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.
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Available Across Canada
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Not available in Quebec or Canadian territories. A licensed provider will confirm eligibility after your assessment.