Trulicity vs Ozempic: Which Medication Is Better?

With the seemingly constant addition of new pharmaceutical options for treating type 2 diabetes, it can become confusing to differentiate between them. 

While newer drugs can come with distinct benefits, they also have potential risks and side effects.

Two more recent medications used to treat diabetes include Trulicity and Ozempic. 

Whether your healthcare provider mentioned them or you saw an ad for them, you might be curious about how they compare and which is a better option.

Keep reading for a complete guide on Trulicity vs Ozempic.

What is Ozempic (Semaglutide)?

Ozempic is a brand name for the generic medication called semaglutide, which the FDA approved in 2017. This medication is used to treat people with type 2 diabetes and isn’t meant for people with type 1 diabetes. 

Ozempic was also approved in January 2020 to reduce the risk of heart attack and stroke, which helps reduce the risk of diabetes-related heart problems.

Ozmepic is in a class of medications called GLP-1 receptor agonists (1). GLP-1 receptors in your pancreas help increase insulin secretion while reducing glucagon secretion, a hormone that raises blood sugar levels. GLP-1 receptor agonists activate these receptors to help control blood sugar levels.

Ozempic may promote weight loss because it helps reduce hunger and promotes fullness by slowing stomach emptying (2, 3). Slowed stomach emptying can also help promote more stable blood sugar levels. The typical dose of Ozempic ranges from 0.5-2 milligrams weekly.

What’s worth discussing here is Ozempic vs Wegovy. Even though Ozempic can cause significant weight loss, it isn’t approved by the FDA to be used as a weight-loss medication. 

A different brand name for the same drug (semaglutide), Wegovy, was approved specifically for weight management in 2021. This, therefore, can be an option for those without type 2 diabetes who want to lose weight.

What is Trulicity (Dulaglutide)?

Trulicity is the brand name for another type of GLP-1 receptor agonist called dulaglutide. The FDA approved Trulicity to treat type 2 diabetes in September 2014 and again in February 2020 to reduce cardiovascular events in people with and without heart disease (similar to Ozempic).

Trulicity works in the same way Ozempic does because they’re both GLP-1 receptor agonists. It is also a non-insulin injectable medication. The common dose range for Trulicity is 0.75-4.5 milligrams weekly.

Is Ozempic in the same class as Trulicity?

Ozempic and Trulicity are both GLP-1 receptor agonists, which put them in the same medication class. Other GLP-1 receptor agonists include Exenatide (Byetta), Liraglutide (Victoza or Saxenda), Lixisenatide (Lyxumia), and Semaglutide (brand name Rybelsus, an oral version of a GLP-1 receptor agonist). 

Trulicity vs Ozempic effectiveness for diabetes

A 40-week clinical trial was conducted to assess the effectiveness of Trulicity vs Ozempic for diabetes. 1201 patients with type 2 diabetes who were at least 18 years old were included in the study. The participant’s blood sugar levels were uncontrolled on metformin (an oral diabetes medication) alone, with A1cs ranging from 7-10.5%.

The group receiving 0.75 milligrams weekly of Trulicity had their A1c levels reduced by an average of 1.1% compared to their baseline. The other group receiving 0.5 milligrams weekly of Ozempic had an average of 1.4% reduction in A1c levels. 

The difference in A1c levels was more drastic when dosages of the medications were increased. The participants receiving 1.5 milligrams of Trulicity had an average reduction in A1c of 1.3%, while those receiving 1 milligram of Ozempic weekly had an average reduction in A1c of 1.6%

Another study examined Trulicity’s ability to lower blood sugar (4). After 18 weeks, the average reduction in hemoglobin A1c was 1.23% on a lower dose (1.5 milligrams weekly), with an average reduction of 1.4% on a higher dose (3 milligrams weekly).

A study on Ozempic showed a reduction in hemoglobin A1c levels by 1-1.5% on a 0.5 milligram weekly dose (5). A1c levels were reduced by 1.3-2% on a 1-milligram weekly dose compared to baseline.

The bottom line is that Ozempic appears to be better at lowering blood glucose levels compared to Trulicity. 

