What is the difference between Trulicity and Ozempic?

You know those puzzles for kids where you need to look at two pictures and figure out what’s different between them? At first glance they seem almost exactly the same, but then you realize that in one picture there are three cats and in the other there are only two. Comparing GLP-1s can often feel the same way.

Take Trulicity vs. Ozempic. They seem so similar — both are prescription, once-weekly injectable GLP-1s approved to treat type 2 diabetes — but keep looking and they have different active ingredients, dosing options, and potential side effects. Read on for a clearer side-by-side comparison.

What is Trulicity?

Trulicity is the brand name of a medication containing the active ingredient dulaglutide. FDA-approved in 2014 for treating type 2 diabetes, it’s taken as a once-weekly injection that lowers blood sugar when combined with a healthy diet and regular exercise. Trulicity is part of a class of drugs known as GLP-1 receptor agonists. These drugs mimic the action of the body’s own glucagon-like peptide-1, a gut hormone that stimulates the release of insulin after you eat, signals the brain that you’re full, and slows the movement of food out of your stomach, so you feel full longer. Dulaglutide also activates GLP-1 receptors in the area of the brain that regulates hunger and energy balance, leading to heightened satiety signals and reduced food intake. That’s why GLP-1 medications like Trulicity don’t just help manage blood sugar, they also cause weight loss by reducing hunger.

What is Ozempic?

Ozempic is the brand name of a medication containing the active ingredient semaglutide. Like Trulicity, it is FDA-approved as a once-a-week injection for managing blood sugar in people with type 2 diabetes, designed to be paired with healthy eating and exercise. It’s another member of the GLP-1 receptor agonist class of drugs, which means it also mirrors the action of the hormone GLP-1, increasing how much insulin your body releases after you eat, telling your brain that you’re full, and slowing down digestion. Like Trulicity, it can also cause weight loss by reducing your appetite, so you eat less.

Do Trulicity and Ozempic have generic versions?

Neither drug currently comes in a generic version. The Trulicity manufacturer’s U.S. patent for the medication expires in 2027, and Ozempic’s in 2032, so after those times, generic versions may become available in the United States, but there’s no way to know for sure.

Key differences between Trulicity and Ozempic

When comparing Ozempic vs. Trulicity, there are many similarities but also a few important differences. “Although both medications are GLP-1s, their active ingredients differ,” says Dr. Bubu Banini, M.D., translational research director of the Metabolic Health and Weight Loss Program at Yale School of Medicine. The compound in Trulicity is dulaglutide, and the compound in Ozempic is semaglutide.

Beyond that, their FDA approvals vary a bit. Trulicity is approved for both adults and children age 10 and older, while Ozempic is only for use in adults over 18. The way you take the two injections is also slightly different, in that the Ozempic pen has multiple doses (you simply attach a new needle for each dose), and the Trulicity pen has one dose.

Last but not least, Ozempic appears to be somewhat more effective than Trulicity for both blood sugar control and weight loss. In a 2018 head-to-head comparison study, participants taking semaglutide had similar or greater improvements in their A1c (a measure of long-term blood sugar levels in people with diabetes) than those taking dulaglutide, as well as greater reductions in their body weight.

Trulicity vs. Ozempic uses

Ozempic and Trulicity are both FDA-approved to improve blood sugar control when paired with diet and exercise in adults with type 2 diabetes. They may also both cause moderate weight loss, though neither one is approved for this purpose. (There is an injectable medication containing semaglutide that’s FDA-approved to treat overweight and obesity: Wegovy. There is no version of dulaglutide that’s approved for weight loss.)

Trulicity and Ozempic are also each approved for additional uses, which differ slightly.

• Ozempic can be used to lower the risk of major cardiovascular events in adults with type 2 diabetes, as well as lower the risk of end-stage kidney disease, sustained eGFR decline (a measure of kidney function), and cardiovascular death in adults with type 2 diabetes and chronic kidney disease.
  
  
• Trulicity can be used to treat type 2 diabetes in children ages 10 and up (in addition to adults), and to lower the risk of major cardiovascular events in adults with type 2 diabetes who also have heart disease or multiple cardiovascular risk factors.

Trulicity vs. Ozempic dosages and administration

Both Trulicity and Ozempic are once-a-week injections that you administer yourself, just under the skin of your thigh, abdomen, or upper arm. The injection pens for the two medications are slightly different. The Ozempic pen is reusable; you attach a new needle to the end of the pen each time you take a dose. The Trulicity pen is single-use, which means you use a new pen (with a pre-attached needle) each time you inject yourself.

