Obesity is a growing epidemic that can lead to a host of complications, including type 2 diabetes, heart disease, and even certain cancers. Estimates show that more than a billion people are living with obesity around the world.

Moreover, data indicates that nearly 90% of adults with type 2 diabetes are overweight or obese. This correlation highlights the urgent need for effective weight management strategies to combat the number of obesity-related health issues.

This article aims to address this pressing issue by exploring two medications, phentermine, and Mounjaro, which have shown promise in aiding weight loss. Understanding these options can help people with obesity make better choices about their weight loss, improving their health and reducing the risk of serious issues like type 2 diabetes.

Key Differences Between Mounjaro and Phentermine

ParametersPhentermineMounjaro
Cost$27 – $100 per month$1,069.08 per package
Active ingredientPhentermineTirzepatide
Approved indicationsWeight managementGlycemic control in adults with type 2 diabetes
Dosage FormsTablets, capsules, orally disintegrating tablets (ODT), and extended-release capsulesSubcutaneous injection
Frequency of administrationTaken orally once a dayWeekly injection
EffectivenessWeight reduction of up to 22 lbsWeight reduction of up to 25 lbs
Side effectsDry mouth, insomnia, itching sensation, headache, diarrhea, tremor, and dizzinessNausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach pain
AdministrationThe 37.5 mg dosage is taken orally daily, before breakfast, or 1 to 2 hrs post-breakfast. The 8 mg strength is taken orally thrice daily, 30 minutes before meals.Begins with a weekly dosage of 2.5 mg, gradually raised to 15 mg per week within 21 weeks.
Onset of action8 -12 weeks28 weeks

Mounjaro vs. Phentermine for Weight Loss

Studies and clinical investigations have been conducted to assess the effectiveness of Mounjaro and Phentermine in promoting weight loss.

Phentermine

Phentermine’s efficacy in promoting weight loss has been well-documented in various studies and clinical trials. Here are some key points supported by scientific literature:

  • Effects on Weight Reduction and Safety of Short-Term Phentermine Administration in Korean Obese People, published in Yonsei Medical Journal (2006)

This trial, which took place in Seoul from February to July 2005, involved 68 relatively healthy obese adults. Participants were randomized to receive either phentermine-HCl 37.5 mg or a placebo once daily, along with behavioral therapy for obesity.

They found that the phentermine-treated group showed significantly greater reductions in body weight and waist circumference than the placebo group. Specifically, the mean decrease in body weight was approximately 14.77 lbs, and the mean decrease in waist circumference was 2.44 inches, both of which were statistically significant. More importantly, a significant number of subjects in the phentermine group achieved a weight reduction of 5% or more and 10% or more from baseline.

Phentermine has been widely used in Korea since 2004. A postmarketing surveillance study was conducted to evaluate safety and effectiveness, with successful treatment defined as a weight loss of 5% or more. The study found that 45.6% of the patients lost at least 5% of their body weight, with an average weight loss of 8.38 lbs.

While phentermine is approved only for short-term use, this study investigated the effects of long-term use of phentermine on weight loss and the risk of cardiovascular disease (CVD) or death. The study found that longer-term use of phentermine led to more significant weight loss without an increased risk of developing CVD or dying. Patients who used the drug continuously lost 7.4% more weight by 24 months compared to those who used it for 3 months or less.

  • Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER), published in The Lancet (2011)

Additionally, phentermine is often combined with other drugs to enhance its efficacy. The CONQUER phase 3 trial assessed the efficacy and safety of controlled-release phentermine and topiramate for weight loss in 2,487 overweight or obese adults with comorbidities.

After 56 weeks, the mean weight changes were 3.09 lbs (placebo), 17.86 lbs (phentermine 7.5 mg/topiramate 46 mg), and 22.49 lbs (phentermine 15 mg/topiramate 92 mg). More importantly, 62% of low-dose and 70% of high-dose participants achieved 5% weight loss.

The SEQUEL study is a follow-up to the CONQUER study, designed to further evaluate the long-term effects of phentermine and topiramate over an additional 52 weeks. At week 108, the phentermine 7.5 mg/topiramate 46 mg group lost an average of 9.3% of their baseline body weight. In contrast, those in the phentermine 15 mg/topiramate 92 mg group lost an average of 10.5% of their baseline body weight. This was compared to a 1.8% weight loss in the placebo group.

Mounjaro (tirzepatide)

Mounjaro (tirzepatide) injection 2.5mg/0.5ml for type 2 diabetes.

