Mounjaro, Ozempic and Wegovy

These three medicines, Mounjaro, Ozempic and Wegovy, belong to GLP-1 class (glucagon-like peptide -1). They are receptor agonists (RAs). Wegovy is semaglutide. Its weekly injection is available in doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg. It is approved by the US FDA for treating obesity in adults with a BMI of 30 or higher or a BMI with BMI 27 or higher (overweight) with a weight-related high B.P. Ozempic is a Wegovy variant with a lower dosage (0.5 mg and 1 mg) approved mainly for type II diabetes. Mounjaro is trizepatide and is GLP-1RA. It is also GIP RA (glucose-dependent insulinotropic-polypeptide). It is approved for treating type II diabetes. Zepbound, its variant, is used for obesity treatment. Both Mounjaro and Zepbound can be administered at higher dosages, starting at 2.5 mg, going up to 15 mg. All these are prescription drugs.

When food is eaten, GLP-1 is a hormone released to slow gastric emptying (the processes through which food leaves the stomach). The body then absorbs nutrients from food. GLP-1 increases insulin release from the pancreas, thus reducing sugar level in the blood. It controls the feeling of satiety.

Wegovy artificially activates GLP-1 receptor in the brain, decreasing the appetite, and causing one to eat less. It is mainly used for type II diabetes.

If we introduce healthy lifestyle changes, (say better diet and exercise), these drugs control both sugar and obesity. These drugs also help in attendant co-morbidities such as cardiovascular issues and PCOs.

There are common side effects. There are pancreatic problems. Contraceptive pills, if taken, should be effective enough as they are less likely to work. These should be taken long term. If discontinued, the weight lost may be regained.

Ozempic is not available in India. In the coming month, Mounjaro and Wegovy will be available in India.

Wegovy will be priced at Rs.17345 ($202) with four monthly doses (0.25 mg, 0.5 mg and 1 mg.) The 1.7 mg dose will cost Rs.24,280 ($ 284). The 2.4 mg dose will cost Rs. 26015 ($304).

Monjaro will cost Rs.3500 ($41) for a 2.5 mg vial and Rs. 4375 for a 5 mg vial.

The Indian pharma industry is trying to bring the generic versions which will be much cheaper. There may be a correction of 60-90 per cent. Novo Nordisk introduced Saxenda, a leraglutide, another GLP-1 version in 2023 but higher costs and restricted availability hampered its adoption.