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Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps lower blood glucose levels in people with type 2 diabetes mellitus. It can also help with weight loss (Chamberlin, 2019). Possible Ozempic alternatives include Bydureon (exenatide), Victoza (liraglutide), Mounjaro (tirzepatide), Tanzeum (Albiglutide), and Trulicity (dulaglutide).
What is Ozempic?
Ozempic (generic semaglutide; see Important Safety Information) is a prescription pen that helps people with type 2 diabetes control their blood sugar levels. Ozempic also lowers the risk of stroke, heart attack, or death in people with type 2 diabetes and cardiovascular disease. The pen comes pre-filled with medicine that the person injects into their abdomen, thigh, or upper arm every week. You can take Ozempic with or without meals (DailyMed, 2022).
Ozempic lowers your appetite and, combined with diet and exercise, can help you lose weight. People with overweight or obesity may benefit from an off-label prescription of Ozempic for weight loss (O’Neil, 2018; Wilding, 2021).
Ozempic side effects
Ozempic side effects typically include nausea, vomiting, and diarrhea, which may be experienced by around one in three people (Chamberlin, 2019). Rarer side effects include abdominal pain, constipation, or redness at the injection site. Ozempic may also increase the risk of experiencing hypoglycemia (low blood sugar) or developing a gallbladder or gastrointestinal disorder (Wilding, 2021; DailyMed, 2022). Ozempic is not recommended for children, people who are pregnant or breastfeeding, or those with (DailyMed, 2022):
- A personal or family history of thyroid cancer
- Multiple endocrine neoplasia syndrome type 2
- Diabetic retinopathy (vision loss caused by diabetes)
The Food and Drug Administration (FDA) has issued a “black box” warning for Ozempic, the most serious advisory they issue for a medication. Animal studies have found that Ozempic increases the risk of thyroid tumors in mice and rats. While we don’t know if it has the same effect in humans, people with a personal or family history of thyroid cancer or multiple endocrine neoplasia syndrome type 2 should not use Ozempic (DailyMed, 2022).
Cheaper alternatives to Ozempic
A one-month supply of Ozempic costs around $800. This is in line with other GLP-1 receptor agonists but is more expensive than some other medications that help lower blood glucose levels (Chamberlin, 2019). For example, one report conducted in Canada found that Trulicity (dulaglutide), Bydureon (exenatide), and Victoza (liraglutide) are cheaper alternatives to Ozempic (CADTH, 2019).
The price of Ozempic will vary based on your insurance coverage and the pharmacy you use. Novo Nordisk, the manufacturer of Ozempic, does offer an Ozempic Savings Card, which may reduce your Ozempic cost. It is only available to people with private or commercial insurance. You can learn more about the program and determine your eligibility here.
5 Ozempic alternatives to consider
Most of the Ozempic alternatives below are GLP-1 receptor agonists, just like Ozempic. These diabetes medications work by directing the pancreas to release more insulin when blood glucose levels get too high. This helps bring blood sugar levels back down. At the same time, GLP-1 receptor agonists also limit the release of glucagon, a hormone that raises your blood glucose levels. Finally, GLP-1 receptor agonists slow down digestion. Since it takes longer for your stomach to empty, you feel full longer, which may lead you to eat less food and experience weight loss (Bridges, 2022; Mehta, 2017).
1. Bydureon or Byetta (exenatide)
Like Ozempic, Bydureon and Byetta (exenatide) are injectable medications that help people with type 2 diabetes control their blood glucose levels. There are two versions of exenatide. The immediate-release version is taken twice daily, up to one hour before eating. The extended-release is used on a weekly basis, similar to Ozempic (Bridges, 2022).
Bydureon and Byetta are typically prescribed to people as a second-line treatment after other medications haven’t worked (the same is true of Ozempic). They are used in addition to diet and exercise, and can be prescribed on their own or with other diabetes medications such as metformin (Bridges, 2022).
The most common side effect is nausea, which usually lessens as you continue to use exenatide. Other side effects include vomiting, diarrhea, dizziness, headaches, and upset stomach. You could also experience low blood sugar, pancreatitis (inflammation of the pancreas), or an allergic reaction while using Bydureon or Byetta. This drug carries the same black box warning as Ozempic and other GLP-1 medications, and should be avoided if you are currently pregnant or breastfeeding or have kidney failure or pancreatitis (Bridges, 2022).
2. Victoza or Saxenda (liraglutide)
Victoza and Saxenda (liraglutide) also help control blood glucose levels. While Victoza is intended for people with type 2 diabetes, Saxenda is FDA-approved to help people with overweight or obesity lose weight. Both Victoza and Saxenda are injected daily (Mehta, 2017).
