Mounjaro Vs Saxenda (Tirzepatide Vs Liraglutide)

Mounjaro Vs Saxenda is a basic comparison of the two highly potent diabetes and weight loss drugs.

Mounjaro is a novel drug and innovation in the field of Diabetes Mellitus. It is FDA licensed drug containing dual GIP (glucose-dependent insulinotropic peptide) as well as GLP-1 analog (Glucagon-like peptide), known as Tirzepatide.

It was seen that GIP alone does not have a significant benefit on glycemic control. However, when used in combination with GLP-1 analog, a marvelous synergistic effect was seen, and much better glycemic control was observed.

Hence the name ‘Twincretin’ was used for this combination. Twincretin, as the name suggests, is a combination of two incretins, GLP-1 and GIP.

Whereas Saxenda contains Liraglutide, a GLP-1 analog. It has been approved by the FDA primarily for the treatment of obesity, weight loss, and dyslipidemia.

Saxenda is basically a high-dose Liraglutide while Victoza is a low-dose Liraglutide. Victoza is approved for the treatment of Diabetes only.

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Mounjaro Vs Saxenda

Saxenda and Mounjaro are two potent diabetes and weight loss drugs. These drugs have not been compared in a head-to-head comparative trial.

Following are some of the similarities and differences between the two drugs:

Saxenda	Mounjaro
Trade Name: SAXENDA	Trade name: MOUNJARO
Manufacturer: NovoNordisk	Manufacturer: Eli Lilly
Uses: To lower body weight if BMI is more than 30 or more than 27 if associated with at least one weight-related risk factor such as: diabetes, hypertension, deranged lipid profile or Ischemic heart disease	Uses: It is used in controlling type 2 diabetes mellitus in conjunction with diet and exercise. Tirzepatide has also been approved for weight loss.
Ingredient: Liraglutide	Ingredient: Tirzepatide
Indication: It is indicated for the treatment of obesity in patients with or without diabetes. It is indicated if the BMI is above 30 or more than 27 with at least one weight-associated medical condition.	Indication: It has been indicated for the control of diabetes with or without other anti-diabetic agents along with dietary control and lifestyle modifications. Currently, it is not approved as a weight loss drug.
Frequency of administration: Once a day It is available in injection form, at 6 mg/mL, and delivers the following doses: 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg or 3 mg.	Frequency of administration: Once a week. It is available as a single-dose pen containing the following doses: 2.5 mg/0.5 mL, 5 mg/0.5 mL, 7.5 mg/0.5 mL, 10 mg/0.5 mL, 12.5 mg/0.5 mL, or 15 mg/0.5 mL
Injection method: subcutaneous	Injection method: subcutaneous

Saxenda is administered as a subcutaneous injection daily while Mounjaro is administered once a week.

The dosing schedule of Saxenda is as follows:

Week 1:
- 0.6 mg once daily
Week 2:
- 1.2 mg once daily
Week 3:
- 1.8 mg once daily
Week 4:
- 2.4 mg once daily
Week 5:
- 3 mg once daily

The dosing schedule of Mounjaro is as follows:

1 – 4 weeks:
- 2.5 mg once weekly
5 – 8 weeks:
- 5 mg once weekly
9 – 12 weeks:
- 7.5 mg once weekly
13 – 16 weeks:
- 10 mg once weekly
17 – 20 weeks:
- 12.5 mg once weekly
21 – 24 weeks:
- 15 mg once weekly

The maximum dose of Saxenda is 3 mg once daily while the maximum dose of Mounjaro is 15 mg once a week.

Efficacy of Mounjaro Vs Saxenda for Diabetes and Weight Loss:

The current FDA approval of Saxenda is primarily for weight loss while that of Mounjaro is for the treatment of Type 2 Diabetes Mellitus.

The A1C reduction and Weight loss effects of Saxenda Vs Mounjaro are summarized in the table below:

Mounjaro Vs Saxenda: Effect on A1C and Weight
Efficacy	Saxenda	Mounjaro
Hba1C reduction	Saxenda is not approved for diabetes. However, Liraglutide in a dose of 1.8 mg daily lowered the A1C by 1.1%.	At 40 weeks Mounjaro has shown a 2% reduction in HBA1c as compared to the placebo. The A1C lowering effect at different doses is: 5 mg: 2.01 10 mg: 2.24 15 mg: 2.3%
Weight loss	Saxenda reduces body weight by 7 kg. The percentage weight loss with Saxenda is estimated to be around 8 – 11%	Mounjaro is associated with about 21% weight loss at maximum doses. Its weight loss effect at different doses is: 5 mg:7.6 kg 10 mg:9.3 kg 15 mg: 11.2 kg

Mounjaro (Tirzepatide) is more effective in lowering HbA1C. It’s almost twice as effective as Saxenda (Liraglutide).

