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Key takeaways
Ozempic (semaglutide) and Trulicity (dulaglutide) are FDA-approved GLP-1 receptor agonists used for Type 2 diabetes and cardiovascular risk reduction. Ozempic can also be used in people with chronic kidney disease.
Common side effects of both drugs include nausea, vomiting, diarrhea, abdominal pain, and constipation, with specific precautions against using either medication for patients with a history (or family history) of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
Ozempic and Trulicity share several similarities, including a gradually increasing weekly dosing schedule and similar warnings and precautions.
Consult your healthcare provider for more information and medical advice about the best treatment for your condition.
Ozempic and Trulicity are two commonly prescribed injectable medications used to manage Type 2 diabetes. While they are in the same class of drugs and share many similarities, they have key differences in active ingredients, dosage, and cost.
Neither is an insulin, but they are potent prescription medications that can improve blood sugar control, aid in weight loss, and reduce the risk of serious cardiovascular events. If your healthcare provider has suggested a GLP-1 receptor agonist, comparing Ozempic and Trulicity can help you understand which option might be best for your treatment plan.
Main differences between Ozempic and Trulicity |
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|---|---|---|
| Ozempic | Trulicity | |
| Drug class | Glucagon-like peptide 1 (GLP-1) receptor agonist | Glucagon-like peptide 1 (GLP-1) receptor agonist |
| Brand/generic status | Brand (made by Novo Nordisk) | Brand (made by Eli Lilly and Company) |
| What is the generic name? | Semaglutide is the active ingredient, but there is no generic version available at this time | Dulaglutide is the active ingredient, but there is no generic version available at this time |
| What form(s) does the drug come in? | Pen injection for subcutaneous injection | Pen injection for subcutaneous injection |
| What is the standard dosage? | Starting dose: 0.25 mg once weekly. The healthcare provider will gradually increase the dose to a maximum of 2 mg weekly. | Starting dose: 0.75 mg once weekly. The healthcare provider may increase the dose, if needed, to a maximum of 4.5 mg weekly. |
| How long is the typical treatment? | Varies; long-term | Varies; long-term |
| Who typically uses the medication? | Adults 18 years and older | Adults and children 10 years and older |
What are the main differences between Ozempic and Trulicity?
Ozempic and Trulicity belong to a drug class called GLP-1 agonists, also known as glucagon-like peptide agonists. Both drugs are available in brand-name only. The active ingredient in Ozempic is semaglutide, and the active ingredient in Trulicity is dulaglutide. However, neither drug is currently available in generic form. Both drugs are available in a pen injection form. With each weekly dose, the medication is injected subcutaneously into the abdomen, thigh, or upper arm. We’ll discuss each drug in more detail below.
Conditions treated by Ozempic and Trulicity
Ozempic and Trulicity both have several FDA-approved uses, as outlined in the table below. These drugs are also sometimes prescribed off-label (for a non-FDA-approved use) for weight loss.
| Ozempic FDA-approved uses | Trulicity FDA-approved uses |
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Is Ozempic or Trulicity more effective?
In a Phase 3b clinical trial, called SUSTAIN 7, comparing Ozempic against Trulicity, Ozempic was found to be slightly more effective in improving blood sugar control and resulting in weight loss, with a similar safety profile.
A 2024 review and analysis of studies compared Ozempic vs Trulicity for blood sugar control and weight loss. The researchers concluded that Ozempic may be a better treatment for people with Type 2 diabetes who require both blood sugar control and weight management.
A 2025 study found that, in terms of cardiovascular risk reduction, Ozempic was associated with lower three-year risks of death due to any cause, heart attack, stroke, and heart failure in people with Type 2 diabetes, compared to Trulicity.
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However, both drugs are considered safe and effective. The best drug for you should be determined by your endocrinologist or primary healthcare provider, who can take into account individual considerations, such as your medical conditions and medical history, as well as any other medications you are taking.
Coverage and cost comparison of Ozempic vs. Trulicity
Both Ozempic and Trulicity are covered by many insurance and Medicare Part D plans. GLP-1s often require prior authorization. Check with your insurance provider for specific details and out-of-pocket costs for your plan.
