Trulicity vs Ozempic: Which is right for you?

Trulicity and Ozempic are both injectable medications used to treat type 2 diabetes. The active ingredient in Trulicity is dulaglutide, and for Ozempic, it is semaglutide.

While both Trulicity and Ozempic belong to the same drug class called GLP-1 receptor agonists and have the same mechanism of action, they differ in their structure, the way they are processed by the body and their clinical effects.

Research has shown that Ozempic is more effective than Trulicity in lowering blood sugar levels and decreasing weight, but lower dosages of Ozempic may have a higher risk of side effects compared to lower dosages of Trulicity.

Is Trulicity the same as Ozempic?

No, Trulicity is not the same as Ozempic, but it is similar because it belongs to the same class of medicines called GLP-1 receptor agonists. This means Trulicity and Ozempic have the same mechanism of action, but there are differences in their likelihood of side effects and effectiveness.

The mechanism of action of GLP-1 agonists such as Trulicity and Ozempic involves mimicking the action of GLP-1, a naturally occurring hormone released by the gut that helps regulate blood glucose (sugar) levels. GLP-1 stimulates insulin secretion from the pancreas and reduces glucagon secretion, which lowers blood glucose levels. It also slows down how fast the stomach empties after eating which means you feel fuller for longer. Feeling fuller for longer means you are less likely to eat as much, which is why Trulicity and Ozempic can also cause weight loss.

Trulicity vs Ozempic: Uses

Both Trulicity and Ozempic are used to improve blood glucose levels in adults with type 2 diabetes in addition to diet and exercise.

• Trulicity is also approved to treat children 10 years of age and older with type 2 diabetes. Ozempic is only for use in adults.

Ozempic is also approved to reduce the risk of serious heart problems such as heart attack or stroke in adults with type 2 diabetes and heart disease. Trulicity can also be used in this population, but its approval extends to include adults with type 2 diabetes and multiple cardiovascular risk factors (such as smoking, high cholesterol, high blood pressure, or obesity).

Although Ozempic is not approved for weight loss, a higher dose version of Ozempic called Wegovy, with the active ingredient semaglutide, is approved for weight loss.

Trulicity is not approved for weight loss, and there is no higher-dose version of dulaglutide approved for weight loss either.

Trulicity vs Ozempic: Side effects

Both Trulicity and Ozempic have similar gastrointestinal (GI) side effects, such as nausea, vomiting, and diarrhea. At lower dosages, Trulicity causes less GI side effects than Ozempic. At higher dosages, Ozempic causes less GI side effects than Trulicity.

In the SUSTAIN 7 trial, gastrointestinal disorders were the most frequently reported side effect and they occurred in:

• 43% of patients receiving semaglutide 0·5 mg
• 44% of patients receiving semaglutide 1·0 mg
• 33% of patients receiving dulaglutide 0·75 mg
• 48%) of patients receiving dulaglutide 1·5 mg.

Overall, more female than male patients reported gastrointestinal side effects and the prevalence of these side effects with semaglutide reduced the heavier the person being treated was. The highest proportion of gastrointestinal side effects was in people whose BMI was less than 25 kg/m2.

Gastrointestinal disorders were also the most common reason for discontinuing treatment with semaglutide and dulaglutide in the SUSTAIN 7 trial. The percentage of people stopping the rial early because of gastrointestinal side effects was reported as:

• 5.4% with semaglutide 0.5 mg
• 2.1% with dulaglutide 0,75 mg
• 5.2% with semaglutide 1 mg
• 5.6% with dulaglutide 1.5 mg.

In the Ozempic Prescribing Information, there is a warning for an increased risk of diabetic retinopathy with Ozempic use. Although this warning is not included in the Trulicity Prescribing Information, it may be because trials of Trulicity did not include diabetic retinopathy as a safety outcome or it may have been listed as an exclusion criteria.

Trulicity vs Ozempic: Cost

Trulicity and Ozempic are both expensive and their average monthly cost is similar, at just over $1000 for a 4-week supply. See Trulicity Prices, Coupons, Copay Cards & Patient Assistance or Ozempic Prices, Coupons, Copay Cards & Patient Assistance for more information.

