Trulicity vs. Ozempic: What's the Difference?

The most common type of diabetes, type 2 diabetes mellitus, happens when blood glucose levels (blood sugar) become too high.

As a consequence of type 2 diabetes, your body doesn’t make enough insulin (a hormone found in the pancreas that allows you to turn carbohydrates into energy) or doesn’t use insulin efficiently. Therefore, too much glucose remains in your blood, and not enough reaches your cells.

To manage this condition, healthcare providers may recommend Trulicity (dulaglutide) or Ozempic (semaglutide): glucagon-like peptide 1 (GLP-1) agonists used to treat high blood sugar levels associated with type 2 diabetes.

While these drugs are generally similar, notable differences between Trulicity and Ozempic include dosage strengths, packaging, and differences in proven efficacy and cardiovascular benefit.

In some cases, the route of administration may also be different, as in the case of Rybelsus (semaglutide).

This article will compare and contrast Trulicity and Ozempic, focusing on the crucial characteristics of each drug that will help you decide if either medicine is potentially appropriate for you or a loved one.

Overview: Trulicity vs. Ozempic

Both Trulicity and Ozempic are available only as brand-name products and are given as once- weekly subcutaneous (under the skin) injections.

As GLP-1 agonists, these medications tell your body to produce insulin after you eat, signal the liver to stop making extra sugar, and slow down the speed at which food moves through your stomach. These all contribute to keeping your blood sugar in check.

Additionally, Trulicity and Ozempic are further classified as incretin mimetics, drugs used to help the pancreas release a healthy amount of insulin when blood sugar levels are high.

Trulicity

Trulicity contains the active ingredient dulaglutide.

Specifically, it is Food and Drug Administration (FDA)-approved for adults (people 18 and older) and children 10 years and older with type 2 diabetes, along with diet/exercise to improve blood sugar.

Trulicity is also used in adults with type 2 diabetes to reduce the chances of cardiovascular events (problems with the heart and blood vessels), including heart attack and stroke in people with heart disease or multiple cardiovascular risk factors.

Trulicity comes in a carton of four different pen injectors, having one dose per pen each week. One carton of four cells will make up your month’s supply of medication. The starting dose is 0.75 milligrams (mg) weekly and can be adjusted to a maximum of 4.5 mg weekly.

Trulicity is also approved for blood sugar control in children 10 and older at the same starting dose as adults and can be increased up to 1.5 mg per week.

Ozempic

Ozempic contains the active ingredient semaglutide. This drug, along with diet and exercise, is FDA-approved to improve blood sugar in adults with type 2 diabetes.

Ozempic is also used to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes with known heart disease. Ozempic comes as one pen injector containing all four quantities for the month, so you will use the same pen every week for a month’s supply of Ozempic.

Dosing starts at 0.25 mg and can go as high as 2 mg weekly. It should be noted that Ozempic is only approved for use in adults.

Efficacy: Trulicity vs. Ozempic

While both drugs are considered safe and tolerable, some differences exist regarding their ability to lower heart disease effectively.

Per clinical trials of Trulicity, results showed an average reduction in hemoglobin A1C (HbA1C; a blood test showing your average blood sugar level over the past several months) ranges from 0.7% to 1.8% as the dose increases.

Ozempic's clinical trials showed that HbA1C might decrease by 1.2% to 2.1% as your dose increases.

Both drugs can also help lower your risk of major adverse cardiac events (MACE), which includes heart attack, stroke, and death related to heart disease.

Within the context of MACE, Trulicity reduces risk by 12% in people with heart disease or who have risk factors for heart disease.

Ozempic has been found to provide a 26% risk reduction, but only in people with established heart disease.

Administration: Trulicity vs. Ozempic

Trulicity and Ozempic are injections given subcutaneously right under the skin of your stomach, upper arm, or thigh.

If you don’t experience side effects, or if they’re minimal and tolerable, your healthcare provider may continue slightly increasing your dose every four weeks to maximize blood sugar control.

Both medications come in prefilled pen injectors that should be stored in the fridge. They can be given with or without food. Constantly rotate injection sites each week and follow proper injection techniques.

Trulicity comes in a package of four single-dose pens, so you will only use one pen each week, then discard it. Store pens in their original packaging in the refrigerator (36 to 46 degrees F) and remove one at a time each week.

Ozempic comes as a single pen containing four doses per pen, each lasting one month. Before first use, keep it in the refrigerator (36 to 46 F). After first use, it can be stored at room temperature (59 to 86 F) for up to 56 days.

An oral form (taken by mouth) of semaglutide does exist, branded as Rybelsus.

Rybelsus is typically given as a 3 mg tablet once daily for 30 days. The 3 mg dosage is intended for treatment initiation (to ween a person safely onto the medication) and is not initially used for glycemic control.

However, after 30 days on the 3-mg dosage, the dose is typically increased to 7 mg daily. Overall, Rybelsus is used alongside diet/exercise to improve glycemic control in adults with type 2 diabetes.

Which Drug Lasts Longer in the Body?

A half-life is the time it takes for half of the drug to clear from your body. Half-lives refer to the time it takes for the medicine to remove entirely from your body, not how long it remains effective.

Ozempic has a half-life of one week, so it will stay in your body for about five weeks. Trulicity’s half-life is five days, so that it will stick around for about three and a half weeks.

Therefore, as a measure of half-lives, Ozempic lasts longer in your body than Trulicity.

Both medications use once weekly dosing for convenience and to maintain necessary levels of the drugs to ensure they continue working to control blood sugar.

Potential for Side Effects

Both Trulicity and Ozempic have a boxed warning (the most severe warning issued by the FDA) for thyroid C-cell tumors. Thyroid cancers were reported during studies when Ozempic and Trulicity were studied in animals, but the risk to humans is unclear.

Do not take these drugs if you have thyroid cancer or a family history.

Other potentially serious side effects include:

• Pancreatitis (inflammation of your pancreas)
• Diabetic eye complications, such as diabetic retinopathy
• Hypoglycemia (low blood sugar)
• Gallbladder problems, such as gallbladder disease
• Gastrointestinal problems, such as Ileus

Know that pancreatitis and gallbladder problems may feel similar to more common, less stomach-related severe side effects of these medications, including nausea, vomiting, diarrhea, constipation, or abdominal pain.

If the symptoms seem extreme, inform your healthcare provider immediately.

Interactions: Trulicity vs. Ozempic

Medications like Trulicity and Ozempic do not have pervasive drug interactions, but there are a few to be aware of:

• Taking Ozempic or Trulicity and another medicine that lowers blood sugar, especially insulin, can cause hypoglycemia or dangerously low blood sugar. It may be appropriate to adjust the dose of these other medicines when you start Trulicity or Ozempic.
• Trulicity and Ozempic delay gastric emptying (gastroparesis), meaning food stays in your stomach longer. This may affect how medications you take orally get absorbed.

Ask your healthcare provider or pharmacist if you have questions about the timing of your injections relative to other medicines you take.

Summary

Managing type 2 diabetes can be challenging, but prescription medications can be helpful.

Trulicity and Ozempic are two GLP-1 agonists that work similarly to treat type 2 diabetes and to modestly lower the risk of heart-related events such as stroke or heart attack. They are both given once weekly as injections under the skin.

However, despite the occasional off-label prescription, neither drug is formally approved for weight loss management.

The main differences between Trulicity and Ozempic include dosage strengths and packaging, plus minor differences in efficacy and cardiovascular benefit.

Deciding between Trulicity and Ozempic will likely come down to you and your healthcare provider’s preference, cost, and insurance coverage.