If you are paying without insurance for Ozempic, the cost for a 3 mL pen of 2 mg/3 mL (0.25 or 0.5 mg per dose) is approximately $1,400. However, you can use a free SingleCare coupon to pay as low as $825 for this Rx.
The out-of-pocket cost for Trulicity is approximately $1,405 for four 1.5 mg/0.5 mL pens. However, you can apply a free SingleCare coupon to pay a lower cost of $777 for your Trulicity prescription.
Comparing the cost of Ozempic vs. Trulicity |
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|---|---|---|
| Ozempic | Trulicity | |
| Typically covered by insurance? | Many plans cover Ozempic for an FDA-approved use, but will often require prior authorization. Check with your specific plan for more information. | Many plans cover Trulicity for an FDA-approved use, but will often require prior authorization. Check with your specific plan for more information. |
| Typically covered by Medicare Part D? | Many Medicare prescription plans cover Ozempic for an FDA-approved use, but will often require prior authorization. Check with your specific plan for more information. | Many Medicare prescription plans cover Trulicity for an FDA-approved use, but will often require prior authorization. Check with your specific plan for more information. |
| Standard dosage | 1 prefilled pen | 1 box of 4, single-dose pens |
| Typical Medicare Part D copay | Varies based on plan as well as coverage phase | Varies based on plan as well as coverage phase |
| SingleCare cost | $825 at CVS Pharmacy | $777 at Walgreens |
Common side effects of Ozempic vs. Trulicity
The most common side effects of both Ozempic and Trulicity are gastrointestinal in nature.
Common side effects of Ozempic
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Constipation
Common side effects of Trulicity
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Decreased appetite
Hypoglycemia (low blood sugar) may occur with either medication, especially when used in combination with insulin or sulfonylurea drugs. This is not a comprehensive list of side effects, and additional side effects may occur. See the Warnings section for more information about serious side effects. You can also consult your healthcare provider for a full list of side effects.
Drug interactions of Ozempic vs. Trulicity
Using Ozempic or Trulicity with insulin or insulin secretagogues (such as sulfonylureas or meglitinides) can significantly increase the risk of severe hypoglycemia (low blood sugar). If you take this combination, your healthcare provider will likely need to adjust the dosing of the insulin or oral medication.
Additionally, because both drugs cause delayed gastric emptying, they can potentially affect the absorption of other medications taken by mouth. While this was not clinically relevant in studies, your healthcare provider may recommend monitoring certain oral medications, especially those with a narrow therapeutic index (a small window between a therapeutic effect and toxicity). Examples include Coumadin (warfarin), Lanoxin (digoxin), and certain seizure medications.
Before taking Ozempic or Trulicity, be sure to inform your healthcare provider about all the medications you are currently taking. This includes prescription and OTC drugs, vitamins, and supplements. Your provider can check for potential drug interactions.
Warnings of Ozempic and Trulicity
Because both medications belong to the same drug class, their warnings and precautions are largely the same. You will receive a medication guide every time you fill a prescription for Ozempic or Trulicity, which outlines side effects and warnings. It is important to carefully read the information and ask your healthcare provider or pharmacist if you have any questions. Before using Ozempic or Trulicity, be sure to tell your healthcare provider about any medical conditions you have. Also, tell them about any upcoming surgeries or procedures, because you may need to pause your treatment for a short time before anesthesia.
There is a boxed warning for Ozempic and Trulicity, which is the most serious warning required by the FDA. In animal studies, Ozempic or Trulicity caused thyroid C-cell tumors, including MTC (medullary thyroid carcinoma). It is not known whether this occurs in humans. Patients with a history (or family history) of MTC or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not take Ozempic or Trulicity. While using Ozempic or Trulicity, patients should call their healthcare provider right away if they have any symptoms of thyroid cancer, such as a lump in the neck, hoarseness, or trouble breathing or swallowing.
Other warnings include:
- Acute pancreatitis: This is a serious condition that can occur. Watch carefully for signs, including persistent severe abdominal pain that may radiate to the back, which may or may not be accompanied by vomiting. If pancreatitis is suspected, discontinue use of your GLP-1 and contact your healthcare provider immediately.
