is most likely in people who are also taking medications for diabetes. Symptoms include dizziness, shakiness, blurred vision, and a fast heartbeat. Read about semaglutide and hypoglycemia here.
- Kidney problems: Diarrhea, nausea, and vomiting can cause dehydration and worsen kidney issues. Go to the ER if you experience decreased urination, swelling in the ankles or legs, fatigue, or shortness of breath.
- Gallbladder problems: Symptoms include upper abdominal pain, fever, jaundice, or clay-colored stools.
- Allergic reaction: Symptoms include swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, or a rapid heartbeat. Get immediate medical attention if you’re having an allergic reaction.
For a full breakdown of potential risks, see the Rybelsus® prescribing information and Mounjaro® safety information.
Mounjaro® vs. Rybelsus®: Which one is safer?
When it comes to overall safety, both Mounjaro® (tirzepatide) and Rybelsus® (semaglutide) are considered safe and effective medications when prescribed appropriately and monitored by a healthcare provider.
Mounjaro® vs. Rybelsus®: Dosage and administration
Taking your medication the right way makes a big difference when it comes to seeing results and avoiding side effects. Mounjaro® and Rybelsus® are taken in very different ways—one’s a weekly injection, the other is a daily pill. They also have their own storage instructions, timing rules, and dosage progression schedules. In this section, we’ll break down exactly how to take each one so you can stay consistent and get the most out of your treatment.
Mounjaro® (tirzepatide)
Mounjaro® is injected once a week under the skin in your abdomen, thigh, or upper arm. It’s best to rotate injection sites to prevent irritation.
Dosage schedule
- Everyone starts with 2.5 mg once weekly for 4 weeks or longer if you’re losing steady weight and side effects are manageable.
- If more weight loss support is needed, the dose can be increased in 2.5 mg increments: 5, 7.5, 10, 12.5, and 15 mg. Again, weight loss progression and side effects will be weighed by your provider before your dose is increased.
- The maximum dose is 15 mg once weekly.
Storage tips: Keep Mounjaro® pens in the refrigerator until you’re ready to use them, but never freeze them.
Rybelsus® (semaglutide)
Rybelsus® should be taken first thing in the morning, on an empty stomach, with no more than 4 ounces of water. You must wait at least 30 minutes before eating, drinking, or taking other medications to ensure proper absorption.
Dosage schedule
- Everyone starts with 3 mg once daily for 30 days.
- It will increase to 7 mg and then 14 mg as needed and tolerated.
- The maximum dose is 14 mg once daily.
Storage tips: Keep tablets at room temperature in their original container to keep them dry.
Choosing between Rybelsus® and Mounjaro®: Which is right for me?
Choosing between Rybelsus® and Mounjaro® comes down to your personal health goals, lifestyle preferences, budget, and how your body responds to medication. Here’s a quick side-by-side breakdown to help guide your decision:
| Medication | Rybelsus® | Mounjaro® |
|---|---|---|
| Effectiveness | People lost about 5% of their body weight over 52 weeks. | People lost an average of 21% of body weight at 72 weeks. |
| Administration | A daily pill taken on an empty stomach with water, before eating or drinking anything else. | A once-weekly injection given in the stomach, thigh, or upper arm using a prefilled pen. |
| Pricing per month (without insurance) | List price of $998 | List price of $1,080 |
| Active ingredient | Semaglutide | Tirzepatide |
| FDA approval and uses | FDA-approved for type 2 diabetes; off-label for weight loss | Same. |
| Manufacturer | Novo Nordisk | Eli Lilly |
| More affordable alternative | Wegovy®: Through the NovoCare Pharmacy: $499 Learn more | Zepbound®: Pens: $1,087 Vials: $349 (2.5 mg); $499 (5 mg, 7.5 mg, 10 mg) Learn more |
| Insurance coverage | Might be covered for diabetes; unlikely for weight loss | Same. |
Alternatives to Mounjaro® and Rybelsus®
If Mounjaro® or Rybelsus® aren’t the right fit for you due to side effects, cost, insurance coverage, or personal preference, there are other medications that may help support your weight loss or blood sugar management goals. Here’s a look at some common alternatives:
| Medication | Brand names and uses | Cost per month (without insurance) | Effectiveness | How it’s taken |
|---|---|---|---|---|
| Semaglutide – GLP-1 receptor agonist – Same active ingredient as Rybelsus® | Ozempic®: type 2 diabetes, off-label weight loss Wegovy®: weight loss and heart disease | Ozempic®: $998 Learn more Wegovy®: $1,350 $499 (NovoCare Pharmacy) Learn more | People lost an average of 15% of body weight in 68 weeks with injectable semaglutide. | Weekly injection |
| Tirzepatide – GLP-1/GIP receptor agonist – Same active ingredients as Mounjaro® | Zepbound®: weight loss and obstructive sleep apnea (OSA) | Zepbound®: Pens: $1,087 Vials: $349 (2.5 mg) $499 (5 mg, 7.5 mg, 10 mg) Learn more | People lost an average of 21% of body weight at 72 weeks. | Weekly injection |
| Liraglutide – GLP-1 receptor agonist | Victoza®: type 2 diabetes, off-label weight loss Saxenda®: weight loss and heart disease Generic liraglutide: type 2 diabetes, off-label weight loss | Victoza®: $800 to $1,400 Saxenda®: $1,350 Learn more. Generic liraglutide: $470 – $700 | People lost an average of 5-6% of body weight in one year. | Daily injection |
Other medications
While GLP-1 medications are popular, they’re not your only option. Other treatments are available that work in their own way to support weight loss.
| Medication | Brand names | Cost per month (without insurance) | Effectiveness | How it’s taken |
|---|---|---|---|---|
| Metformin (off-label weight loss) | Glucophage®, Fortamet®, Glumetza® | Generic: $4–$15 Brand name: $100–$500+ Learn more. | People lost an average of about 6% of their body weight over six months while taking metformin. | Pill taken up to two times daily |
| Phentermine | Lomaira®, Adipex-P® | $27-$100 | About 80% of people with a BMI of 30 or more lost at least 5% of their body weight in 6 months. | Daily pill |
| Diethylpropion | Tenuate®, Tenuate Dospan® | $40-$85 | People lost an average of 10% of their body weight in 6 months. | Pill taken one to three times daily |
| Naltrexone and bupropion | Contrave® | $600-$800 CurAccess™: $99 | People lost an average of 7 to 8% of their body weight in a year. | Pill taken up to twice daily |
| Orlistat | Xenical®, Alli® | $50-$800 | People in a study lost about 10% of body weight after taking Orlistat for 1 year. | Pill taken three times daily with meals. |
Mounjaro® and Rybelsus®: Making informed choices
Both Mounjaro® and Rybelsus® can support weight loss when prescribed off-label, but each offers unique advantages depending on your needs. Mounjaro® tends to lead to greater weight loss, likely due to its dual-hormone action and injectable delivery. Rybelsus®, on the other hand, offers a needle-free option, though the results are generally more modest. If cost is a concern and you don’t have insurance coverage (which is common for both medications when used for weight loss), Zepbound® vials through LillyDirect may be a more affordable alternative to Mounjaro®.
The best choice ultimately depends on your health history, weight loss goals, and what fits best into your lifestyle. Whatever path you choose, combining medication with consistent habits—like balanced eating, movement, and support from programs like Noom—can help you get better, longer-lasting results. Always work closely with your healthcare provider to find a plan that’s right for you.
Note: Mounjaro®, Rybelsus®, Ozempic®, Victoza®, and metformin are not FDA-approved to treat obesity or for weight loss.
