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Health Guide / GLP-1

Trulicity vs. Ozempic: uses, dosage, side effects, comparison

felix gussone

Reviewed by Felix Gussone, MD, written by Patricia Weiser, PharmD

Last updated: Jun 01, 2023
6 min read

table of contents

  1. What are Trulicity and Ozempic?
  2. Dosage of Trulicity vs. Ozempic
  3. Conditions treated with Trulicity vs. Ozempic
  4. How effective are Trulicity and Ozempic?
  5. Side effects of Trulicity vs. Ozempic
  6. Potential drug interactions of Trulicity vs. Ozempic
  7. Cost of Trulicity vs. Ozempic 
  8. Differences and similarities between Trulicity vs. Ozempic

With the right tools, living with type 2 diabetes doesn’t have to be daunting. You can manage type 2 diabetes—and potentially prevent complications—with medications including Trulicity and Ozempic. 

Healthcare providers typically add Trulicity or Ozempic when one diabetes medication isn’t helping enough to control blood sugar levels. But how do you know if Trulicity vs. Ozempic is right for you?  Continue reading to learn about the similarities and differences between Trulicity and Ozempic.

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What are Trulicity and Ozempic?

Trulicity (dulaglutide) and Ozempic (semaglutide; see Important Safety Information) belong to a drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. 

Your healthcare provider may prescribe this type of medication to people with type 2 diabetes mellitus when other medications, such as metformin, aren’t effective enough at controlling a person’s blood sugar.

Seven medications currently belong to the GLP-1 drug class. All of them are injectable medications, except Rybelsus is an oral tablet version of semaglutide (the same active ingredient in Ozempic). Keep reading to learn more about the specifics.

Trulicity

Trulicity is a brand-name prescription drug that contains the active ingredient dulaglutide. It comes as a clear liquid solution in an injection pen with a built-in needle. Each Trulicity pen contains a single dose.

After a healthcare professional shows you how to use Trulicity, you’ll give yourself a subcutaneous (under the skin) injection in your thigh or abdomen once a week. If someone else helps you with your injection, they may also administer it in the upper arm.

Ozempic

Ozempic is a brand-name prescription drug that contains the active ingredient semaglutide. It comes as a clear liquid solution in an injection pen. Ozempic comes with needles you’ll attach to the pen before each dose. Each Ozempic pen contains multiple doses. The exact number of doses per pen depends on your healthcare provider’s recommended dosage.

After your provider shows you how to use Ozempic, you’ll give yourself a subcutaneous injection in your thigh or abdomen once weekly. Like Trulicity, if someone else assists you with your injection, it can also be injected into the upper arm.

Dosage of Trulicity vs. Ozempic

The typical starting dosage of Trulicity is 0.75 mg once per week. After four weeks of treatment, your healthcare provider may increase your dose to 1.5 mg once per week. After another month, they may increase your dose to 3 mg once per week. 

If your blood sugar levels remain too high after another month, they may increase your dose to the maximum of 4.5 mg once per week.

The typical starting dosage of Ozempic is 0.25 mg once per week. Again, after four weeks of treatment, your healthcare provider may increase your dose to 0.5 mg once per week. After another month, they may increase your dose to 1 mg, and later to a maximum of 2 mg once per week, if additional blood sugar control is needed.

Conditions treated with Trulicity vs. Ozempic

The U.S. Food and Drug Administration (FDA) approves medications, such as Trulicity and Ozempic, for specific uses or indications described in detail on each drug’s official labeling (summarized in the sections below). 

Healthcare providers may also prescribe Trulicity or Ozempic for off-label (“non-official”) uses, such as weight loss.

Trulicity uses

Trulicity is used to:

Cardiovascular risk factors include obesity, smoking, high blood pressure, high cholesterol, and a sedentary lifestyle.

Ozempic uses

Ozempic is used to:

  • Improve control of blood sugar levels in adults with type 2 diabetes, along with a healthy diet and exercise
  • Reduce the risk of major cardiovascular problems (such as heart attack and stroke) in adults with type 2 diabetes who also have heart disease

How effective are Trulicity and Ozempic?

Both Trulicity and Ozempic are effective medications for treating type 2 diabetes. However, some research has found a slight difference in the effectiveness of managing blood sugar levels and reaching weight loss goals between Trulicity vs. Ozempic.

One study from 2018 compared the effectiveness of Trulicity and Ozempic to lower average blood sugar levels over a 3-month period. Ozempic lowered blood sugar and reduced body weight more than Trulicity. 

Side effects of Trulicity vs. Ozempic

Trulicity and Ozempic cause similar common side effects, including:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Constipation

Trulicity also commonly causes decreased appetite. These side effects may contribute to weight loss. Rarely, Trulicity and Ozempic may cause severe side effects like: 

  • Pancreatitis (inflammation of the pancreas)
  • Kidney problems
  • Vision changes
  • Severe allergic reactions
  • Increased risk of medullary thyroid carcinoma (MTC), a type of thyroid tumor

Some people may be at higher risk for these serious side effects than others. These drugs may not be safe if you have multiple endocrine neoplasia syndrome or a family history of thyroid cancer. Trulicity and Ozempic are not meant for use while pregnant or breastfeeding or in people with type 1 diabetes, a history of pancreatitis, or severe stomach problems such as gastroparesis.