Tirzepatide is a relatively new medication found to significantly reduce A1C levels and body weight in patients with type 2 diabetes. Though the primary focus of the studies on Mounjaro was not on weight reduction, its impact on body weight was assessed as a secondary factor.

The SURPASS phase 3 global clinical development program for tirzepatide involved five global registration trials, each lasting between 40 and 104 weeks. These trials investigated the efficacy and safety of tirzepatide at 5 mg, 10 mg, and 15 mg doses. Participants received Mounjaro through weekly subcutaneous injections.

Key observations from these trials are:

  • Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1), published in The Lancet (2021)

In the SURPASS-1 study, more than half of the participants (54.2%) had never received treatment for their diabetes before. On average, participants had diabetes for about 4.7 years, had a starting A1C (a measure of blood sugar levels over time) of 7.9%, and weighed about 189.3 pounds. Impressively, participants experienced average weight reductions of 14 lbs (5 mg), 15 lbs (10 mg), and 17 lbs (15 mg) from their starting weight. In contrast, those on the placebo only saw a 2 lb reduction

The SURPASS-2 trial, lasting 40 weeks, assessed the efficacy and safety of tirzepatide versus semaglutide in addition to metformin for adults with type 2 diabetes. The study included participants with an average diabetes duration of 8.6 years, an initial A1C of 8.28%, and a starting weight of 206.5 lbs. Participants experienced average weight reductions of 17 lbs (5 mg), 21 lbs (10 mg), and 25 lbs (15 mg) with tirzepatide, compared to 13 lbs with semaglutide.

It is important to mention that the researchers used a 1.0 mg dose of semaglutide for comparison. In another study, a higher dose of 2.4 mg led to an average weight loss of 21 lbs.

  • Once-weekly tirzepatide versus once-daily insulin degludec as an add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3), published in The Lancet (2021)

In this 52-week study involving adults with type 2 diabetes who were being treated with metformin, either with or without an SGLT-2 inhibitor, tirzepatide was compared to insulin degludec. The findings showed that participants taking tirzepatide experienced significant weight loss, averaging 15 lbs (5 mg), 21 lbs (10 mg), and 25 lbs (15 mg). In contrast, those receiving insulin degludec experienced a weight gain of 4 lbs.

  • Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes (SURPASS-4), published in The Lancet (2022)

In this 104-week study, tirzepatide was compared to insulin glargine in adults with type 2 diabetes who were not adequately controlled with oral antihyperglycemic medications and had increased cardiovascular risk. The results indicated that tirzepatide led to significant weight loss, with participants losing an average of 14 lbs (5 mg), 20 lbs (10 mg), and 23 lbs (15 mg). Conversely, those treated with insulin glargine gained an average of 4 lbs.

  • Effect of subcutaneous tirzepatide vs. placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes (SURPASS-5), published in JAMA Network (2022)

In a 40-week study comparing tirzepatide to a placebo in adults with inadequately controlled type 2 diabetes already receiving insulin glargine, with or without metformin, notable average weight reductions were observed in participants treated with tirzepatide. Specifically, those receiving tirzepatide experienced weight decreases averaging 12 lbs (5 mg), 17 lbs (10 mg), and 19 lbs (15 mg) from their initial weight, while individuals on the placebo showed an average weight gain of 4 lbs.

Both phentermine and Mounjaro have demonstrated effectiveness in weight loss, with users experiencing reductions of up to 20 lbs. However, it is important to note that there are currently no direct comparative studies between the two drugs.

While both medications have shown similar results in certain instances, numerous factors need to be considered, such as the participants’ characteristics, the dosages administered, and other variables.

Side Effects of Phentermine vs Mounjaro

A man sitting on an outdoor bench holds his stomach in pain.

Before considering phentermine or Mounjaro for weight loss or diabetes management, individuals need to understand the potential side effects linked to these medications. These side effects can vary in severity and are important to consider before starting the medication.

Phentermine

According to clinical trials and Gate Pharmaceuticals, which manufactures phentermine medications, the side effects of phentermine include:

  • Dry mouth
  • Insomnia
  • Itching sensation
  • Headache
  • Diarrhea
  • Tremor
  • Dizziness
  • Unpleasant taste
  • Rapid heart rate
  • Palpitation
  • Sexual side effects
  • Urticaria
  • Changes in mood
  • Temporary skin lesion on the face
  • Epigastric pain (located in the region just below the ribs) and chest discomfort

Less common but serious side effects include:

  • Primary pulmonary hypertension (PPH), also known as idiopathic pulmonary arterial hypertension (IPAH)
  • Valvular heart disease
  • Hypersensitivity

Additional precautions regarding the use of phentermine:

  • Impaired task performance
  • Abuse and dependence risk
  • Alcohol interaction
  • Use in patients with hypertension
  • Diabetes medication interaction
  • Withdrawal risk

Mounjaro

The following adverse reactions were reported in at least 5% of patients using Mounjaro during placebo-controlled trials.