Ozempic and Victoza share some side effects, such as nausea, vomiting, and the potential for pancreatitis or hypoglycemia. However, increased heart rate is another side effect of Victoza. Liraglutide has the same black box warning as Ozempic and other GLP-1 drugs (Mehta, 2017).
3. Tanzeum or Eperzan (albiglutide)
Like Ozempic, Tanzeum and Eperzan (albiglutide) are prescription pens filled with a medication you inject weekly to help control blood sugar levels. The side effects are usually gastrointestinal issues, ranging from mild to moderate (Blair, 2015). However, injection site reactions and diarrhea may be more common with Tanzeum or Eperzan than with other GLP-1 receptor agonists like Ozempic (Ahrén, 2017).
4. Trulicity (dulaglutide)
Trulicity (dulaglutide) is another injectable medication that helps improve blood sugar levels and weight loss (Burness, 2015). It should be injected weekly and prescribed in addition to lifestyle changes like diet and exercise (Scott, 2020).
Like Ozempic, Trulicity is prescribed to people with type 2 diabetes who have not found other treatments successful. You can take it on its own or with other diabetes drugs like insulin and metformin. Trulicity also reduces the risk that people with type 2 diabetes—both with and without heart disease—will experience a major cardiac event like stroke, heart attack, or death (Scott, 2020; Burness, 2015).
Trulicity and Ozempic share similar side effects, like nausea, vomiting, and diarrhea (Burness, 2015).
5. Mounjaro (tirzepatide)
The previous medications on this list, including Ozempic, are all GLP-1 agonists. Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist, which may make it more effective at controlling blood sugar levels and subsequent weight loss. Like Ozempic, Mounjaro is injected on a weekly basis (Min, 2021).
Like Ozempic, Mounjaro side effects are typically gastrointestinal, with nausea, diarrhea, and vomiting being the most common. Reduced appetite is another side effect of Mounjaro, and part of how it can lead to weight loss (Min, 2021).
There are several alternatives to Ozempic. The best option for you may depend on your personal medical history and treatment plan. Talk to your healthcare provider about your options.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
- Ahrén, B., Carr, M. C., Murphy, K., et al. (2017). Albiglutide for the treatment of type 2 diabetes mellitus: An integrated safety analysis of the HARMONY phase 3 trials. Diabetes Research and Clinical Practice, 126, 230–239. doi:10.1016/j.diabres.2017.02.017. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28284167/
- Blair, H. A. & Keating, G. M. (2015). Albiglutide: a review of its use in patients with type 2 diabetes mellitus. Drugs, 75(6), 651–663. doi:10.1007/s40265-015-0370-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25777969/
- Bridges, A., Bistas, K. G., & Jacobs, T. F. (2022). Exenatide. StatPearls. Retrieved on July 16, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK518981/
- Burness, C. B. & Scott, L. J. (2015). Dulaglutide: A review in type 2 diabetes. BioDrugs, 29(6), 407–418. doi:10.1007/s40259-015-0143-4. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26423061/
- Canadian Agency for Drugs and Technologies in Health (CADTH). (2019). Pharmacoeconomic Review Report: Semaglutide (Ozempic): (Novo Nordisk Canada Inc.): Indication: For the treatment of adults patients with type 2 diabetes mellitus to improve glycemic control, in combination with metformin (second-line treatment), and in combination with metformin and sulfonylurea (third-line treatment) [Internet]. Canadian Agency for Drugs and Technologies in Health. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK543967/
- Chamberlin, S. & Dabbs, W. (2019). Semaglutide (Ozempic) for type 2 diabetes mellitus. American Family Physician, 100(2), 116–117. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31305048/
- DailyMed. (2022). OZEMPIC-semaglutide injection, solution. National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- Mehta, A., Marso, S. P., & Neeland, I. J. (2017). Liraglutide for weight management: a critical review of the evidence. Obesity Science & Practice, 3(1), 3–14. doi:10.1002/osp4.84. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28392927/
- Min, T. & Bain, S. C. (2021). The Role of tirzepatide, dual GIP and GLP-1 receptor agonist, in the management of type 2 diabetes: The SURPASS clinical trials. Diabetes Therapy, 12(1), 143–157. doi:10.1007/s13300-020-00981-0. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33325008/
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD). Pramlintide. (2016). LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK548949/
- O’Neil, P. M., Birkenfeld, A. L., McGowan, B., et al. (2018). Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet (London, England), 392(10148), 637–649. doi:10.1016/S0140-6736(18)31773-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30122305/
- Scott, L. J. (2020). Dulaglutide: A review in type 2 diabetes. Drugs, 80(2), 197–208. doi:10.1007/s40265-020-01260-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32002850/
- Wilding, J., Batterham, R. L., Calanna, S., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989–1002. doi:10.1056/NEJMoa2032183. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33567185/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.