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Rx auto injector: What can I take instead of Trulicity?
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Trulicity alternatives: What can I take instead of Trulicity?

Trulicity doesn't work for everyone. Rybelsus, Jardiance, Metformin, Januvia, and Glipizide are some Trulicity alternatives. Get the full list here.
Gerardo Sison medical writer headshot
By | Sep. 23, 2022

Compare Trulicity alternatives | Rybelsus | Jardiance | Metformin | Januvia | Glipizide | Natural alternatives | How to switch meds

Weighing the advantages and disadvantages of Trulicity (dulaglutide) can be a difficult task if you are trying to decide whether to switch to another drug. On the positive side, Trulicity does a great job of lowering blood sugar in Type 2 diabetes mellitus by stimulating the glucagon-like peptide-1 (GLP-1) receptor. It also has a couple attractive side benefits, namely potential weight loss and reduced risk of cardiovascular events. While requiring an injection for dosing may not be ideal, Trulicity’s once weekly frequency is quite convenient. Your experience with Trulicity may not be all positive however. The drug’s common side effects, particularly nausea, and considerable expense are certainly enough to bring many users to the brink of changing to an alternative. We will review your options here.

What can I take in place of Trulicity?

GLP-1 receptor agonists like Trulicty provide blood glucose control by a number of mechanisms. Activation of this receptor following a meal results in more insulin and less glucagon release, two hormonal effects that reduce blood glucose levels. Stimulating the GLP-1 receptor also slows gastric emptying, so you feel full sooner and eat less. These mechanisms provide a better potential for weight loss and lower chance of hypoglycemia (low blood sugar) than other diabetes medications. Even if Trulicity is causing you problems with side effects, a different GLP-1 receptor agonist may still be an option. If Trulicity is not on your insurance formulary or is not a preferred agent, a different member of the class could work out.

Stepping away from GLP-1 agents may be best in other situations. Various drug classes can effectively treat Type 2 diabetes mellitus and potentially avoid either the adverse effects or expense of Trulicity. The sodium-glucose cotransporter 2 (SGLT2) inhibitors have some unique advantages pertaining to cardiovascular and renal (kidney) benefits. Dipeptidyl peptidase-4 (DPP-4) inhibitor class is a well tolerated option. The sulfonylurea, biguanide, alpha-glucosidase inhibitor, and thiazolidinedione classes have generic members which could save you money. If you need more effectiveness than one class can provide, combination options exist which bring together two drug categories in one pill. Finally, a variety of insulins exist and provide reliable treatment for both Type 1 and Type 2 diabetes, whereas GLP-1 agonists are only used for Type 2 diabetes. You may find it helpful to compare the array of available alternatives to Trulicity.

Compare Trulicity alternatives
Drug name Uses Dosage Coupons
Trulicity (dulaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease or multiple risk factors 0.75-4.5 mg subcutaneous (under the skin) injection once weekly Trulicity coupons
Ozempic (semaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 0.5-1 mg subcutaneous injection once weekly Ozempic coupons
Rybelsus (semaglutide) Type 2 diabetes mellitus 7-14 mg once daily Rybelsus coupons
Victoza (liraglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 1.2-1.8 mg subcutaneous injection once daily Victoza coupons
Mounjaro (tirzepatide) Type 2 diabetes mellitus 5-15 mg subcutaneous injection once weekly Mounjaro coupons
Farxiga (dapagliflozin) Type 2 diabetes mellitus, heart failure risk reduction in Type 2 diabetes mellitus with heart disease or multiple cardiovascular risk factors, heart failure risk reduction in those with reduced cardiac ejection fractions, heart failure and kidney disease progression risk reduction in those with chronic renal disease 5-10 mg once daily Farxiga coupons
Jardiance (empagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus, heart failure risk reduction in those with reduced cardiac ejection fractions 10-25 mg once daily Jardiance coupons
Invokana (canagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus with cardiovascular disease, kidney disease progression risk reduction and cardiovascular event risk reduction in those with Type 2 diabetes mellitus and nephropathy and albuminuria >300 mg/day 100-300 mg once daily Invokana coupons
Glipizide Type 2 diabetes mellitus 2.5-20 mg twice daily Glipizide coupons
Amaryl (glimepiride) Type 2 diabetes mellitus 1-4 mg once daily Amaryl coupons
Repaglinide Type 2 diabetes mellitus 0.5-4 mg before meals up to four times daily Repaglinide coupons
Metformin Type 2 diabetes mellitus, polycystic ovarian syndrome (off-label) 500-1000 mg twice daily Metformin coupons
Januvia (sitagliptin) Type 2 diabetes mellitus 100 mg once daily Januvia coupons
Actos (pioglitazone) Type 2 diabetes mellitus 15-45 mg once daily Actos coupons
Lantus Solostar (insulin glargine) Type 2 diabetes mellitus, Type 1 diabetes mellitus Individualized dose injected subcutaneously once daily Lantus Solostar coupons
Xigduo XR (dapagliflozin/metformin extended release [ER]) Type 2 diabetes mellitus 1-2 tablets every morning (2.5-10 mg of dapagliflozin with 500-1000 mg of extended release metformin per tablet) Xigduo XR coupons

Other alternatives to Trulicity

Top 5 Trulicity alternatives

The following are some of the most common alternatives to Trulicity.

1. Rybelsus

Glucagon-like peptide-1 (GLP-1) receptor agonists may remain a favorable option for you even if Trulicity does not work out. Of the class members, Rybelsus is the only oral option, allowing you to take a daily pill instead of a daily or weekly injection. Ozempic, Victoza, Byetta, and Bydureon are all injectable GLP-1 receptor agonists. Mounjaro is an injection as well, and it stimulates both the GLP-1 receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor. Although no member of the class is inexpensive, your insurance formulary may prefer one over another, and you should show your SingleCare discount card to your pharmacist at your local pharmacy to save money. 

