Wegovy 7.2mg vs Mounjaro: What Does the Evidence Actually Show?

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With the arrival of Wegovy 7.2 mg, one question is being asked repeatedly:

“Is high-dose Wegovy now as effective as Mounjaro?”

The responsible answer is that we do not yet have a direct head-to-head trial comparing Wegovy 7.2 mg with Mounjaro.

But we do have useful evidence.

What did the direct Mounjaro vs Wegovy trial show?

SURMOUNT-5 directly compared tirzepatide with semaglutide in adults with obesity without diabetes.

Participants received the maximum tolerated dose of:

tirzepatide 10 or 15 mg, or
semaglutide 1.7 or 2.4 mg.

At 72 weeks, average weight reduction was 20.2% with tirzepatide and 13.7% with semaglutide.

But this study did not use Wegovy 7.2 mg.

What happened in the Wegovy 7.2mg trial?

STEP UP studied adults with obesity receiving Wegovy 7.2 mg, Wegovy 2.4 mg or placebo.

Average weight reduction in the treatment-policy analysis was:

18.7% with 7.2 mg versus 15.6% with 2.4 mg.

This demonstrates that the higher Wegovy dose produced greater average weight reduction than 2.4 mg in that trial.

But STEP UP and SURMOUNT-5 were different trials with different populations and designs.

It would therefore be misleading to place 18.7% beside Mounjaro's 20.2% and claim the medicines are now equivalent.

So why might someone choose Wegovy?

Weight loss percentage is only one part of choosing treatment.

Other considerations can include:

previous response and tolerability
cost and long-term affordability
contraception
treatment continuity
cardiovascular history
patient preference
the need for maintenance
individual contraindications and precautions.

Wegovy also has a UK indication for reducing major cardiovascular events in certain adults with established cardiovascular disease and overweight or obesity.

Can I switch from Mounjaro to Wegovy?

Potentially.

There is no manufacturer-approved milligram-for-milligram conversion between tirzepatide and semaglutide.

Any switch therefore needs an individual prescribing decision based on your current dose, previous side effects, treatment gap and weight-management goals.

How Pharmulous can help

Pharmulous supports patients who are starting, continuing, maintaining or considering switching weight-management treatment.

Our clinicians look at the whole treatment journey rather than assuming that the medicine producing the highest average trial result is automatically right for every patient.

The question isn't simply “which injection is strongest?” It is “which treatment is appropriate and sustainable for me?”