Similarly, Mounjaro is associated with greater weight loss compared to Saxenda. Although Mounjaro’s FDA approval as a weight loss drug is still pending, it is twice as effective in reducing body weight compared to Saxenda.

Mounjaro (Tirzepatide) is also more effective than Ozempic and Wegovy as a weight loss drug (21% weight loss vs 16% with Ozempic and Wegovy).

Safety of Mounjaro Vs Saxenda:

Both Saxenda and Mounjaro are incretins, GLP-1 analogs. However, Mounjaro is a “Twincretin”. It is a dual GLP-1 and GIP analog.

The side effects of both Mounjaro and Saxenda are comparable:

Mounjaro Vs Saxenda: Side effects
Saxenda	Mounjaro
Common side effects: Nausea, vomiting, and epigastric discomfort Diarrhea Constipation Tachycardia Lethargy Headaches	Common side effects: Nausea and vomiting Diarrhea Constipation Weakness Headaches Anorexia Palpitations and tachycardia
Serious side effects: Jaundice (yellowing of eyes and skin) Refractory nausea and vomiting Ankle swelling Low blood sugars especially if used with sulfonylureas Extreme lethargy, confusion, and severe malaise Pain during micturition (passing urine) Thyroid Cancer Pancreatitis	Serious side effects: Pancreatitis Thyroid malignancy Hypoglycemia if combined with insulin or sulfonylureas Renal injury Severe epigastric pain Allergic reactions Inflammation of gall bladder

Mounjaro Vs Saxenda Drug Interactions:

Certain drugs when combined with Saxenda and Mounjaro may result in a loss of the blood glucose-lowering effects of these drugs. These include corticosteroids, thiazides, and beta-agonists.

Other drugs such as insulin and sulfonylurea may result in hypoglycemia when given in combination with Saxenda and Mounjaro.

Drug Interactions

Both of these are associated with severe drug reactions when used along with one of the fluoroquinolones called Gatifloxacin.

And another drug that is used to treat skin malignancies called Bexarotene

Less Severe Drug Interactions

Hypoglycemia:

Patients having diabetes mellitus using another type of insulin or oral medications like sulfonylureas can develop severe hypoglycemia

Diuretics:

Diuretics, especially hydrochlorothiazide and bumetanide can cause dehydration and renal injury.

Oral, IV, and Topical steroids:

Steroids cause weight gain and impair diabetes control.
Topical steroids which are used in acne-like mometasone can have moderate adverse reactions with both Saxenda and Mounjaro

Long-acting beta-agonists like Salmeterol which are used in asthma

Estrogen-containing drugs like Combined oral contraceptive pills have severe adverse reactions when combined with the use of Saxenda

Antivirals like Indinavir, Atazanavir, and Ritonavir cause severe interactions with Mounjaro.

Antibiotics including clarithromycin and atypical antipsychotics like clozapine

Saxenda and Mounjaro: Who should not take these drugs:

There are certain conditions where both these drugs may do more harm than help you. If you have any of the following conditions, seek medical advice and avoid Saxenda and Mounjaro:

Warnings:
Saxenda	Mounjaro
Saxenda should not be used if one of the following is present: You are allergic to the active component of liraglutide Have MEN-2 syndrome Have DKA Are under 18 years of age Have a family history of thyroid cancers especially medullary thyroid cancers	Mounjaro should not be used if any of the following is present: You are allergic to Tirzepatide Have a history of renal disease Have a history of diabetic retinopathy are planning to conceive are planning to lactate or lactating are having severe stomach problems.

There are other medical conditions where both Saxenda and Mounjaro may not be contraindicated but you should tell your healthcare provider and be cautious about these conditions.

Seek medical advice if you have any of the following conditions:

Seek medical advice:
Saxenda	Mounjaro
Medical advice should be sought before using Saxenda if: Have a chronic renal failure Have liver disease Have ischemic heart disease Have a deranged lipid profile About to conceive or pregnant You are breastfeeding or are planning to breastfeed Have had pancreatitis	Medical advice should be sought before using Mounjaro if: Have pancreatic problems Are about to conceive Are breastfeeding or about to start Have a history of diabetic retinopathy have a personal or a family history of MTC (Medullary thyroid cancer) or MEN syndrome.