Trulicity vs Mounjaro: How do they compare?

Trulicity (dulaglutide) and Mounjaro (tirzepatide) are injectable medicines used to manage blood sugar levels in people with type 2 diabetes. Both are manufactured by Eli Lilly and Company and are available only as brand-name drugs. Trulicity is also approved to lower the risk of major cardiovascular events such as heart attack or stroke in adults with type 2 diabetes and heart disease. Mounjaro is not currently approved for this indication.

Who is eligible for Trulicity and Mounjaro?

Trulicity is FDA approved for:

• Individuals 10 years and older with type 2 diabetes, alongside diet and exercise
• Adults with type 2 diabetes and heart disease, to lower the risk of major cardiovascular events

Mounjaro is FDA approved for:

• Adults with type 2 diabetes, alongside diet and exercise

How do Trulicity and Mounjaro work?

Both medications belong to a class of drugs called incretin mimetics, which help regulate blood sugar by stimulating insulin release.

• Trulicity: A GLP-1 receptor agonist that mimics glucagon-like peptide-1 (GLP-1), helping to lower blood sugar levels.
• Mounjaro: A dual GIP and GLP-1 receptor agonist, mimicking both glucose-dependent insulinotropic polypeptide (GIP) and GLP-1, potentially offering enhanced blood sugar control.

How are Trulicity and Mounjaro given?

Both medications are administered as once-weekly subcutaneous (under the skin) injections in the stomach, thigh, or upper arm.

Trulicity

The usual starting dose of Trulicity is 0.75 mg injected under the skin once a week. Your healthcare provider may raise your dose based on your response.

Mounjaro

The usual starting dose of Mounjaro is 2.5 mg injected under the skin once a week. After 4 weeks, your healthcare provider will raise your dose to 5 mg once a week. If you need more blood sugar control, your dose might be raised to a maximum of 15 mg once a week.

You can inject Trulicity or Mounjaro at any time of day, but choose the same day every week for your injection.

Which is more effective - Trulicity or Mounjaro?

There are no direct head-to-head studies comparing Trulicity and Mounjaro, but clinical trials suggest differences in blood sugar reduction.

In a clinical trial of Trulicity in adults with type 2 diabetes, the medication lowered hemoglobin A1C by up to 0.8%. In a separate study of children 10 to 17 years of age, Trulicity lowered hemoglobin A1C by up to 0.9% after 26 weeks.

Mounjaro was studied during a 40-week clinical trial (SURPASS-1) in adults with type 2 diabetes. At 40 weeks, Mounjaro lowered hemoglobin A1C by up to 1.8% when used by itself.

How do side effects compare between Trulicity and Mounjaro?

The most common side effects of Trulicity and Mounjaro are gastrointestinal side effects, such as nausea and diarrhea. These side effects are more common at the beginning of treatment, and when the dose is raised. They tend to get better over time.

The side effects of Trulicity and Mounjaro cannot be compared since there are not any head-to-head studies comparing the two medications directly.

Trulicity side effects (≥5%):

• Nausea (up to 21%)
• Diarrhea (up to 13%)
• Vomiting (up to 13%)
• Stomach pain (up to 9%)
• Decreased appetite (up to 9%)
• Indigestion (up to 6%)
• Feeling tired (up to 6%)

Other side effects reported with Trulicity include low blood sugar, increased heart rate, severe allergic reactions, gallbladder problems, an increase in pancreas enzymes, and injection site reactions. Rarely, some people have reported ileus (when your bowels are not moving properly) after the medication came onto the market.

The side effects in children were similar to those seen in adults.

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Mounjaro side effects (≥5%):

• Nausea (up to 18%)
• Diarrhea (up to 17%)
• Decreased appetite (up to 11%)
• Vomiting (up to 9%)
• Constipation (up to 7%)
• Indigestion (up to 8%)
• Stomach pain (up to 6%)

Other reported side effects for Mounjaro include low blood sugar, increased heart rate, severe allergic reactions, injection site reactions, gallbladder problems, and a rise in pancreatic enzymes. Ileus has also rarely been reported by people taking Mounjaro.

FDA Boxed Warning

Both Trulicity and Mounjaro have an FDA Boxed Warning (the FDA’s strictest warning in prescription labeling) for a risk of thyroid C-cell tumors. These medications cause thyroid C-cell tumors in animal studies. Trulicity: Reduced hemoglobin A1C by up to 0.8% in adults and 0.9% in children (10–17 years old) over 26 weeks.

Mounjaro (SURPASS-1 Trial): Lowered hemoglobin A1C by up to 1.8% over 40 weeks when used alone.
Side Effects ComparisonThe most common side effects for both medications are gastrointestinal-related, particularly during dose adjustments.
Trulicity Side Effects (≥5%):Nausea (up to 21%)
Diarrhea (up to 13%)
Vomiting (up to 13%)
Stomach pain (up to 9%)
Decreased appetite (up to 9%)
Indigestion (up to 6%)
Fatigue (up to 6%)
Mounjaro Side Effects (≥5%):Nausea (up to 18%)
Diarrhea (up to 17%)
Decreased appetite (up to 11%)
Vomiting (up to 9%)
Constipation (up to 7%)
Indigestion (up to 8%)
Stomach pain (up to 6%)
Both medications may cause low blood sugar, increased heart rate, severe allergic reactions, gallbladder issues, and pancreatic enzyme increases. Rarely, ileus (intestinal blockage) has been reported.
FDA Boxed Warning:Both Trulicity and Mounjaro carry a boxed warning for thyroid C-cell tumors, based on animal studies. The relevance to humans is unknown, but these drugs are contraindicated for individuals with:

• Personal or family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2

Comparing the cost of Trulicity and Mounjaro

There are no generic versions of Trulicity or Mounjaro available. Both medications are available as brand-names only. Your out-of-pocket cost depends on whether or not you have insurance, and if your insurance company covers the medication. If you have insurance, you can call them using the number on the back of your insurance card to find out if the medication is covered and how much you will be responsible for paying.

The manufacturer may have a copay savings program, and you can check on their website or call them for the most up-to-date information about savings programs they offer.

If you don’t have insurance, or your insurance does not cover your medication, you can try using a discount card or coupon at the pharmacy.

• Based on the Drugs.com Trulicity Price Guide, a one-month supply of Trulicity costs around $1,038.
• Based on the Drugs.com Mounjaro Price Guide, a one-month supply of Mounjaro costs around $1,135.

Note: Cash prices are estimates using the Drug.com Drug Discount Card and are subject to change. Cost can vary for these medicines depending upon your pharmacy and location, your insurance and copays, deductibles, patient financial assistance or any discount coupons you may have.

This is not all the information you need to know about Trulicity or Mounjaro for safe and effective use and does not take the place of your healthcare provider’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.