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Drug vs. Drug

Ozempic vs. Trulicity: Differences, similarities, and which is better for you

Karen Berger medical writer and reviewer headshot By | May 12, 2020

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

If you have Type 2 diabetes, your endocrinologist or primary healthcare provider may have mentioned using an injectable medication to control your blood sugar. Ozempic (semaglutide) and Trulicity (dulaglutide) are two brand-name injectable medications used in the treatment of type 2 diabetes. Ozempic is made by Novo Nordisk, and Trulicity is made by Eli Lilly and Company. Both medications are approved by the FDA. They are classified in a group of medications called GLP-1 receptor agonists (glucagon-like peptide agonists).

Ozempic and Trulicity are injectable diabetes drugs—but are not insulin. They work by stimulating insulin secretion and lowering glucagon secretion, thereby lowering blood glucose levels. These medications also slightly delay gastric emptying, which helps control both appetite and postprandial (after a meal) blood sugar levels. They aid weight loss by helping to reduce body weight.

Ozempic and Trulicity also help with hemoglobin A1c reduction (HbA1c), which is a measure of glucose control over time. Although both medications are GLP-1 agonists, they have some differences, which we will discuss below.

What are the main differences between Ozempic and Trulicity?

Ozempic and Trulicity are in a drug class called GLP-1 agonists, or 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.

Main differences between Ozempic and Trulicity
Ozempic Trulicity
Drug class Glucagon-like peptide 1 (GLP-1) receptor agonist Glucagon-like peptide 1 (GLP-1) receptor agonist
Brand/generic status Brand Brand
What is the generic name? Semaglutide Dulaglutide
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.
After 4 weeks, increase dose to 0.5 mg once weekly.
May increase to 1 mg once weekly after 4 weeks if additional glycemic control is needed.
Maximum recommended dosage is 1 mg weekly
Starting dose: 0.75 mg once weekly.
May increase to 1.5 mg once weekly if additional glycemic control is needed.
Maximum recommended dose is 1.5 mg once weekly
How long is the typical treatment? Varies Varies
Who typically uses the medication? Adults 18 years and older Adults 18 years and older

Conditions treated by Ozempic and Trulicity

Both Ozempic and Trulicity have two indications. The first indication is to improve glycemic control in adults with Type 2 diabetes (in conjunction with diet and exercise). The second indication is to lower the risk of major heart events (stroke, heart attack, cardiovascular death) in patients who have Type 2 diabetes and heart disease.

Condition Ozempic Trulicity
Adjunct to diet and exercise to improve glycemic control in adults with Type 2 diabetes mellitus (DM) Yes Yes
To reduce the risk of major adverse cardiovascular events in adults with Type 2 DM and cardiovascular disease Yes Yes

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 better in terms of improving blood sugar control and resulting in weight loss, with a similar safety profile. However, it is important to note that the study was performed by Novo Nordisk, the manufacturer of Ozempic. No other head-to-head studies have been done comparing Ozempic to Trulicity.

The most effective drug for you is best determined by your endocrinologist or primary healthcare provider, who can take into account your medical condition(s) and medical history, along with other medications you take.

Coverage and cost comparison of Ozempic vs. Trulicity

Both Ozempic and Trulicity are covered by most insurance and Medicare Part D plans. Check with your insurance provider for specific details/costs for your plan.

An Ozempic prescription is approximately $970. You can purchase it for $711 with a SingleCare Ozempic discount coupon.

A prescription for Trulicity can run nearly $2,000. You can save with SingleCare and pay $1,432 at participating pharmacies.

  Ozempic Trulicity
Typically covered by insurance? Yes (usually) Yes (usually)
Typically covered by Medicare Part D? Yes (usually) Yes (usually)
Standard dosage 1 prefilled pen (delivers 0.25 mg, 0.5 mg, or 1 mg per injection) 1 box of 4, single-dose pens (0.75 mg or 1.5 mg per 0.5 ml injection)
Typical Medicare Part D copay $25-$888 $25-$873
SingleCare cost $711 $1,432

Common side effects of Ozempic vs. Trulicity

The most common side effects of Ozempic are nausea, vomiting, diarrhea, abdominal pain, and constipation. The most common side effects of Trulicity are nausea, vomiting, diarrhea, abdominal pain, constipation, decreased appetite, fatigue, and indigestion. Hypoglycemia (low blood sugar) may occur with either medication. This is not a full list of side effects. Other adverse effects may occur. Consult your healthcare provider for a full list of side effects.

  Ozempic Trulicity
Side effect Applicable? Frequency Applicable? Frequency
Nausea Yes 15.8-20.3%* Yes 12.4-21.1%*
Vomiting Yes 5.0-9.2% Yes 6.0-12.7%
Diarrhea Yes 8.5-8.8% Yes 8.9-12.6%
Abdominal pain Yes 5.7-7.3% Yes 6.5-9.4%
Constipation Yes 3.1-5.0% Yes 3.7-3.9%
Hypoglycemia (low blood sugar) Yes Varies Yes Varies
Decreased appetite Yes % not reported Yes 4.9-8.6%
Fatigue Yes >0.4% Yes 4.2-5.6%
Dyspepsia (indigestion) Yes 2.7-3.5% Yes 4.1-5.8%

*Dependent on dosage
Source: DailyMed (Ozempic), DailyMed (Trulicity).

