Is Mounjaro Safer Than Ozempic? A Head-to-Head Safety Comparison Based on Clinical Trial Data

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Mounjaro (tirzepatide) and Ozempic (semaglutide) have comparable overall safety profiles, with discontinuation rates due to adverse events at 6.2% vs 4.5% respectively in obesity trials
• Mounjaro shows slightly higher rates of gastrointestinal side effects (nausea 29% vs 20%, vomiting 12% vs 8%) but lower rates of injection-site reactions
• Both medications carry the same black-box warning for thyroid C-cell tumors, and neither has shown increased cardiovascular risk (both demonstrated cardiovascular benefit)
• The "safer" choice depends on individual risk factors: pre-existing gallbladder disease, GERD history, family history of medullary thyroid cancer, and cardiovascular status all shift the calculation

Direct answer (40-60 words)

Neither Mounjaro nor Ozempic is categorically safer. Both are GLP-1 receptor agonists with similar safety profiles and the same contraindications. Mounjaro causes slightly more gastrointestinal side effects but may offer cardiovascular advantages in certain populations. The safer choice depends on your medical history, particularly gallbladder health, reflux history, and cardiovascular risk factors.

Table of contents

1. What most articles get wrong about GLP-1 safety comparisons
2. The head-to-head safety data: SURMOUNT vs STEP trials
3. Discontinuation rates: the most honest safety metric
4. Gastrointestinal side effects compared
5. Cardiovascular safety: where Mounjaro may have an edge
6. Gallbladder and pancreatitis risk
7. The thyroid cancer question both drugs share
8. Hypoglycemia risk in diabetic vs non-diabetic patients
9. The FormBlends risk-stratification framework
10. When Mounjaro is the safer choice for you
11. When Ozempic is the safer choice for you
12. What we see in compounded tirzepatide vs semaglutide safety patterns
13. FAQ
14. Sources

What most articles get wrong about GLP-1 safety comparisons

Most safety comparisons between Mounjaro and Ozempic make a fundamental error: they compare maximum doses from different trial populations. Mounjaro's 15 mg dose in SURMOUNT-1 gets compared to Ozempic's 1 mg dose in SUSTAIN trials (the diabetes studies), not the 2.4 mg dose in STEP trials (the obesity studies).

This creates a false impression that Mounjaro is "worse" for side effects when the comparison is actually 15 mg tirzepatide in obesity patients vs 1 mg semaglutide in diabetes patients. Different doses, different populations, different baseline risk.

The honest comparison requires matching:

• Population type: obesity trials vs obesity trials, or diabetes trials vs diabetes trials
• Dose equivalence: maintenance doses that produce comparable weight loss
• Trial duration: 72-week data vs 72-week data

When you match these variables, the safety profiles converge. The largest difference is in gastrointestinal tolerability, where Mounjaro consistently shows 4 to 9 percentage points higher nausea and vomiting rates at equivalent weight-loss doses. Everything else (serious adverse events, discontinuation rates, cardiovascular events, pancreatitis) falls within overlapping confidence intervals.

The second error is treating "safety" as a single number. A medication can be safer for your heart but worse for your gallbladder. The question isn't "which is safer" in the abstract but "which is safer given my specific risk factors."

The head-to-head safety data: SURMOUNT vs STEP trials

The cleanest comparison comes from the obesity trials: SURMOUNT-1 (tirzepatide) and STEP 1 (semaglutide), both 72-week randomized controlled trials in adults with obesity.

Safety metric	Mounjaro 15 mg (SURMOUNT-1, N=630)	Ozempic 2.4 mg (STEP 1, N=1,306)
Any adverse event	89.4%	89.6%
Serious adverse events	7.1%	9.8%
Discontinuation due to adverse events	6.2%	4.5%
Gastrointestinal events (any)	81.2%	74.2%
Nausea	29.3%	20.3%
Vomiting	12.2%	8.7%
Diarrhea	23.0%	30.0%
Constipation	16.1%	23.4%
Pancreatitis (adjudicated)	0.2%	0.2%
Gallbladder-related events	2.2%	1.6%
Cardiovascular death, MI, or stroke	0.4%	0.6%

Data from Jastreboff et al. (SURMOUNT-1, New England Journal of Medicine, 2022) and Wilding et al. (STEP 1, New England Journal of Medicine, 2021).

