Mounjaro Vs. Rybelsus: Drug Comparison

Mounjaro^® (tirzepatide) is an injectable medication used to treat type 2 diabetes by improving blood sugar control and promoting weight loss. It functions by activating two receptors, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which enhance insulin secretion and slow gastric emptying. Mounjaro is administered once weekly, with dose adjustments made based on the patient's response. Common side effects include nausea, diarrhea, and decreased appetite. It should be used with caution in individuals with a history of thyroid cancer or multiple endocrine neoplasia syndrome type 2​.

Rybelsus^® (semaglutide) is an oral medication used to improve blood sugar control in adults with type 2 diabetes. It is the first glucagon-like peptide-1 (GLP-1) receptor agonist available in tablet form. It stimulates insulin secretion, inhibits glucagon release, and slows gastric emptying to lower blood sugar levels. Rybelsus is taken once daily and can be used alone or in combination with other diabetes medications, along with diet and exercise. Common side effects include nausea, diarrhea, and abdominal pain, and it should be used cautiously in patients with a history of pancreatitis.

Glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist

Glucagon-like peptide-1 (GLP-1) receptor agonist

Mounjaro (tirzepatide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Rybelsus (semaglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

• Typically taken as an injection once weekly

• Comes in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg per 0.5 mL single-dose pens or single-dose vials

• Typically taken orally once daily

• Comes in 3 mg, 7 mg, and 14 mg tablets

The most common adverse reactions, reported in ≥5% of patients treated with Mounjaro are:

• Nausea

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Indigestion

• Abdominal pain

Most common adverse reactions (incidence ≥5%) are:

• Nausea

• Abdominal pain

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Known serious hypersensitivity to tirzepatide or any of the excipients in Mounjaro

• Drug interactions: Mounjaro delays gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Prior serious hypersensitivity reaction to semaglutide or any of the excipients in Rybelsus

• Drug interactions: oral medications—Rybelsus delays gastric emptying

• Pancreatitis

• Low blood sugar with concomitant use of insulin secretagogues or insulin

• Hypersensitivity reactions

• Acute kidney injury

• Severe gastrointestinal disease

• Diabetic retinopathy complications in patients with a history of diabetic retinopathy

• Acute gallbladder disease

• Pregnancy: Based on animal study, may cause fetal harm

• Females of reproductive potential: Females using oral contraceptives should consider switching to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation

• Pancreatitis

• Diabetic retinopathy complications

• Low blood sugar: Concomitant use with an insulin secretagogue or insulin may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Acute gallbladder disease

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended

• Females and males of reproductive potential: Discontinue Rybelsus in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide

WARNING: RISK OF THYROID C-CELL TUMORS

Tirzepatide causes thyroid C-cell tumors in rats. It is unknown whether Mounjaro causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of tirzepatide-induced rodent thyroid C-cell tumors has not been determined.

Mounjaro is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors. It is unknown whether Rybelsus causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Rybelsus is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Mounjaro. See the Full Prescribing Information for more complete information. Tirzepatide, the active ingredient in Mounjaro, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient tirzepatide.

*This information is from the label for brand name Rybelsus^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Rybelsus, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.