Potential drug interactions of Trulicity vs. Ozempic

Both Trulicity and Ozempic can raise the chance of having hypoglycemia (low blood sugar) if you take other diabetes medications, such as:

  • Glimepiride (Amaryl)
  • Glipizide (Glucotrol)
  • Glyburide (Diabeta)
  • Insulin, such as Lantus, Humulin, Novolog, and many others
  • Nateglinide
  • Repaglinide

Your healthcare provider will go over how to monitor your blood sugar and what to do if it gets too low.

Trulicity and Ozempic may cause you to absorb certain oral medications more slowly. For example, if you take warfarin, a blood thinner medicine, your healthcare provider may monitor you more closely to see if they need to adjust your warfarin dosage.

It’s a good idea to tell your healthcare provider and pharmacist about all the drugs you take so that they can help prevent harmful interactions.

Cost of Trulicity vs. Ozempic 

Both Trulicity and Ozempic are brand-name prescription drugs that are not currently available in generic forms. That means they can be quite pricey. As of June 2023, both drugs are available for around $800 – $1,000 for a month’s supply.

The price you’ll pay may be lower if you have health insurance with prescription drug coverage. Patient assistance programs and manufacturer coupons can also help you save money. Talk to your pharmacist if you are looking for ways to help lower your cost of Trulicity or Ozempic.

Differences and similarities between Trulicity vs. Ozempic

Some key information about Trulicity and Ozempic is summarized in the table below.

trulicity ozempic
Active ingredient dulaglutide semaglutide
What comes in the box? 4 single-dose injection pens with built-in needles 1 or 2 multi-dose injection pens and needles that you attach before each dose
What does it do? Improves control of blood sugar levels in adults with type 2 diabetes, along with a healthy diet and exercise

Reduces the risk of major cardiovascular problems (such as heart attack and stroke) in adults with type 2 diabetes and cardiovascular disease or multiple cardiovascular risk factors		 Improves control of blood sugar levels in adults with type 2 diabetes, along with a healthy diet and exercise

Reduces the risk of major cardiovascular problems (such as heart attack and stroke) in adults with type 2 diabetes and cardiovascular disease
Most common side effects Nausea, vomiting, diarrhea, belly pain, constipation, decreased appetite Nausea, vomiting, diarrhea, belly pain, constipation
Typical dosage schedule Once per week Once per week
Drug interactions Hypoglycemia (low blood sugar) risk if taking other diabetes medications; Slowed absorption of certain oral medications Hypoglycemia (low blood sugar) risk if taking other diabetes medications; Slowed absorption of certain oral medications

If other medications aren’t doing the trick to manage your blood sugar levels and achieve your weight loss goals, talk to your healthcare provider about Trulicity and Ozempic. One of these options may be right for you. Your provider will help you develop a safe treatment plan.

Disclaimer

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.

References

  1. Collins, L. & Costello, R. A. (2021). Glucagon-like peptide-1 receptor agonists. StatPearls. Retrieved on Feb. 9, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK551568/ 
  2. GoodRx-a. (n.d.). Ozempic. Retrieved on Feb. 9, 2022 from https://www.goodrx.com/ozempic 
  3. GoodRx-b. (n.d.). Trulicity. Retrieved on Feb. 9, 2022 from https://www.goodrx.com/trulicity 
  4. Olvera-Lopez, E., Ballard, B. D., & Jan, A. (2021). Cardiovascular disease. StatPearls. Retrieved on Feb. 9., 2022 from https://www.ncbi.nlm.nih.gov/books/NBK535419/ 
  5. Pratley, R. E., Aroda, V. R., Lingvay, I., et al. (2018). Semaglutide versus Dulaglutide once weekly in patients with type 2 diabetes (sustain 7): A randomised, open-label, phase 3B trial. The Lancet Diabetes & Endocrinology, 6(4), 275–286. doi: 10.1016/S2213-8587(18)30024-X. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29397376/ 
  6. U.S. Food and Drug Administration (FDA-a). (2021). Ozempic (semaglutide) injection, for subcutaneous use. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/209637s008lbl.pdf 
  7. U.S. Food and Drug Administration (FDA-b). (2021). Trulicity (dulaglutide) injection, for subcutaneous use. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/125469s044lbl.pdf 
  8. U.S. Food and Drug Administration (FDA). (n.d.). Drugs@FDA: FDA-approved drugs. Retrieved on Feb. 9, 2022 from https://www.accessdata.fda.gov/scripts/cder/daf/ 
felix gussone
Felix Gussone, MD

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.