However, everyone responds to medications differently, so it’s impossible to say that Ozempic would be better than Trulicity at lowering blood glucose in all cases.

What are the side effects of each medication?

Ozempic and Trulicity have similar side effects.

The most common side effects of Trulicity are:

• Nausea
• Diarrhea
• Vomiting
• Abdominal Pain
• Decreased appetite
• Indigestion
• Fatigue

The most common side effects of Ozempic are:

• Gastrointestinal symptoms like upset stomach (nausea and vomiting), stomach pain, loss of appetite, heartburn, burping, gas, and bloating
• Diarrhea or constipation 
• Headache
• Dizziness
• Fatigue
• Injection site pain
• Low blood sugar, especially when taken with a sulfonylurea or insulin

According to the Sustain 7 trial: at doses of 0.75 milligrams of Trulicity and 0.5 milligrams of Ozempic, Ozempic caused nausea in more patients (23% vs 12%), as well as diarrhea and vomiting when compared to Trulicity.

However, with doses of 1.5 milligrams of Trulicity and 2 milligrams of Ozempic, the prevalence of nausea, vomiting, and diarrhea were more similar between the two drugs.

While rare, Ozempic and Trulicity both have black box warnings from the FDA regarding their potential to cause thyroid cancer. Other potential rare side effects include pancreatitis and gallbladder problems.

Ozempic is more likely to cause retinopathy and vision changes than Trulicity, which is one potential disadvantage when comparing the two.

What is the price difference between Ozempic and Trulicity?

The price for Ozempic and Trulicity will vary depending on your medical and/or prescription drug coverage. 

According to GoodRx, when this article was written, four prefilled pens containing 1.5 milligrams each of Trulicity cost around $770, while two prefilled pens containing 2 milligrams each of Ozempic cost around $900 and higher. 

This means that Trulicity might be more affordable when paying out-of-pocket, but it depends on the dose you need. 

To get the most accurate price estimate, you should check with your local pharmacies and/or health insurance companies to determine your coverage and eligibility for discounts.

Ease of use for Trulicity vs Ozempic

Both Trulicity and Ozempic are meant to be injected once weekly, which is more convenient than injecting insulin once or multiple times a day. Once-weekly dosing is a flexible option that can make medication compliance more attainable.

Trulicity and Ozempic should be injected into the subcutaneous tissue, which is below the skin but not in a muscle. Good injection areas for subcutaneous injections are the abdomen, the front of your thighs, or the back of your upper arm (not in muscle). 

Needle size

Ozempic pens come with a 32-gauge (0.24 mm), 4-millimeter needle, which is very fine. Trulicity pens are equipped with a 29-gauge (0.33 mm) needle with an approximate injection depth of 5 millimeters. 

Ozempic pen needles are slightly finer than Trulicity, but both are very small needles.

Trulicity vs Ozempic for weight loss

Ozempic appears to be more effective at promoting weight loss compared to Trulicity. According to the same trial comparing Ozempic and Trulicity mentioned above:

Participants taking 0.75 milligrams weekly of Trulicity averaged 4.6 pound weight loss compared to their baseline, while those taking 0.5 milligrams of Ozempic weekly lost an average of 9.3 pounds.

When dosages of Ozempic and Trulicity were increased (1.5 milligrams weekly for Trulicity and 1 milligram weekly of Ozempic), the average weight loss was 6.2 pounds for Trulicity and 12.8 pounds for Ozempic.

Ozempic vs Trulicity for PCOS

Polycystic ovary syndrome (PCOS) is a hormonal condition that impacts hormone levels in women. Most often, PCOS causes high levels of androgens, a type of male hormone. PCOS can cause infertility, unwanted hair growth, hair loss, acne, and other symptoms.

Most types of PCOS are rooted in insulin resistance, which means women with PCOS often have elevated blood sugar and insulin levels. 

Because Ozempic and Trulicity can improve insulin sensitivity and blood sugar levels, they might help treat PCOS.