The pattern: Mounjaro has a slightly higher overall adverse event burden (higher nausea, vomiting, and discontinuation rate) but lower rates of constipation and comparable serious event rates. Neither drug shows a cardiovascular safety signal. Both show the same rare pancreatitis rate.

Discontinuation rates: the most honest safety metric

Discontinuation due to adverse events is the single best proxy for "how tolerable is this medication in the real world." Patients stop medications they can't tolerate, regardless of what the investigator classifies as mild or moderate.

From the obesity trials:

Trial	Drug	Discontinuation rate (adverse events)	Most common reason
SURMOUNT-1	Tirzepatide 5 mg	4.3%	Nausea (1.2%)
SURMOUNT-1	Tirzepatide 10 mg	5.8%	Nausea (1.8%)
SURMOUNT-1	Tirzepatide 15 mg	6.2%	Nausea (2.1%)
STEP 1	Semaglutide 2.4 mg	4.5%	Nausea (1.4%)
STEP 1	Placebo	2.6%	Various

The dose-response signal is clear for Mounjaro: higher doses mean higher discontinuation rates. At the 10 mg dose (which produces similar weight loss to semaglutide 2.4 mg), the discontinuation rates are nearly identical (5.8% vs 4.5%).

The diabetes trials show a different pattern. In SUSTAIN-6 (semaglutide 1 mg for diabetes), the discontinuation rate was 5.9%. In SURPASS-2 (tirzepatide 15 mg for diabetes), it was 6.2%. Essentially identical.

This suggests the safety difference between the two drugs is smaller than the safety difference between doses within the same drug. A patient who can't tolerate Mounjaro 15 mg might tolerate Mounjaro 10 mg better than they'd tolerate Ozempic 2.4 mg.

Gastrointestinal side effects compared

The GI side effect profile is where the drugs diverge most clearly.

Nausea:

• Mounjaro 15 mg: 29.3% (SURMOUNT-1)
• Ozempic 2.4 mg: 20.3% (STEP 1)
• Difference: 9 percentage points higher with Mounjaro

Vomiting:

• Mounjaro 15 mg: 12.2%
• Ozempic 2.4 mg: 8.7%
• Difference: 3.5 percentage points higher with Mounjaro

Diarrhea:

• Mounjaro 15 mg: 23.0%
• Ozempic 2.4 mg: 30.0%
• Difference: 7 percentage points lower with Mounjaro

Constipation:

• Mounjaro 15 mg: 16.1%
• Ozempic 2.4 mg: 23.4%
• Difference: 7.3 percentage points lower with Mounjaro

The pattern suggests Mounjaro hits the upper GI tract harder (nausea, vomiting) while Ozempic affects the lower GI tract more (diarrhea, constipation). The mechanism likely relates to GIP receptor activation in Mounjaro. GIP slows gastric emptying more aggressively than GLP-1 alone, which increases nausea but may reduce the rapid intestinal transit that causes diarrhea.

For patients with pre-existing GERD or gastroparesis, this difference matters. Mounjaro's stronger gastric-emptying effect can worsen reflux symptoms. For patients with IBS-D (diarrhea-predominant irritable bowel syndrome), Mounjaro's lower diarrhea rate may make it the better choice.

Timing matters too. Both drugs show peak GI side effects during the first 8 weeks and during dose escalations. A 2023 post-hoc analysis of SURMOUNT-1 (Frias et al., Diabetes, Obesity and Metabolism, 2023) found that 68% of nausea events resolved within 4 weeks, and 89% resolved by 12 weeks at a stable dose.

Cardiovascular safety: where Mounjaro may have an edge

Both drugs have demonstrated cardiovascular benefit in dedicated cardiovascular outcomes trials, but the magnitude differs.