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Important Safety Information for Ozempic®

Important Safety Information for Ozempic (semaglutide) injection

Warning: Risk of Thyroid C-Cell Tumors

  • In studies with mice and rats, semaglutide (the active ingredient in Ozempic and Wegovy) caused thyroid tumors, including thyroid cancer. It is not known if Ozempic will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Do not use Ozempic if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

What is the FDA-approved use of Ozempic?

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that is used:

  • with diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
  • to reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus and established cardiovascular disease.

Limitations of Use:

  • Ozempic has not been studied in patients with a history of pancreatitis.
  • Ozempic is not for treatment of type 1 diabetes mellitus.

Your Ro-affiliated provider may recommend the use of Ozempic as treatment for chronic weight management (obesity or overweight).

Who should not use Ozempic?

Do not use Ozempic if:

  • You or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • You have a known allergic reaction to semaglutide (the active ingredient in Wegovy or Ozempic). 

How should Ozempic be administered? 

You can take Ozempic with or without food. The pre-filled injector pen is self-administered as a subcutaneous injection in the stomach, thigh, or upper arm once a week on the same day every week. Your Ro-affiliated provider will guide you on a treatment regimen that may include an increase in dose every four weeks. 

You should not change your dosing regimen or stop taking Ozempic as prescribed without discussing with your provider first.  

What should I tell my Ro-affiliated provider before using Ozempic?

  • Ozempic has certain drug interactions. It’s important to tell your Ro-affiliated provider all of the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements. 

Some medications to watch out for include:

  • Medications used to treat type 1 or type 2 diabetes, including insulin or sulfonylureas (such as Amaryl or Glucotrol XL)
  • Ozempic causes a delay in gastric emptying so it has the potential to impact the absorption of medications that are taken by mouth at the same time. Your provider can guide you on how to schedule your medications.
  • Other GLP-1 medications, including Wegovy, Saxenda, Victoza, Byetta, or Bydureon
  • If you’re using other products for weight loss, including dietary supplements

It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a past history of:

  • Type 1 or type 2 diabetes
  • Thyroid cancer
  • Pancreatitis
  • Kidney disease
  • Diabetic retinopathy
  • Depression
  • Suicidal thoughts or behavior

Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. 

  • If you are pregnant: Ozempic should not be used during pregnancy. Based on animal studies, there may be potential risks to an unborn baby from exposure to Ozempic during pregnancy. There is no benefit to weight loss during pregnancy and it may cause harm to the unborn baby. 
  • If you are a female or male of reproductive potential: Discontinue Ozempic at least 2 months before a planned pregnancy since the drug can stay in the bloodstream for a long time.
  • If you are breastfeeding: Ozempic was found in the milk of lactating rats. Tell your Ro-affiliated provider if you are breastfeeding before you start Ozempic.

Pregnancy registry: There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to semaglutide (the active ingredient in Ozempic and Ozempic) during pregnancy. Pregnant women exposed to semaglutide and healthcare providers are encouraged to contact Novo Nordisk at 1-800-727-6500.

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I or a caregiver should monitor for when taking Ozempic? 

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects can occur with Ozempic. You or a caregiver should carefully monitor for these side effects, especially in the beginning of treatment and with dose changes.

  • Thyroid C-Cell Tumors: In mice and rats, semaglutide (the active ingredient in Ozempic and Ozempic) caused an increase in thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is unknown whether Ozempic causes thyroid C-cell tumors in humans. There were cases of MTC reported in patients who took liraglutide (the active ingredient in Victoza and Saxenda) after the drug was put on the market. Ozempic is contraindicated in patients with a family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Inflammation of Pancreas (Acute Pancreatitis): Monitor for signs of acute pancreatitis, including severe abdominal pain that does not go away, sometimes radiating to the back, with or without vomiting.
  • Diabetic Retinopathy Complications in Patients with Type 2 Diabetes: If you have type 2 diabetes, tell your provider right away if you experience changes in vision.
  • Never Share a Pen: Pen-sharing poses a risk of infection. 
  • Low Blood Sugar (hypoglycemia): Ozempic lowers blood glucose. It can cause too low blood sugar in patients with type 2 diabetes who also take another glucose control medication. Monitor your blood sugar and watch out for signs of too low blood sugar such as dizziness, blurred vision, mood changes, sweating, or fast heartbeat.
  • Acute Kidney Injury: In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse. It is important for you to drink plenty of water to help reduce your chance of dehydration.
  • Serious Allergic Reactions: Stop using Ozempic right away if you experience symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, severe rash or itching, very rapid heartbeat, problems breathing or swallowing, or fainting or feeling dizzy.
  • Acute Gallbladder Disease: Ozempic may cause gallbladder problems, including gallstones. Some gallbladder problems require surgery. Tell your provider right away if you have pain in your upper stomach, yellowing of skin or eyes (jaundice), fever, or clay-colored stools.
  • Increase in Heart Rate: Tell your provider right away if you have a racing heartbeat while at rest. 
  • Suicidal Behavior and Ideation: You should pay attention to any mental health changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.

What are the most common side effects of Ozempic?

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Constipation

You are encouraged to report negative side effects of prescription products:

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.