Drug interactions of Ozempic vs. Trulicity

Using Ozempic or Trulicity with insulin or insulin secretagogues (certain oral diabetes medications) can increase the risk of hypoglycemia. If you take this combination of medications, your prescriber will most likely adjust the dosing of your insulin or oral medication. Also, because Ozempic or Trulicity causes delayed gastric emptying, the absorption of oral medications can potentially be affected if taken at the same time. In studies, these interactions did not occur to a clinically relevant degree; however, it is a good idea to consult your healthcare provider about the timing of your medications.

Drugs with a narrow therapeutic index should especially be monitored. These include drugs where there is a small window between therapeutic effect and toxicity such as Coumadin (warfarin), Lanoxin (digoxin), and seizure medications.

This is not a full list of drug interactions. Consult your healthcare provider for a full list of drug interactions.

Drug Drug class Ozempic Trulicity
Meglitinides
(nateglinide,
repaglinide)
Sulfonylureas
(glimepiride, glipizide, glyburide)
Insulin secretagogues Yes Yes
Basaglar
Humalog
Lantus
Levemir
Novolog
Toujeo
Tresiba
Insulin Yes Yes
Oral medications Oral medications Yes (possibly) Yes (possibly)

Warnings of Ozempic and Trulicity

Because both medications are in the same drug class, warnings and precautions are mostly the same. You will receive a medication guide any time you fill a prescription for Ozempic or Trulicity, which goes over side effects and warnings.

There is a boxed warning for Ozempic and Trulicity, which is a serious warning required by the FDA. In rodents, Ozempic or Trulicity causes thyroid C-cell tumors, including MTC (medullary thyroid carcinoma). It is not known whether this is caused in humans. Also, 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.

Other warnings include:

  • Acute pancreatitis may occur. Patients should be carefully observed for signs and symptoms of pancreatitis, including persistent severe abdominal pain, which may radiate to the back, and may or may not be accompanied by vomiting. If pancreatitis is suspected, Ozempic or Trulicity treatment should be stopped and appropriate management should be initiated. If pancreatitis is confirmed, the drug should not be restarted.
  • Diabetic retinopathy complications may occur—the risk is higher in patients who have a history of diabetic retinopathy. Rapid improvement of blood sugar control may be associated with a temporary worsening of diabetic retinopathy. Patients should be monitored.
  • Ozempic or Trulicity pens should never be shared between patients, even if the needle is changed, due to an increased risk for transmission of blood-borne pathogens. Trulicity pens are single-use pens—each Trulicity pen is used only one time.
  • Low blood sugar may occur when Ozempic or Trulicity is taken with insulin or insulin secretagogue medication. Dose adjustment of insulin or the insulin secretagogue may be required.
  • Acute kidney injury and worsening of chronic kidney failure may occur, which may require dialysis. Symptoms may include nausea, vomiting, diarrhea, and/or dehydration. Kidney function should be monitored.
  • Serious hypersensitivity reactions (anaphylaxis or angioedema) have been reported. If this occurs, Ozempic or Trulicity should be discontinued. Patients with a previous hypersensitivity reaction should not use Ozempic or Trulicity.
  • Because of the potential risk to the fetus, Ozempic or Trulicity generally should not be used in pregnancy, unless benefits outweigh risks. Your healthcare provider will most likely find another alternative medication to use.
  • Additionally, the Trulicity manufacturer information states that the medication may be associated with gastrointestinal (GI) reactions, sometimes severe. Because Trulicity has not been studied in patients with severe GI disease, including severe gastroparesis, it is not recommended for use in these patients.

Frequently asked questions about Ozempic vs. Trulicity

What is Ozempic?

Ozempic is a once-weekly injectable medication used in the treatment of Type 2 diabetes. It is known as a GLP-1 receptor agonist.

What is Trulicity?

Trulicity is a once-weekly injection used for the treatment of Type 2 diabetes. It is a GLP-1 receptor agonist.

Are Ozempic and Trulicity the same?

Ozempic and Trulicity are both in the drug class called GLP-1 receptor agonists. They are very similar, but not quite the same. The information above goes into more detail about each medication. Other drugs in the GLP-1 receptor agonist class include Victoza (liraglutide), Byetta (exenatide), Bydureon (extended-release exenatide), and Adlyxin (lixisenatide). There is also an oral semaglutide tablet available, with the same ingredient in Ozempic. The oral tablet is called Rybelsus.

Is Ozempic or Trulicity better?

Both drugs seem to be similar in efficacy in terms of achieving glycemic control and helping reduce weight. One study (see above) compared the two drugs and found Ozempic to be slightly better. But it’s important to note that the study was done by the manufacturer of Ozempic. 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?

There is limited data on Ozempic and Trulicity in pregnancy. They may cause fetal harm. Consult your healthcare provider for guidance. 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 low blood sugar.

Is Ozempic the same as metformin?

No. Ozempic injection or metformin oral medication may be used in combination with insulin and/or other oral medications, as well as diet and exercise, for the treatment of Type 2 diabetes. (Ozempic is not indicated for the treatment of Type 1 diabetes or for the treatment of diabetic ketoacidosis).

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. The most common dose is to start at 0.25 mg once a week and after four weeks, you will increase the dose to 0.5 mg once a week. If after four more weeks, you need more control, you will increase to 1 mg once a week. Your healthcare provider will guide you on the proper dosage.

Does Ozempic cause anxiety?

The Ozempic manufacturer’s 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.