However, neither Ozempic nor Trulicity are approved to treat PCOS. But studies note that GLP-1 receptor agonists like Ozempic and Trulicity are among many potential therapeutic options for treating PCOS (6).

Benefits of Trulicity vs Ozempic

• Ozempic appears to be better at lowering blood sugar levels and reducing body weight.
• Trulicity has a lower risk of causing diabetic retinopathy and other vision problems.
• Ozempic appears to be better at reducing cardiovascular disease risk compared to Trulicity, according to a study (7). While it’s unknown exactly how GLP-1 receptor agonists can help reduce cardiovascular disease, the presumed method of action is by reducing plaque buildup in the arteries, which can cause artery blockages.
• Trulicity might be more affordable out-of-pocket.
• Trulicity might be less likely to cause gastrointestinal side effects (nausea, vomiting, diarrhea) when comparing both drugs at lower doses.

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What’s better – Trulicity or Ozempic?

Overall, Ozempic appears to be better at lowering blood sugar levels and promoting weight loss when compared to Trulicity. Ozempic might also be more effective at preventing cardiovascular events compared to Trulicity.

The main disadvantages of Ozempic, when compared to Trulicity, are cost (Ozempic is more expensive out of pocket), the potential for more prevalent side effects at starting doses, and the fact that Ozempic has a higher rate of causing retinopathy and vision issues compared to Trulicity.

Can you take Trulicity with Ozempic?

Trulicity and Ozempic aren’t meant to be taken together. Taking Ozempic and Trulicity together could increase your risk of adverse side effects and low blood sugar.

Trulicity and Ozempic can be taken with other diabetes medications like metformin, sulfonylureas, and insulin.

Natural alternatives to Ozempic and Trulicity

If your healthcare provider recommends Ozempic or Trulicity to help manage your type 2 diabetes, you should discuss your options if you’re looking for alternatives or don’t wish to take them. 

However, if you’re cleared to try natural supplements by your healthcare provider, here are some options to consider.

Berberine

Berberine is a compound in some plants and is a natural alternative for treating insulin resistance and high blood sugar.

According to a small study on people with metabolic syndrome (a condition that can lead to type 2 diabetes), berberine improved insulin sensitivity and reduced participants’ waist circumference (8). Waist circumference is positively associated with insulin resistance.

A pilot study compared berberine vs metformin (a popular oral medication used to treat diabetes) directly for their ability to help treat symptoms of type 2 diabetes (9). 

The researchers found that berberine produced identical results as metformin in terms of improving blood glucose metabolism. 

Berberine may also help promote weight loss by improving insulin resistance, since insulin resistance can make weight loss more difficult to attain. If you want to take berberine for weight loss, the typical dosage range is 400-1500 milligrams a day.

Magnesium

Type 2 diabetes stems from insulin resistance, which is when your body doesn’t use insulin effectively. Insulin resistance can lead to worsening blood sugar control and reduced insulin secretion in your pancreas. 

Magnesium supplementation can help improve insulin sensitivity, which means it can help lower blood sugar levels (10). 

People with diabetes tend to have lower levels of magnesium in their blood compared to people without diabetes, which suggests that magnesium may play a role in the development of diabetes.

According to a study, magnesium helps improve insulin sensitivity and boosts insulin secretion (11). 

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Conclusion

Ozempic (semaglutide) and Trulicity (dulaglutide) are brand names for two types of GLP-1 receptor agonists meant to treat type 2 diabetes. GLP-1 receptor agonists help boost insulin secretion, slow gastric emptying, and reduce hormones that increase blood sugar.

While they have similar benefits and potential side effects, Ozempic appears to be more advantageous over Trulicity in many aspects, including its ability to lower blood sugar, promote weight loss, and reduce cardiovascular outcomes like heart attack and stroke.

The main advantages of Trulicity over Ozempic are its potential lower cost when paying out-of-pocket and lower risk of eye/vision problems like diabetic retinopathy compared to Ozempic.

To determine which medication might be best for you, you should consult your trusted healthcare provider and/or pharmacist. They can help you choose an option that best suits your needs, budget, and other factors.

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