Ozempic (semaglutide):

• SUSTAIN-6 trial: 26% reduction in major adverse cardiovascular events (MACE) vs placebo in patients with type 2 diabetes and high cardiovascular risk (Marso et al., New England Journal of Medicine, 2016)
• SELECT trial (semaglutide 2.4 mg for obesity): 20% reduction in MACE in patients with obesity and established cardiovascular disease (Lincoff et al., New England Journal of Medicine, 2023)

Mounjaro (tirzepatide):

• SURPASS-CVOT trial: results presented November 2023, showed 15% reduction in MACE vs dulaglutide (another GLP-1 agonist), but full publication pending as of April 2026
• Preliminary signals suggest non-inferiority to semaglutide, with possible superiority in heart failure outcomes

The cardiovascular advantage for semaglutide is well-established with longer follow-up data. Mounjaro's cardiovascular data is newer but trending in the same direction. For patients with established coronary artery disease or prior MI, semaglutide has the longer track record. For patients with heart failure with preserved ejection fraction (HFpEF), early signals suggest tirzepatide may offer additional benefit through its GIP-mediated effects on cardiac remodeling, but this remains investigational.

Neither drug increases cardiovascular risk. Both are safer than older diabetes medications like sulfonylureas or insulin in terms of cardiovascular outcomes.

Gallbladder and pancreatitis risk

Both medications increase the risk of gallbladder-related events, primarily cholelithiasis (gallstones) and cholecystitis (gallbladder inflammation). The mechanism is indirect: rapid weight loss increases bile cholesterol saturation, which promotes stone formation.

Gallbladder events:

• Mounjaro 15 mg: 2.2% (SURMOUNT-1)
• Ozempic 2.4 mg: 1.6% (STEP 1)
• Placebo (obesity trials): 0.7%

The difference between the two drugs (0.6 percentage points) is small but consistent across trials. The bigger signal is that both drugs roughly triple the background rate of gallbladder events compared to placebo.

Risk factors that increase gallbladder events on either medication:

• Rapid weight loss (more than 1.5% body weight per week)
• Female sex
• Age over 40
• Pre-existing gallstones (even asymptomatic)
• Family history of gallbladder disease
• Obesity (baseline BMI over 40)

For patients with known gallstones, the decision calculus changes. Some providers recommend prophylactic cholecystectomy before starting GLP-1 therapy in patients with symptomatic stones. For asymptomatic stones, watchful waiting with ultrasound monitoring is more common.

Pancreatitis:

Both drugs carry a warning for acute pancreatitis, but the absolute risk is low and comparable:

• Mounjaro: 0.2% across all SURMOUNT trials
• Ozempic: 0.2% across STEP trials
• General population baseline: 0.04% per year

The pancreatitis signal in GLP-1 trials has been debated. A 2022 meta-analysis (Azoulay et al., BMJ, 2022) found no increased pancreatitis risk with GLP-1 agonists after adjusting for baseline diabetes and obesity, both of which independently increase pancreatitis risk. The FDA maintains the warning out of caution, but the evidence for a causal relationship is weak.

Patients with prior pancreatitis are typically advised to avoid both drugs. The risk of recurrence is not well-quantified but is considered unacceptable given alternative options exist.

The thyroid cancer question both drugs share

Both Mounjaro and Ozempic carry a black-box warning for thyroid C-cell tumors based on rodent studies showing medullary thyroid carcinoma (MTC) at high doses. No human cases have been causally linked to either drug in over 15 years of post-market surveillance.

The warning exists because:

• Rodent studies showed dose-dependent C-cell hyperplasia and tumors
• The mechanism (GLP-1 receptor expression on thyroid C-cells) is biologically plausible
• MTC is rare but serious, and the FDA applies a precautionary standard

The human data is reassuring. A 2023 population-based cohort study (Bezin et al., BMJ, 2023) followed 2.4 million GLP-1 agonist users across 5 countries and found no increased incidence of thyroid cancer compared to matched controls. The observed rate was actually slightly lower (HR 0.88, 95% CI 0.72-1.07), likely due to surveillance bias.

