Ozempic vs. Wegovy vs. Mounjaro vs. Rybelsus
A complete side-by-side comparison of all major GLP-1 weight loss medications available in Canada - efficacy, cost, dosing, and coverage.
Medication Profiles
Ozempic
semaglutide · Novo Nordisk
- ✓Most commonly prescribed GLP-1 in Canada
- ✓Widely prescribed off-label for weight management
- ✓Weekly auto-inject pen
- ✓Generic versions now approved (2025)
- ✓Covered by most provincial plans for T2D
Wegovy
semaglutide 2.4 mg · Novo Nordisk
- ✓Specifically approved for weight management (BMI ≥30 or ≥27 + comorbidity)
- ✓Higher dose than Ozempic - greater weight loss
- ✓16–20 week titration to maintenance dose
- ✓Home delivery at no extra cost via Care Rx
- ✓Not covered provincially for weight management alone
Mounjaro
tirzepatide · Eli Lilly
- ✓Dual GIP + GLP-1 receptor agonist (unique mechanism)
- ✓Greatest average weight loss of any approved GLP-1
- ✓~47% of patients lose ≥20% body weight (SURMOUNT-1, 15 mg)
- ✓Not yet separately approved for weight management in Canada
- ✓Highest price of the class; no generics yet
Rybelsus
oral semaglutide · Novo Nordisk
- ✓World's first approved oral GLP-1 receptor agonist
- ✓No needles - daily tablet
- ✓Must be taken fasted, with ≤120 mL plain water, 30 min before eating
- ✓Less weight loss than injectable at approved doses
- ✓Higher-dose versions (25–50 mg) in trials; may close gap with injectable
Side-by-Side Comparison
| Feature | Ozempic | Wegovy | Mounjaro | Rybelsus |
|---|---|---|---|---|
| Drug class | GLP-1 agonist | GLP-1 agonist | GIP + GLP-1 agonist | GLP-1 agonist |
| Administration | Weekly injection | Weekly injection | Weekly injection | Daily tablet |
| Health Canada approved for | Type 2 diabetes | Weight management | Type 2 diabetes | Type 2 diabetes |
| Average weight loss | ~9–13% | ~15% | ~15–21% | ~4–5% |
| Monthly cost (no insurance) | $200–$450 | $385–$430 | $400–$620+ | $200–$350 |
| Generic available? | Yes (2025) | Yes (2025) | No | No |
| Provincial formulary (diabetes) | Most provinces | N/A | Limited | Several provinces |
| Off-label weight management | Common | N/A (on-label) | Common | Some use |
| Titration period | 4–12 weeks | 16–20 weeks | 8–20 weeks | 4–8 weeks |
| GI side effects | Common (mild) | Common (mild) | Common (mild) | Common (mild-mod) |
Which Should You Choose?
If:
I have type 2 diabetes and want public coverage
→ Ozempic (via ODB or provincial plan)
Covered in most provinces with LU code. Most cost-effective option if you qualify.
If:
I want maximum weight loss and cost is secondary
→ Mounjaro 15 mg
Highest average weight loss in clinical trials (~21%). Most expensive and no generic yet.
If:
I want the best weight loss at the most accessible price
→ Wegovy or generic semaglutide
Wegovy has a formal weight-management approval. Generic semaglutide (arriving 2025-26) will be dramatically cheaper.
If:
I have needle phobia and prefer a pill
→ Rybelsus
Only approved oral GLP-1. Less weight loss than injectables at current doses, but next-generation higher doses may close the gap.
Head-to-Head Comparisons
Deep-dive articles comparing two medications at a time - efficacy, cost, side effects, and who each is best suited for.
Ozempic vs Wegovy
Both are semaglutide - what actually differs?
Read comparison →Ozempic vs Mounjaro
GLP-1 vs dual GIP + GLP-1 - which wins on weight loss?
Read comparison →Wegovy vs Mounjaro
The two top weight-loss drugs compared side by side.
Read comparison →Ozempic vs Rybelsus
Injectable vs oral semaglutide - same drug, different delivery.
Read comparison →Recommended Providers
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Province Guides
Coverage criteria, drug plan details, and access options for each province.
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