Related questions

• Ozempic Side Effects to Watch For
• Mounjaro vs Ozempic: How do they compare?
• How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?

Trulicity vs Ozempic: Effectiveness

There are few head-to-head trials comparing Trulicity (dulaglutide) and Ozempic (semaglutide), but an open-label parallel-group trial (SUSTAIN 7) of 1201 patients sponsored by Novo Nordisk (the makers of Ozempic) reported Ozempic was more effective than Trulicity at improving blood sugar control at low and high doses.

• Semaglutide 0.5 mg had a higher HbA1c reduction than dulaglutide 0.75 mg (1.5 vs 1.1; p<0.0001)
• Semaglutide 1mg had a higher HBA1C reduction than dulaglutide 1.5mg (1.8 vs 1.4; p < 0.0001).
• By week 40, 65% of patients taking semaglutide 0.5 mg versus 51% of those taking dulaglutide 0.75 mg were able to achieve an HbA1C of less than 7%.

The average weight loss reported with Ozempic was significantly more than that reported with Trulicity.

• Patients taking semaglutide 0.5 mg reported an average weight loss of 4.6 kg compared to 2.3 kg with dulaglutide 0.75 mg (p<0.0001).
• Patients taking semaglutide 1 mg reported an average weight loss of 6.5 kg compared to 3 kg with dulaglutide 1.5 mg (p<0.0001).

Trulicity vs Ozempic: Dosing

Both Trulicity and Ozempic are dosed 1 time a week for type 2 diabetes and are both provided as a pre-filled pen for injection. They are both given subcutaneously (SC) – which means an injection under the skin of your stomach (abdomen) area, front of your thighs, or if a caregiver is giving them to you, back of your upper arms.

• The recommended initial dose of Trulicity is 0.75mg which may be increased to 1.5 mg or higher if the blood glucose levels are not completely controlled. The maximum dose of Trulicity is 4.5 mg weekly.
• The recommended initial dose of Ozempic is 0.25 mg once weekly which is increased to 0.5 mg after 4 weeks. The dose can be increased further to 1mg after at least 4 weeks at 0.5 mg. The maximum dose of Ozempic is 2 mg once weekly.

Trulicity vs Ozempic: Pen sizes

The Trulicity prefilled pen is single-use only and only contains one dose of Trulicity. Trulicity is available in 4 strengths: 0.75 mg/0.5 ml, 1.5 mg/0.5 mL, 3 mg/0.5 ml, 4.5 mg/0.5 ml. See How do you use/inject Trulicity? For more information.

The Ozempic prefilled pen comes in 3 sizes and each pen holds 4 doses of either 0.5 mg, 1 mg, or 2 mg of Ozempic to be given once weekly. This means each pen will last for 1 month (see How many doses are in an Ozempic pen?).

Switching from Trulicity to Ozempic

Switching from Trulicity to Ozempic (and vice versa) is possible and an estimated one-fourth of patients switch between GLP-1 receptor agonists within their first year of treatment. Reasons for switching include the need for improved blood sugar or weight control, a requirement for protection from cardiovascular events (such as a heart attack, to reduce side effects, or patient preference.

Because Trulicity and Ozempic are both administered once weekly, switching is relatively easy. The first dose of Ozempic should be administered 7 days after the last dose of Trulicity and vice versa. Ozempic should be initiated at the equivalent or a lower dose of Trulicity (dulaglutide 0.75 mg is equivalent to semaglutide 0.25 mg).

Trulicity to Ozempic conversion

Can you take Ozempic and Trulicity together?

No, Ozempic and Trulicity should NOT be taken together because they belong to the same drug class (GLP-1 agonists) and have the same mechanism of action.

Taking both together will increase your risk of side effects without being any more effective. The best option would be to talk to your healthcare provider about increasing the dose of either Trulicity or Ozempic, although you may benefit from switching from one to the other instead.

Trulicity vs Ozempic: Manufacturer

Trulicity is made by Eli Lilly and Company and gained FDA approval on September 18, 2014.

Ozempic is made by Novo Nordisk and gained FDA approval on December 5, 2017.