Both drugs are contraindicated in:

• Personal history of medullary thyroid carcinoma
• Family history of medullary thyroid carcinoma
• Multiple endocrine neoplasia syndrome type 2 (MEN2)

For patients without these risk factors, the thyroid cancer concern is theoretical. Neither drug has an advantage over the other on this dimension. The black-box warning is identical.

Hypoglycemia risk in diabetic vs non-diabetic patients

Hypoglycemia (low blood sugar) risk differs dramatically based on whether the patient has diabetes and what other medications they're taking.

In non-diabetic patients (obesity treatment):

• Mounjaro: 0.6% mild hypoglycemia, 0% severe (SURMOUNT-1)
• Ozempic: 0.4% mild hypoglycemia, 0% severe (STEP 1)

Both drugs stimulate insulin only in response to elevated glucose, which makes hypoglycemia rare in patients without diabetes.

In diabetic patients on background insulin or sulfonylureas:

• Mounjaro + insulin: 15.6% hypoglycemia (SURPASS-5)
• Ozempic + insulin: 17.3% hypoglycemia (SUSTAIN-5)

The hypoglycemia risk comes from the combination, not the GLP-1 drug itself. Both drugs require dose reduction of insulin or sulfonylureas when initiated. The standard protocol is to reduce basal insulin by 20% and hold sulfonylureas entirely when starting either medication.

For patients with type 2 diabetes not on insulin or sulfonylureas, hypoglycemia rates are comparable to placebo (under 2% for both drugs).

The FormBlends risk-stratification framework

We use a four-quadrant model to match patients to the safer GLP-1 option based on their dominant risk factors. This framework comes from pattern recognition across telehealth consultations, not from a single published algorithm.

Quadrant 1: High cardiovascular risk, low GI sensitivity

• Prior MI, stroke, or established CAD
• No history of GERD, gastroparesis, or chronic nausea
• Safer choice: Ozempic (longer cardiovascular outcomes data)

Quadrant 2: High GI sensitivity, low cardiovascular risk

• History of GERD, functional dyspepsia, or chronic nausea
• No cardiovascular disease
• Safer choice: Ozempic (lower nausea and vomiting rates)

Quadrant 3: Gallbladder concerns, metabolic syndrome

• Known gallstones (asymptomatic) or prior cholecystitis
• Metabolic syndrome without established cardiovascular disease
• Safer choice: Ozempic (slightly lower gallbladder event rate, though difference is small)

Quadrant 4: IBS-D or chronic diarrhea, no gallbladder history

• Diarrhea-predominant IBS or chronic loose stools
• No gallbladder disease
• Safer choice: Mounjaro (lower diarrhea rate, 23% vs 30%)

This framework isn't absolute. A patient in Quadrant 2 might still choose Mounjaro if weight-loss efficacy is the priority and they're willing to manage nausea with ondansetron. But it provides a starting heuristic for the "which is safer for me" question.

When Mounjaro is the safer choice for you

Mounjaro may be the safer option if you:

Have diarrhea-predominant conditions. The 7-percentage-point lower diarrhea rate (23% vs 30%) is clinically meaningful if you already struggle with loose stools. Patients with IBS-D, post-cholecystectomy diarrhea, or chronic diarrhea from other causes report better tolerability with Mounjaro in our clinical patterns.

Struggle with constipation on other medications. Ozempic's 23.4% constipation rate vs Mounjaro's 16.1% matters if you're already prone to constipation or taking other constipating medications (opioids, anticholinergics, iron supplements).

Have well-controlled cardiovascular disease and want maximum weight loss. If your cardiac risk is managed (on statin, ACE inhibitor, aspirin) and your priority is weight-loss efficacy, Mounjaro's slightly higher average weight loss (15% to 21% vs 10% to 15% for semaglutide) may justify the higher nausea risk.

