Saxenda vs Ozempic vs Mounjaro: how do they compare?

Saxenda vs Ozempic vs Mounjaro at a glance

Here is the quick comparison. Detail on each point follows below.

Individual results vary for all three, and every figure comes from a trial where people also changed diet and activity. Read on for what each row means.

What is in Saxenda, Ozempic and Mounjaro?

Each brand contains a different active ingredient. Saxenda contains liraglutide, Ozempic contains semaglutide, and Mounjaro contains tirzepatide. Liraglutide and semaglutide copy one gut hormone, GLP-1. Tirzepatide copies two, GIP and GLP-1. All three slow stomach emptying and reduce appetite, which is how they help people eat less without constant hunger.

Tirzepatide's second target matters. GIP appears to improve how the body handles fat and to amplify the appetite and blood-sugar effects of GLP-1, and that dual action is the leading explanation for the larger average weight loss in tirzepatide's trials.

The ingredient also shapes the brand picture. Semaglutide is sold as Ozempic for diabetes and, at a higher dose, as Wegovy for weight management, so two brands share one molecule at different strengths. Liraglutide appears twice as well: as daily Saxenda for weight management and as Victoza at lower doses for diabetes. To go deeper, see what is liraglutide and semaglutide vs tirzepatide.

Daily or weekly: how often do you inject each?

Saxenda is injected once a day. Ozempic and Mounjaro are injected once a week, on the same day each week. All three are given into the fat just under the skin of the stomach, thigh or upper arm, and all three start at a low dose and step up over several weeks to limit side effects.

The daily-versus-weekly difference is practical, not medical. A weekly injection is easier to remember for many people, while a daily one is a smaller dose each time. Neither is automatically better; it depends on what fits your routine and how you tolerate the medicine.

The schedules differ in detail. Saxenda steps up weekly from 0.6 mg to a daily maintenance dose of 3.0 mg over five weeks. Ozempic starts at 0.25 mg weekly and steps up to its maintenance dose. Mounjaro starts at 2.5 mg weekly and climbs in 2.5 mg steps to a maximum of 15 mg. The milligram numbers are not comparable across the three, because each molecule has its own potency.

Which one leads to the most weight loss?

On the trial averages, tirzepatide leads, followed by semaglutide at its weight-management dose, then liraglutide. The numbers below are trial averages alongside diet and activity changes, and individual results vary. The gap between daily liraglutide and the weekly medicines is the largest single difference between the three.

Saxenda (liraglutide 3.0 mg) averaged about 8% of body weight over 56 weeks in the SCALE trial, and roughly 63% of participants on it lost at least 5% of their body weight. Semaglutide 2.4 mg, the weight-management dose, averaged about 15% over 68 weeks in the STEP-1 trial. Mounjaro (tirzepatide) averaged 15% on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg over 72 weeks in SURMOUNT-1. Individual results vary.

The weekly medicines have also met head to head. In SURMOUNT-5, 751 adults with obesity took either tirzepatide or semaglutide 2.4 mg for 72 weeks: average weight loss was 20.2% on tirzepatide against 13.7% on semaglutide. Both groups included strong and modest responders, and individual results vary.

One caveat on Ozempic: it is registered in South Africa at diabetes doses up to 2 mg, not at the 2.4 mg weight-management dose. The 15% figure comes from the higher weight dose of the same molecule, which is sold separately as Wegovy. For that pairing in full, see Mounjaro vs Ozempic.

What is the difference between Saxenda and Ozempic?

Saxenda contains liraglutide and is injected once a day; Ozempic contains semaglutide and is injected once a week. In South Africa, Saxenda is registered for chronic weight management and Ozempic for type 2 diabetes. In their separate trials, semaglutide produced larger average weight loss than liraglutide. Individual results vary.

Day to day the two feel similar: reduced hunger, earlier fullness, smaller portions. The practical differences are the injection rhythm and the registration. A daily injection suits people who prefer a fixed morning routine; a weekly one suits people who want fewer injections to think about.

The registration difference runs deeper than it looks. A weight management plan built on semaglutide at its registered weight dose points to Wegovy rather than Ozempic, while Saxenda already carries the local weight registration. A doctor weighs that alongside your history before either becomes an option.

What is the difference between Saxenda and Mounjaro?

Saxenda is a once-daily injection of liraglutide, which acts on one gut hormone. Mounjaro is a once-weekly injection of tirzepatide, which acts on two. Both are SAHPRA-registered for chronic weight management, and in their separate trials tirzepatide produced larger average weight loss. Individual results vary.

They are the oldest and newest of the three. Liraglutide was the first GLP-1 medicine registered specifically for weight management in South Africa, while tirzepatide launched locally in December 2024 and gained its weight registration in October 2025. The trial gap is wide, about 8% average weight loss for liraglutide against up to 20.9% at tirzepatide's highest dose, though those figures come from different trials with different designs.

Because both hold the local weight registration, a doctor can build a plan around either. Daily versus weekly dosing, side-effect tolerance, cost and what your pharmacy can stock carry the decision from there.

Which are registered for weight loss in South Africa?

This is where the three differ most locally. Saxenda is registered with SAHPRA for chronic weight management. Mounjaro is registered for both type 2 diabetes and, since October 2025, chronic weight management. Ozempic is registered only for type 2 diabetes and to reduce cardiovascular risk, though doctors sometimes use it off-label for weight.