  • Nausea
  • Diarrhea
  • Decreased Appetite
  • Vomiting
  • Constipation
  • Dyspepsia
  • Abdominal Pain

Other adverse effects involve:

  • Gastrointestinal Adverse Reactions (eructation, flatulence, gastroesophageal reflux disease, and abdominal distension)
  • Hypoglycemia (more prevalent when Mounjaro was administered alongside a sulfonylurea)
  • Heart Rate Increase
  • Hypersensitivity Reactions
  • Injection Site Reactions
  • Acute Gallbladder Disease
  • Laboratory Abnormalities (Amylase and Lipase increase)

Additionally, there may be potential risks or safety issues that users should be informed about, such as:

  • Risk of Thyroid C-cell Tumors
  • Pancreatitis
  • Acute Kidney Injury
  • Severe Gastrointestinal Disease (including severe gastroparesis)
  • Diabetic Retinopathy Complications

Mechanism of Action

Phentermine and Mounjaro target different conditions and work through distinct mechanisms to achieve their therapeutic effects. To understand this better, here’s how they work:

Phentermine

Phentermine is a sympathomimetic amine that primarily functions as an appetite suppressant. It exerts its effects by stimulating the release of norepinephrine in the brain, which subsequently activates the central nervous system (CNS). This stimulation leads to increased levels of dopamine and serotonin, which are neurotransmitters associated with mood regulation and feelings of satiety.

By enhancing these neurotransmitters, phentermine reduces appetite and promotes a sense of fullness, helping individuals consume fewer calories. Additionally, phentermine may increase energy expenditure by raising basal metabolic rate, although this effect is secondary to its appetite-suppressing properties.

Mounjaro

Mounjaro, on the other hand, is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. It mimics the actions of endogenous incretin hormones, which play a crucial role in regulating glucose metabolism.

By activating GIP and GLP-1 receptors, Mounjaro enhances insulin secretion in response to food intake while simultaneously inhibiting glucagon release, improving blood glucose control. Furthermore, GLP-1 receptor activation slows gastric emptying and promotes satiety, reducing food intake. This dual mechanism not only aids in glycemic control but also supports weight loss by decreasing appetite and caloric consumption.

In summary, phentermine primarily affects the brain and CNS to suppress appetite, while Mounjaro affects the digestive system to control blood sugar levels and increase feelings of fullness.

Approved Indications

Mounjaro and phentermine were tested in clinical trials with varying primary endpoints, leading to their distinct approved uses.

Phentermine

Phentermine is approved for short-term use (less than 12 weeks) as part of a regimen of weight reduction based on exercise, behavioral modification, and caloric restriction in the management of exogenous obesity for patients with an initial body mass index (BMI) of 30 kg/m² or higher, or 27 kg/m² or higher in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia).

Additionally, the US FDA approved the combination of phentermine and extended-release (ER) topiramate drugs (Qsymia) in 2012 to treat obesity. Qsymia is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult and pediatric patients aged 12 years and older with the following conditions:

  • Obese individuals (BMI ? 30 mg/kg²)
  • Overweight individuals (BMI ? 27 mg/kg²) with at least one weight-related comorbidity like high blood pressure, type 2 diabetes, or abnormal lipid levels.
  • At or above the 95th percentile, adjusted for age and sex (for pediatric patients)

Mounjaro

Mounjaro is prescribed for adults with type 2 diabetes to help manage blood sugar levels when used alongside diet and exercise. It can be taken alone or in combination with other diabetes medications, like metformin.

Dosage and Administration

An elderly woman sitting on a bench is handed a pill and a glass of water by a doctor.

Phentermine and Mounjaro vary in their formulations, routes of administration, and prescribed dosages.

Phentermine

Phentermine is prescribed under several brand names, such as Adipex-P, Lomaira, and Qsymia. These medications come in different dosages and have specific administration guidelines.

Adipex-P

Adipex-P is available in tablet and capsule forms, each containing 37.5 mg of phentermine hydrochloride. The typical administration involves taking one tablet or capsule once daily, usually in the morning, either before breakfast or 1 to 2 hours after breakfast. It is important to take Adipex-P early in the day to avoid insomnia, a common side effect. The tablets can be divided into half doses if prescribed by a doctor, but the capsules should be taken whole and not crushed or chewed.