- Diabetic retinopathy complications: The risk of temporary worsening of this eye complication is higher in patients who have a history of diabetic retinopathy. Patients should be closely monitored and undergo regular eye exams.
- Acute kidney injury: Worsening of chronic kidney failure that may require dialysis can occur, especially if accompanied by vomiting or diarrhea leading to dehydration.
- Hypersensitivity reactions: Serious reactions like anaphylaxis or angioedema have been reported. If you experience symptoms of an allergic reaction, such as hives, difficulty breathing, or swelling, seek emergency medical attention immediately.
- Pregnancy and breastfeeding: It is not known if Ozempic or Trulicity can harm an unborn baby. Consult your healthcare provider for medical advice if you are pregnant, planning to become pregnant, or breastfeeding. Typically, your provider will advise you to stop Ozempic or Trulicity at least two months before you try to become pregnant. It is also unknown whether Ozempic or Trulicity passes into breast milk; therefore, consult your healthcare provider for medical advice.
Frequently asked questions about Ozempic vs. Trulicity
Are Ozempic and Trulicity the same?
Ozempic and Trulicity are both classified as GLP-1 receptor agonists. They are very similar, but not quite the same. The information above provides more details about each medication. Other drugs in the GLP-1 receptor agonist class include Victoza (liraglutide), Byetta (exenatide), and Adlyxin (lixisenatide). There is also an oral semaglutide tablet available, with the same ingredient as Ozempic. The oral tablet is called Rybelsus. Mounjaro is an injectable Type 2 diabetes medicine classified as a GIP/GLP-1 agonist. It’s similar to Ozempic and Trulicity, but works on an additional hormonal pathway to help lower blood sugar levels and control weight.
Is Ozempic or Trulicity better?
Some studies have found Ozempic to be better for blood sugar control and weight loss, as well as reducing cardiovascular risk. However, both drugs are considered safe and effective. Consult your healthcare provider to see if Ozempic or Trulicity might be an appropriate medication for you.
Can I use Ozempic or Trulicity while pregnant?
It is not known whether Ozempic or Trulicity can harm an unborn baby, so you should talk with your healthcare provider if you are pregnant or planning to conceive. Usually, healthcare providers advise patients to stop using Ozempic or Trulicity a few months before trying to conceive. If you are already taking Ozempic or Trulicity and find out that you are pregnant, contact your OB-GYN immediately for guidance.
Can I use Ozempic or Trulicity with alcohol?
It is best to avoid alcohol while using Ozempic or Trulicity. Alcohol can cause low blood sugar, and Ozempic or Trulicity can cause low blood sugar as well. The combination can cause severe or prolonged hypoglycemia.
Is Ozempic the same as metformin?
No, these drugs are not the same, although they are both commonly prescribed for Type 2 diabetes. Ozempic is a once-weekly injection that contains the active ingredient semaglutide. It is FDA-approved for Type 2 diabetes, cardiovascular risk reduction, and kidney disease. Metformin is an oral medication that is taken every day (or sometimes twice daily, depending on the formulation) for Type 2 diabetes.
How long does it take Ozempic to start working?
Once you inject Ozempic, the maximum level is reached in one to three days. However, it may take longer to see its effects on blood sugar control and weight. It may take a few dosage increases to reach the maximum effects, but dosing will vary based on the individual. Your healthcare provider will guide you on the proper dosage.
Does Ozempic cause anxiety?
The Ozempic prescribing information does not list anxiety as a side effect. However, Ozempic may cause hypoglycemia (low blood sugar), and anxiety can be one of many symptoms of low blood sugar. If you are on Ozempic and have anxiety that you have not experienced before, consult your healthcare provider.
- Ozempic, DailyMed (2025)
- Trulicity, DailyMed (2025)
- Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): A randomised, open-label, phase 3b trial, The Lancet Diabetes & Endocrinology (2018)
- Semaglutide vs. dulaglutide for glycemic and weight control in patients with type 2 diabetes mellitus: A systematic review and meta-analysis, Biomedical Reports (2024)
- Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes, Scientific Reports (2025)