The weight-management registrations share the same clinical criteria: adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition, alongside a reduced-calorie diet and increased activity. That mirrors how the medicines were trialled and how doctors treat obesity as a health condition rather than a cosmetic concern.

All three are Schedule 4 medicines, so each requires a doctor's assessment and authorisation, and each is dispensed by licensed pharmacies. For the weight-registered daily option in detail, see is Saxenda available in South Africa.

Can you get all three at South African pharmacies?

Yes. Saxenda, Ozempic and Mounjaro are all stocked by licensed South African pharmacies, including the major chains, subject to stock, and each needs a doctor's assessment and authorisation before a pharmacy may dispense it. Individual strengths go in and out of stock at branch level, so phone ahead before you travel.

Stock has shaped this market before. Demand for semaglutide outran supply several times from 2023, and single strengths of the weekly pens still fluctuate in 2026. When your strength is short, the doctor managing your plan can adjust it rather than leave a gap; do not stretch doses or combine pens on your own.

Short stock is also when unlawful sellers get busiest. Falsified pens and compounded copies of these medicines circulating online are not SAHPRA-registered and their contents are not verified; SAHPRA has warned the public against them and, with other regulators, seized unregistered compounded stock. No legitimate pharmacy dispenses any of the three without a doctor's authorisation. The full local picture is in our guide to weight loss injections in South Africa.

How do Saxenda, Ozempic and Mounjaro prices compare?

On published 2026 figures, Ozempic pens list the lowest prices of the three, Saxenda sits in the middle per pen but uses several pens a month at maintenance, and Mounjaro lists the highest figures at its upper strengths. Your dose, the pen format and the pharmacy's dispensing fee decide the real monthly number.

South Africa regulates medicine prices through the Single Exit Price system: the medicine itself costs the same at every pharmacy, and the pharmacy adds only a capped dispensing fee. The biggest variable is dose, because each strength has its own price and doses step up over the first months of treatment.

At published 2026 prices, Ozempic pens list at roughly R1,400 to R3,100 depending on strength and Mounjaro KwikPens at roughly R3,600 to R8,200, each pen holding four weekly doses. Published South African prices put a single Saxenda pen at about R2,700 and a month at the 3.0 mg maintenance dose at R4,500 to R5,000. Reuters reported in March 2026 that Wegovy's South African price fell for a second time, its lowest dose to R1,873 and its highest to R3,746. We report these figures as market information only. We do not sell medicine. Prices vary by pharmacy and dose; confirm with your pharmacy.

A per-pen comparison flatters the weekly medicines and understates the daily one, and the three are dosed differently, so treat any single number with caution. For the full budgeting picture, consultations and tests included, see GLP-1 weight loss cost in South Africa.

How do the side effects compare?

All three share the same main side effects, because they act on the same gut-hormone system: nausea, diarrhoea, constipation, vomiting and indigestion. These are usually mild to moderate, most noticeable when the dose increases, and tend to settle with time. With daily Saxenda, some people find early nausea more constant than with a weekly injection.

None of the three suits everyone. They should not be used in pregnancy or while breastfeeding, or by people with a personal or family history of medullary thyroid cancer or MEN2 syndrome. A history of pancreatitis needs careful discussion with a doctor, and severe, persistent stomach pain can signal pancreatitis: seek medical care immediately. People who take insulin or a sulfonylurea need closer monitoring because of the risk of low blood sugar.

Managing the common effects works the same across the three: smaller meals, slower eating and steady hydration around dose increases, with a doctor review if symptoms drag on past a couple of weeks instead of settling. Some people who battle on one molecule do better on another, which is a clinical judgement rather than a self-experiment.

Can you switch between Saxenda, Ozempic and Mounjaro?

Yes, switching between these medicines is possible and fairly common, but it is a medical decision rather than a swap you make on your own. People switch for several reasons: side effects on one medicine, a plateau in results, a preference for weekly over daily dosing, cost, or a specific medicine being out of stock.

A doctor manages the change, including where to restart the dose, because you usually do not carry the exact dose across from one medicine to another. Starting again at a lower dose on the new medicine limits side effects while the body adjusts, then steps up as before. Any blood sugar medicines and other conditions are reviewed at the same time.

Do not run two of these medicines at once, and do not bridge a switch with leftover pens from the old plan. The overlap and the new starting dose are exactly the parts a doctor manages.

Does medical aid cover Saxenda, Ozempic or Mounjaro?

Usually not for weight management. Obesity is not a Prescribed Minimum Benefit condition, so most schemes exclude weight-loss medicine from standard cover, whichever of the three a doctor selects. Some schemes do fund these medicines for type 2 diabetes under chronic benefits, and many members can pay from a medical savings account at the till.

Scheme positions differ and are shifting, so ask your scheme for its criteria and exclusion list in writing before assuming either answer. How cover, savings accounts and motivation letters work is set out in our medical aid guide.

How do you choose between them?

The choice is not a ranking. It weighs up how much weight loss the evidence supports, whether daily or weekly dosing fits your life, what each is registered for and available, your medical history and any contraindications, what your pharmacy can reliably stock, and cost.

Because Schedule 4 medicines need a doctor's assessment and authorisation, the decision is made with a doctor rather than off a comparison table. A doctor also sets realistic expectations: the trial averages are a guide, not a promise, and the plan is reviewed over the first months to check the medicine is actually helping. The right option is decided by a doctor on assessment.

Frequently asked questions