Lomaira

Lomaira is available in tablet form, with each tablet containing 8 mg of phentermine hydrochloride. It is typically prescribed to be taken up to three times daily, about 30 minutes before meals. This dosing schedule helps control appetite throughout the day. The tablets should be taken whole, without crushing or chewing.

Qsymia (phentermine/topiramate)

Qsymia is available in extended-release capsule form and combines phentermine with topiramate. The capsules come in various dosage strengths, including

  • 3.75 mg/23 mg
  • 7.5 mg/46 mg
  • 11.25 mg/69 mg
  • 15 mg/92 mg

Here’s the typical administration of Qsymia:

DosageDosing scheduleEvaluation
Starter dose (weeks 1-2)One Qsymia 3.75 mg/23 mg capsule each morning for the first two weeks.
Recommended dose (weeks 3-12)On the first day of week 3, individuals will start the recommended dose, taking one Qsymia 7.5 mg/46 mg capsule each morning.Adult and pediatric patients may continue at this dose if 3% or greater weight loss is achieved after 12 weeks. Otherwise, discontinue or escalate the dose.

Consider a dosage reduction for pediatric patients who experienced weight loss exceeding 2 lbs/week.

Titration dose (weeks 13-14)If the doctor increases the dose, the patient will take one Qsymia 11.25 mg/69 mg on the first day of week 13 until the end of week 14.
Maximum dose (weeks 15 or more)On the first day of week 15, the patient will take monthly prescriptions of Qsymia 15 mg/92 mg.Discontinue use if 5% weight loss isn’t achieved after 12 weeks.

Mounjaro

Mounjaro is administered as a subcutaneous injection and is available in pre-filled, single-dose pens. The pens come in various strengths, including:

  • 2.5 mg/0.5 mL
  • 5 mg/0.5 mL
  • 7.5 mg/0.5 mL
  • 10 mg/0.5 mL
  • 12.5 mg/0.5 mL
  • 15 mg/0.5 mL

The typical administration involves injecting Mounjaro once weekly, on the same day each week, at any time of the day, with or without meals. It can be injected into the abdomen, thigh, or upper arm. Below is Mounjaro’s usual dosing plan.

Dosing ScheduleWeeksDosage Strength (once weekly)
Starting Dose1 through 42.5 mg
Dose Escalation5 through 85 mg
9 through 127.5 mg
13 through 1610 mg
17 through 2012.5 mg
Maintenance Dose21 and onward15 mg

Cost

Mounjaro has a list price of $1,069.08 per package. In contrast, Phentermine is available as a generic medication, making it more affordable. Adipex-P, for instance, typically costs around $100 for a 30-day supply, whereas the generic version is priced at approximately $42 without insurance. Another economical option is Lomaira, which is available for around $27 for a 30-day supply. Additionally, individuals can often use coupons and discount cards to further reduce these costs, making these medications more accessible.

The list price for Qsymia can be significantly higher due to the combination of medications and extended-release formulation. The average monthly cost without insurance is around $200 to $300.

Out-of-pocket costs for these medications will vary based on individuals’ insurance plans and their pharmacy. Commercially insured patients might be eligible for savings card programs provided by the drug manufacturers.

Buying medication from Canadian pharmacies such as Pharma Giant offers an alternative for those who don’t qualify for these savings programs. At Pharma Giant, customers can save up to 90% on prescription medications, including Mounjaro. Additional discounts and promotions are available, especially for bulk orders.

New customers can use the coupon code FIRST10 to receive a 10% discount on their first purchase. Pharma Giant also ensures convenient and quick service with expedited delivery, typically within 3-5 business days.

Here’s a price comparison of popular weight loss drugs available on Pharma Giant versus those offered by online pharmacies in the US:

Brand NamePharma GiantWalgreensCVS PharmacyRite Aid
Ozempic$469.79$1,141$1,131$1,250
Saxenda$515$1,640$1,590$1,738
Wegovy$609.99$1,388$1,389$1,315
Mounjaro$158.99$1,284$1,261$1,044
Victoza$255$969$656$737
Trulicity$282$1,106$1,167$1,263

Data Source: GoodRx

Onset of Action

The speed at which weight loss medications begin to show effects can be an important factor. Here’s a comparison of phentermine and Mounjaro in terms of their onset of action.

Phentermine

Phentermine’s onset of action is relatively rapid, often within a few hours of taking the medication. Patients typically begin noticing a reduced appetite and increased energy levels soon after starting the drug. Significant weight loss can often be observed within the first few weeks of treatment.