Both medications come in four different dosages. You start by taking the lowest dose for four weeks, then you and your doctor will decide whether to increase the dose every four weeks depending on how you’re doing. The standard Trulicity dosage is .75 mg to start, then increasing to 1.5 mg, 3 mg, and 4.5 mg if needed. The corresponding Ozempic dosage is .25 mg to start, increasing to .5 mg, 1 mg, and 2 mg if needed.

Effectiveness of Trulicity vs. Ozempic

Both medications are highly effective, though one appears to have an edge over the other. “The main difference between Trulicity and Ozempic is in potency and duration of action,” says Dr. Disha Narang, M.D. endocrinologist and director of obesity medicine at Endeavor Health System in Chicago. “Semaglutide (Ozempic) binds more strongly to the GLP-1 receptors, which contributes to greater effects on weight and blood sugar control compared to dulaglutide (Trulicity).” Semaglutide also works in your body for a longer period of time.

This is supported by research: A 40-week study published in The Lancet Diabetes & Endocrinology found that semaglutide was better at improving blood sugar control and decreasing body weight — and helped more participants with type 2 diabetes lose weight and reach their target blood sugar levels — than dulaglutide. Participants taking 1 mg per week of semaglutide lost about 14 pounds and lowered their A1c by 1.8 percentage points on average, while those taking 1.5 mg per week of dulaglutide lost an average 6.5 pounds and took 1.4 percentage points off their A1c.

A more recent follow-up study found that a 1 mg dosage of semaglutide improved blood sugar more than the 3 mg dose of dulaglutide, and about the same as the highest dose of dulaglutide (4.5 mg). The 1 mg dose of semaglutide was also more effective at reducing body weight than either of the higher doses of dulaglutide.

Trulicity vs. Ozempic cost and insurance coverage

There’s not much difference between the cost of Trulicity and the cost of Ozempic. The list price for a one-month supply of either medication is just under $1,000, according to their manufacturers ($997.58 for Ozempic, and $987.19 for Trulicity). The manufacturers of both drugs also offer savings programs and patient assistance programs for people who qualify.

Health insurance, including Medicare and Medicaid, will likely reduce the cost you pay out of pocket, but you’ll need to check with your insurance company to find out the exact amount. “Coverage for both Trulicity and Ozempic depends on the insurance plan,” says Banini. It also depends on what the medication is being prescribed for. “The medications are more likely to be covered for treatment of diabetes than when prescribed off-label for weight loss,” says Banini.

Trulicity vs. Ozempic side effects

Trulicity and Ozempic can cause similar side effects — in particular, mild gastrointestinal upset in the first few days-to-weeks of starting the medication or when you increase the dose. Side effects, particularly gastrointestinal symptoms, are reported more frequently with semaglutide compared to dulaglutide. Rarely, people on either an Ozempic prescription or Trulicity prescription can experience more serious side effects, including pancreatitis; vision changes; problems with the gallbladder, stomach, and kidneys; and low blood sugar (especially if you also take another medication that can lower blood sugar, such as sulfonylurea or insulin).

“The overall risk of severe side effects, such as pancreatitis, is low and appears comparable between the two medications,” says Narang. “However, because Ozempic tends to be more potent, some patients may experience stronger GI effects when starting or increasing the dose.”

Trulicity side effects

The most commonly reported Trulicity side effects are:

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Indigestion
• Decreased appetite
• Fatigue

You can see the full list of potential side effects on the Trulicity manufacturer’s website.

Ozempic side effects

The most commonly reported Ozempic side effects are:

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Constipation

You can see the full list of potential side effects on the Ozempic manufacturer’s website.

Trulicity and Ozempic drug warnings

Both Trulicity and Ozempic contain a “black box warning” — the FDA’s highest-level safety warning for a medication — for an increased risk of a specific rare kind of thyroid cancer and caution that people with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) shouldn’t take them. The warning is based on studies in mice and rats, however, and studies in humans have found no increased risk of thyroid cancer.

Both medications also carry a risk for people undergoing sedation, since they can slow stomach emptying and raise the chance of breathing food particles into the lungs during surgery.

The bottom line

Trulicity and Ozempic are both effective GLP-1 medications for managing type 2 diabetes, with the added benefit of potential weight loss. While studies suggest Ozempic may offer stronger results overall, Trulicity remains a solid option, especially for those most concerned about GI side effects, which can be a little more intense in Ozempic. In the end, the choice between the two medications may come down to practical factors like insurance coverage and personal preference. Talk with your healthcare provider to learn more about these two medications and if one is right for you.