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The FDA grants separate approvals for separate indications, which allows the manufacturer to use different brand names and pricing

References include the SURMOUNT-1 trial publication (Jastreboff et al., New England Journal of Medicine, 2022), the Mounjaro and Zepbound prescribing information (Eli Lilly, 2024), Liu et al., JAMA Internal Medicine, 2018 (steroid-induced hyperglycemia), and American Diabetes Association Standards of Care, 2024

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Moreover formulation (L-carnitine vs propionyl-/acetyl-L-carnitine), dose, route, timing relative to ischemia/reperfusion, and treatment duration of L carnitine (short peri-procedural courses vs chronic supplementation) may contribute to these differences (Da Silva Guimares et al

doi:10.1016/S0140-6736(21)01751-7 DAscanio AM, Mullally JA, Frishman WH