Clinical trials have shown that it can reduce a person’s weight by up to 5% of their overall body weight within three months. Phentermine/topiramate, which is approved for longer-term use, may result in weight loss within the first 8 to 12 weeks of treatment.

Mounjaro

Although Mounjaro is not officially approved for weight management, substantial weight loss was documented in adults during phase 3 trials. Participants saw a weight reduction of up to 25 lbs. Smaller phase 1 studies from the SURPASS program reported notable weight reduction at 28 weeks, with Mounjaro users experiencing weight and fat mass reductions.

Wrap-Up

Mounjaro and phentermine are distinct medications with different indications. Mounjaro manages type 2 diabetes by activating GIP and GLP-1 receptors. In contrast, phentermine is used as a short-term aid in weight loss programs, which functions as an appetite suppressant by triggering the release of specific chemicals in the brain.

Mounjaro commonly causes side effects such as nausea and diarrhea, while Phentermine can lead to headaches and insomnia. Despite their impact on weight, these medications vary in their mechanisms of action, purposes, and associated risks.

Frequently Asked Questions

What should you not take with phentermine?

Avoid taking phentermine with other stimulants such as amphetamines (e.g., Adderall, Vyvanse) and medications containing pseudoephedrine (e.g., Sudafed). Do not combine it with MAO inhibitors (e.g., phenelzine, selegiline), which can cause a dangerous interaction. Alcohol should also be avoided due to the increased risk of cardiovascular side effects. Other medications to avoid include SSRIs, SNRIs, and tricyclic antidepressants, as these can increase the risk of serotonin syndrome and hypertensive crisis?.

Can you take Mounjaro and phentermine together?

There is no widely available clinical data on the combined use of Mounjaro and phentermine. Both medications can affect appetite and weight, but combining them could increase the risk of side effects such as increased heart rate and blood pressure. Consult with a healthcare provider before combining these medications.

What can you take with phentermine to lose more weight?

Phentermine is often combined with other lifestyle interventions, such as a calorie-reduced diet, regular physical activity, and behavioral modifications for maximum weight loss. It is sometimes prescribed in combination with topiramate (as in Qsymia), which has shown efficacy in enhancing weight loss effects.

What is phentermine classified as?

Phentermine is classified as a sympathomimetic amine anorectic, similar to amphetamines. It is a central nervous system stimulant that suppresses appetite.

Which phentermine brand is the best?

The effectiveness of phentermine can depend on the specific formulation and individual response. Common brands include Adipex-P, Lomaira, and generic phentermine. The best phentermine option can vary depending on individual needs, but Adipex-P is often considered one of the most effective and widely used formulations of phentermine.

Which is better for weight loss, phentermine or Mounjaro?

Phentermine is primarily an appetite suppressant, while Mounjaro is a GIP/GLP-1 receptor agonist that helps regulate blood sugar and appetite. Mounjaro has shown significant weight loss effects in clinical trials, often more than traditional weight loss medications like phentermine. However, Mounjaro is not indicated for weight loss. The best choice depends on individual health conditions and should be made with medical advice.

Does phentermine affect metabolism?

Yes, phentermine affects metabolism by stimulating the central nervous system. This increases heart rate and blood pressure and decreases appetite, temporarily leading to an increased metabolic rate?.

Which phentermine brand is the strongest?

Phentermine’s strength is usually consistent across different brands and forms, with the typical dose being 15 to 37.5 mg daily. Adipex-P and generic phentermine 37.5 mg are among the most commonly prescribed and potent options??.

What are the top phentermine alternatives?

Alternatives to phentermine include orlistat (Alli, Xenical), lorcaserin (Belviq), naltrexone/bupropion (Contrave), liraglutide (Saxenda), and semaglutide (Wegovy). These alternatives vary in mechanism and effectiveness and should be chosen based on individual health profiles and doctor’s recommendations?.

Is Mounjaro a stimulant?

No, Mounjaro is not a stimulant. It is a GIP/GLP-1 receptor agonist that helps control blood sugar levels and appetite, which distinguishes it from stimulant medications like phentermine.

How to use phentermine effectively?

To use phentermine effectively, follow the prescribed dosage and combine it with a healthy, calorie-controlled diet. Incorporate regular physical activity and avoid taking phentermine late in the day to prevent insomnia. It’s important to monitor for side effects and consult your doctor regularly.

What’s better than phentermine for weight loss?

For some individuals, medications like liraglutide (Saxenda) or semaglutide (Wegovy) may offer better weight loss results than phentermine. These medications are GLP-1 receptor agonists and have shown significant weight loss benefits in clinical studies. However, they are also more expensive than phentermine, which could be an important consideration for many patients.

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