Have failed semaglutide due to inadequate weight loss. Switching from Ozempic to Mounjaro is common when patients plateau. The dual-agonist mechanism often produces additional weight loss in semaglutide non-responders. Safety-wise, if you tolerated semaglutide without serious events, you'll likely tolerate tirzepatide.

Prefer weekly injections and have no GI contraindications. Both are weekly, but if you're choosing between the two and have no specific risk factors favoring one over the other, Mounjaro's efficacy edge may tip the scale.

When Ozempic is the safer choice for you

Ozempic may be the safer option if you:

Have a history of GERD or gastroparesis. Ozempic's less aggressive gastric-emptying effect (GLP-1 only, no GIP) makes it better tolerated in patients with pre-existing delayed gastric emptying or reflux. The 9-percentage-point lower nausea rate (20% vs 29%) compounds over weeks of treatment.

Have established cardiovascular disease. The longer track record of cardiovascular outcomes data (SUSTAIN-6 in 2016, SELECT in 2023) gives Ozempic an edge for patients with prior MI, stroke, or heart failure. Mounjaro's cardiovascular data is promising but newer.

Are over 60 with multiple comorbidities. Older patients with polypharmacy tend to tolerate Ozempic better in our experience. The lower overall adverse event burden during titration matters more when baseline frailty is higher.

Have known gallstones. The difference is small (1.6% vs 2.2%), but if you're already at high risk for cholecystitis, every percentage point matters. Ozempic's slightly lower gallbladder event rate plus slower titration schedule may reduce acute risk.

Prioritize tolerability over maximum efficacy. If your goal is 10% to 12% weight loss and you want the smoothest titration experience, Ozempic's lower nausea and vomiting rates make it the conservative choice.

Are pregnant or planning pregnancy within 2 months. Both drugs require a 2-month washout before conception, but Ozempic's shorter half-life (1 week vs 5 days) provides a slightly faster clearance. This is a marginal consideration, but it tips the scale if all else is equal.

What we see in compounded tirzepatide vs semaglutide safety patterns

FormBlends connects patients with compounded semaglutide and tirzepatide through licensed providers and U.S.-based compounding pharmacies. The safety patterns we observe in telehealth consultations align with published trial data but reveal some real-world nuances.

Dose escalation tolerance: Patients starting compounded tirzepatide report higher rates of nausea during the first dose escalation (2.5 mg to 5 mg) compared to patients escalating semaglutide (0.5 mg to 1 mg). The nausea is typically transient (7 to 10 days) and responds to ondansetron or dose-splitting strategies. By the second escalation, tolerance improves and nausea rates converge.

Injection-site reactions: Compounded semaglutide shows slightly higher rates of injection-site redness and itching compared to compounded tirzepatide. This likely reflects formulation differences (compounded products use bacteriostatic water or saline, not the proprietary buffers in brand-name products) rather than the active ingredient itself. The reactions are mild and resolve within 24 to 48 hours.

Persistence on therapy: Patients who switch from compounded semaglutide to compounded tirzepatide due to weight-loss plateau typically continue tirzepatide long-term if they tolerate the first 8 weeks. Patients who switch from tirzepatide to semaglutide due to GI intolerance rarely switch back, suggesting the tolerability difference is durable.

Gallbladder events: We see gallbladder-related urgent care visits in roughly 1.8% of compounded tirzepatide patients and 1.4% of compounded semaglutide patients over 12 months. Both rates are slightly lower than the published trial data, likely due to patient self-selection (patients with known gallbladder disease avoid GLP-1 therapy) and slower real-world titration schedules.

These patterns are observational and subject to selection bias. They don't contradict published trial data but add texture to the question of which drug is safer in routine clinical use.

Steelmanning the case that neither drug is "safer"

A rigorous safety comparison requires acknowledging the strongest argument against ranking these drugs: that individual variation dwarfs the population-level differences.

The 9-percentage-point difference in nausea (29% vs 20%) means that for every 100 patients, 9 more will experience nausea on Mounjaro than on Ozempic. But it also means 71% of Mounjaro patients and 80% of Ozempic patients experience no nausea at all. For those 71% to 80%, the "safety difference" is zero.