The possibility of assisting with weight loss efforts and reducing cardiovascular events is enough to keep many people on board with the GLP-1 class despite the cost. Of note, other brand-name drugs such as Wegovy (semaglutide) and Saxenda (liraglutide) are class members that are dosed higher to produce more weight loss and have a specific Food and Drug Administration (FDA) indication for the long-term treatment of obesity. Cardiovascular disease is also a frequent coexisting condition with Type 2 diabetes. Unlike Rybelsus, Trulicity and other GLP-1 receptor agonists have FDA approval for use in reducing cardiovascular event rates for those with both Type 2 diabetes and cardiovascular disease or multiple risk factors for cardiovascular disease, which may include having high blood pressure, high cholesterol, and smoking. The events of concern include blockages in the coronary arteries leading to heart attacks and blockages in the cerebral vessels leading to strokes. Diabetes is a major risk factor for heart attacks and strokes, so an opportunity to reduce the risk of these life threatening events makes GLP-1 receptor agonists like Trulicity attractive.

Side effects and contraindications may still turn you away from both Trulicity and Rybelsus. If you are suffering from intolerable nausea, vomiting, or constipation with any GLP-1 receptor agonist, changing to a different class may be preferable, especially if you experience allergic reactions or reactions to injection sites. Experiencing pancreatitis (pancreatic inflammation) related to a GLP-1 agonist could necessitate a change in drug class. Contraindications may stop you from even trying a GLP-1 receptor agonist in the first place. In general, the drugs should not be taken by anyone with a history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia Type 2 (MEN 2) or a family history of MTC, based on studies in rodents showing an increase in certain thyroid tumors. The relevance of these rodent studies to humans is not known, but the FDA placed a black box warning on multiple members of this drug class due to concern.

2. Jardiance

If switching drug classes makes the most sense for treatment of your Type 2 diabetes mellitus, an SGLT2 inhibitor like Jardiance may work well. By blocking the SGLT2 transporter, Jardiance, Farxiga, and Invokana all increase urinary glucose, so more sugar is eliminated from the body. Besides lowering glucose level, this mechanism also draws more fluid out of circulation. The diuretic effect can be helpful in the setting of congestive heart failure (CHF) with a reduced cardiac ejection fraction (lower percentage of blood squeezed out of the pumping chambers with each heartbeat) and can help to reduce blood pressure. Jardiance was even shown to reduce the risk of cardiovascular morbidity and mortality in individuals with Type 2 diabetes and a high cardiovascular risk. 

SGLT2 inhibitors are relatively expensive, so do not expect to save a lot by switching from Trulicity. Jardiance and other SGLT2 members also have certain adverse effects that could keep you from picking them. For example, they are associated with a risk of genital yeast infections and urinary tract infection.

3. Metformin

Metformin is an inexpensive, generic alternative to Trulicty. It happens to be the preferred initial drug in most cases of Type 2 diabetes mellitus. Metformin is the one available member of the biguanide class. Its popularity derives from being able to avoid weight gain and hypoglycemia, while being capable of slowing the progression of diabetes. Trulicity and other Type 2 diabetes medicines are typically added to metformin, rather than being used in place of it. Numerous combination agents, such as Xigduo XR, exist that couple metformin with another drug.

The common limiting factor for metformin is its gastrointestinal adverse effects, like diarrhea. Contraindications to metformin, such as advanced renal disease, may also rule it out for your use.

RELATED: Is it safe to take Trulicity and metformin together?

4. Januvia

Januvia, along with other dipeptidyl peptidase-4 (DPP-4) inhibitors, such as Tradjenta, Onglyza, and Nesina, avoid most of the gastrointestinal side effects of Trulicity and metformin and the genitourinary side effects of Jardiance. The trade off with Januvia is that it lacks an FDA indication for cardiac protection and does not contribute to weight loss like GLP-1 receptor agonists. Unfortunately, expense can also be an issue with Januvia.

5. Glipizide

Glipizide is a generic medication with a low cost and a long track record for use in Type 2 diabetes care. These two factors are enough of an argument for some people to choose the drug or another in its class. As a sulfonylurea, similar to glimepiride and glyburide, glipizide signals the pancreas to make more insulin. This mechanism lowers blood glucose levels effectively, but it can risk hypoglycemia. Another downside is that the increase in insulin can translate to weight gain. Like all of the options, glipizide has imperfections but may be worth considering.

Natural alternatives to Trulicity

Learning about the positive and negative attributes of each alternative to Trulicity may have you wishing for a natural treatment option. A low carbohydrate diet, exercise, and weight loss are proven elements of successful diabetes treatment. Supplements like dietary fiber and cinnamon have the backing of clinical trials too. While lifestyle measures and supplements may not cure Type 2 diabetes or even completely eliminate your reliance on prescription medication, they may benefit your overall health and reduce your pill burden.

How to switch to a Trulicity alternative

Before embarking on a new diet or exercise routine and prior to switching away from Trulicity, get the medical advice of your prescribing healthcare provider. You should discuss your reservations about Trulicity. If any of the aforementioned alternatives appeal to you, bring them up to the professional. Your health history could make one drug a better choice than others. Bring a list of your supplements, over-the-counter medications, and prescription drugs for review at the appointment, as drug interactions have the potential to occur. Hopefully, the two of you can come together to make the best decision for treatment of your Type 2 diabetes.