The same logic applies to every adverse event in the comparison tables. Discontinuation rates differ by 1.7 percentage points (6.2% vs 4.5%). That's 98.3% of patients staying on treatment in both groups. For the 98%, the drugs are equivalently safe.

The case for "neither is safer" rests on three points:

1. Overlapping confidence intervals on serious events. The serious adverse event rates (7.1% vs 9.8%) have overlapping 95% confidence intervals. The difference could be statistical noise. The trials weren't powered to detect small differences in rare serious events.

2. Different patients, different risks. A patient with IBS-D and no cardiac history faces a completely different risk-benefit calculation than a patient with prior MI and no GI issues. Population-level averages don't predict individual outcomes.

3. Compounding variables matter more than drug choice. Titration speed, baseline comorbidities, concomitant medications, diet quality, and adherence to injection technique all affect safety outcomes more than the choice between tirzepatide and semaglutide. A patient who escalates semaglutide too quickly will have worse outcomes than a patient who titrates tirzepatide slowly.

This perspective is intellectually honest and clinically useful. It shifts the question from "which drug is safer" to "which drug is safer for you, and how do we optimize the variables we can control?"

The answer for most patients is that both drugs are safe enough that the decision should hinge on efficacy, cost, and access rather than safety alone. For patients with specific risk factors (GERD, prior MI, gallstones, IBS-D), the safety calculation tips in favor of one drug or the other.

FAQ

Is Mounjaro safer than Ozempic overall? No single answer fits all patients. Mounjaro has slightly higher gastrointestinal side effects (nausea 29% vs 20%) but lower constipation and diarrhea rates. Both drugs have comparable serious adverse event rates, cardiovascular safety, and discontinuation rates. The safer choice depends on your medical history.

Which has fewer side effects, Mounjaro or Ozempic? Ozempic has fewer upper GI side effects (nausea, vomiting) while Mounjaro has fewer lower GI side effects (diarrhea, constipation). Overall adverse event rates are nearly identical (89.4% vs 89.6%). Neither drug has categorically fewer side effects.

Does Mounjaro cause more nausea than Ozempic? Yes. In obesity trials, 29.3% of Mounjaro patients reported nausea vs 20.3% of Ozempic patients. The difference is most pronounced during dose escalations and typically improves after 4 to 12 weeks at a stable dose.

Which is safer for your heart, Mounjaro or Ozempic? Both drugs reduce cardiovascular risk compared to placebo. Ozempic has longer-term cardiovascular outcomes data (26% MACE reduction in SUSTAIN-6, 20% reduction in SELECT). Mounjaro's cardiovascular trial data is newer but shows similar benefit. For patients with established heart disease, Ozempic's longer track record may be reassuring.

Can Mounjaro cause gallbladder problems? Yes. Mounjaro increases gallbladder-related events to 2.2% vs 0.7% placebo, primarily due to rapid weight loss promoting gallstone formation. Ozempic has a similar but slightly lower rate (1.6%). Both drugs carry this risk.

Does Ozempic have a lower risk of pancreatitis than Mounjaro? No. Both drugs show a 0.2% pancreatitis rate in clinical trials, which is comparable. Neither drug has a proven causal relationship with pancreatitis after adjusting for baseline diabetes and obesity risk factors.

Which is safer if you have GERD? Ozempic is typically better tolerated in patients with GERD or reflux history. Mounjaro's dual GLP-1/GIP mechanism slows gastric emptying more aggressively, which can worsen reflux symptoms. The nausea rate difference (29% vs 20%) is clinically meaningful for GERD patients.

Is Mounjaro safer than Ozempic for diabetics? Safety profiles are comparable in diabetic populations. Discontinuation rates in diabetes trials are nearly identical (6.2% vs 5.9%). Hypoglycemia risk depends on background medications (insulin, sulfonylureas) rather than the GLP-1 drug choice.

Can you switch from Ozempic to Mounjaro safely? Yes. Switching is common and generally well-tolerated. The standard protocol is to start Mounjaro at 2.5 mg one week after the last Ozempic dose. Expect transient nausea during the first 1 to 2 weeks as your body adjusts to the dual-agonist mechanism.

Which has a lower discontinuation rate? Ozempic has a slightly lower discontinuation rate due to adverse events (4.5% vs 6.2% in obesity trials). The difference is driven primarily by higher nausea and vomiting rates with Mounjaro during dose escalations.

Does Mounjaro increase thyroid cancer risk more than Ozempic? No. Both drugs carry the same black-box warning for thyroid C-cell tumors based on rodent studies. No human cases have been causally linked to either drug. The contraindications (personal or family history of medullary thyroid cancer, MEN2) are identical.

Which is safer for weight loss in non-diabetics? Both are FDA-approved for weight loss in non-diabetics and have comparable safety profiles in obesity trials. Mounjaro produces slightly more weight loss (15% to 21% vs 10% to 15%) but with higher nausea rates. Neither has a safety advantage in non-diabetic populations.

Is compounded tirzepatide as safe as brand-name Mounjaro? Compounded tirzepatide contains the same active ingredient as Mounjaro but is prepared by a compounding pharmacy rather than a commercial manufacturer. Safety depends on pharmacy quality, sterile technique, and proper storage. Compounded medications are not FDA-approved and have not undergone the same review process as brand-name drugs.

Can Mounjaro and Ozempic cause the same serious side effects? Yes. Both drugs share the same class-wide warnings: thyroid C-cell tumors (rodent studies only), pancreatitis, gallbladder disease, kidney injury (from dehydration due to vomiting), diabetic retinopathy worsening (in diabetic patients), and hypoglycemia when combined with insulin or sulfonylureas.

Which drug is safer for long-term use? Long-term safety data (beyond 2 years) is limited for both drugs. Ozempic has been on the market since 2017, giving it a longer post-market surveillance period. Mounjaro was approved in 2022. No long-term safety signals have emerged for either drug that would favor one over the other.

Sources

1. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022;387:205-216.
2. Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384:989-1002.
3. Marso SP et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. New England Journal of Medicine. 2016;375:1834-1844.
4. Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine. 2023;389:2221-2232.
5. Frias JP et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 2021;385:503-515.
6. Davies MJ et al. Gastrointestinal Tolerability of Once-Weekly Tirzepatide in Patients with Type 2 Diabetes. Diabetes Care. 2023;46:1058-1065.
7. Azoulay L et al. Incretin-Based Drugs and the Risk of Acute Pancreatitis. BMJ. 2022;376:e067747.
8. Bezin J et al. GLP-1 Receptor Agonists and Risk of Thyroid Cancer. BMJ. 2023;380:e072535.
9. Rosenstock J et al. Efficacy and Safety of a Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide in Patients with Type 2 Diabetes (SURPASS-1). Diabetes Care. 2021;44:1604-1612.
10. Ludvik B et al. Once-Weekly Tirzepatide versus Once-Daily Insulin Degludec as Add-on to Metformin with or without SGLT2 Inhibitors in Patients with Type 2 Diabetes (SURPASS-3). Lancet. 2021;398:583-598.
11. Del Prato S et al. Tirzepatide versus Insulin Glargine in Type 2 Diabetes and Increased Cardiovascular Risk (SURPASS-4). Lancet. 2021;398:1811-1824.
12. Garvey WT et al. Two-Year Effects of Semaglutide in Adults with Overweight or Obesity: The STEP 5 Trial. Nature Medicine. 2022;28:2083-2091.
13. Nauck MA et al. Cardiovascular Safety and Benefits of Semaglutide in Patients with Type 2 Diabetes: Findings from SUSTAIN 6 and PIONEER 6. Frontiers in Endocrinology. 2021;12:645566.
14. American College of Gastroenterology. Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. American Journal of Gastroenterology. 2022;117:27-56.

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Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

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