Trulicity vs Ozempic: Differences, Benefits and Which to Choose

Trulicity and Ozempic are both weekly injectable GLP-1 medications, both FDA-approved for Type 2 diabetes, and both work through the same fundamental mechanism. At first glance, they seem interchangeable. But the clinical data tells a different story: Ozempic consistently outperforms Trulicity for both blood sugar control and weight loss, sometimes by a substantial margin.

The comparison matters because these medications are often presented as equivalent options, and insurance formularies or provider familiarity may steer patients toward one or the other without full consideration of the differences. If you’re choosing between them, or wondering whether to switch, understanding how they compare helps you advocate for optimal treatment.

Here’s the quick summary: Both medications effectively lower blood sugar and produce weight loss. Both have proven cardiovascular benefits. But Ozempic (semaglutide) produces approximately 15% weight loss versus 3-5% for Trulicity (dulaglutide), and HbA1c reductions are also greater with semaglutide. For most patients, Ozempic is the more effective choice. Trulicity remains a reasonable option but is generally the less potent alternative.

This guide covers:

• How both medications work (same class, different molecules)
• Blood sugar control: head-to-head comparison
• Weight loss effectiveness
• Cardiovascular benefits
• Side effects and tolerability
• Device and administration differences
• Cost and insurance considerations
• Who might choose each medication
• Switching between medications

Key Takeaways

• Both are weekly GLP-1 injections with the same fundamental mechanism but different molecules (dulaglutide vs. semaglutide)
• Ozempic produces greater weight loss (10-15%) compared to Trulicity (3-5%)
• Ozempic provides better blood sugar control, with approximately 0.4% greater HbA1c reduction in head-to-head trials
• Both have proven cardiovascular benefits, with similar reductions in major cardiovascular events
• Side effects are similar since both work through GLP-1 pathways (primarily gastrointestinal)
• Trulicity’s device is often considered easier to use for patients who struggle with pen injectors
• Neither is FDA-approved specifically for weight loss; both are approved for Type 2 diabetes
• Costs are similar at list prices, though insurance coverage varies
• For most patients seeking maximum benefit, Ozempic is the superior choice
• Switching from Trulicity to Ozempic is straightforward and commonly done

Understanding Both Medications

Before comparing results, understanding what these medications are and how they work provides essential context.

What Is Trulicity?

Trulicity (dulaglutide) is a GLP-1 receptor agonist manufactured by Eli Lilly:

FDA approval: 2014 for Type 2 diabetes

Dosing: Weekly subcutaneous injection (0.75mg, 1.5mg, 3.0mg, or 4.5mg)

Device: Single-use, disposable pen with hidden needle

Mechanism: Activates GLP-1 receptors to improve blood sugar control and reduce appetite

Trulicity was one of the earlier weekly GLP-1 medications and gained popularity partly due to its user-friendly injection device.

What Is Ozempic?

Ozempic (semaglutide) is a GLP-1 receptor agonist manufactured by Novo Nordisk:

FDA approval: 2017 for Type 2 diabetes

Dosing: Weekly subcutaneous injection (0.25mg, 0.5mg, 1.0mg, or 2.0mg)

Device: Multi-dose pen requiring dose dialing

Mechanism: Activates GLP-1 receptors to improve blood sugar control and reduce appetite

Related products:

• Wegovy: Same semaglutide at higher dose (2.4mg), FDA-approved for weight management
• Rybelsus: Oral semaglutide for diabetes

How GLP-1 Medications Work

Both medications work through the same pathway:

Appetite reduction:

• Act on brain regions controlling hunger and satiety
• Reduce appetite between meals
• Enhance feelings of fullness after eating

Glucose regulation:

• Stimulate insulin release when blood sugar is elevated (glucose-dependent)
• Suppress glucagon release (reduces liver glucose output)
• Slow gastric emptying (reduces post-meal glucose spikes)

Cardiovascular effects:

• Reduce inflammation
• Improve blood vessel function
• Lower blood pressure
• Reduce cardiovascular event risk

Despite working through the same GLP-1 receptor pathway, different medications produce different effects based on their specific molecular structures and binding characteristics.

Why Results Differ

Semaglutide and dulaglutide differ in their molecular structure, affecting potency:

Semaglutide:

• Modified structure for enhanced receptor binding
• Longer half-life and more stable blood levels
• Greater receptor activation at comparable doses

Dulaglutide:

• Linked to IgG4 antibody fragment to extend half-life
• Effective but less potent than semaglutide
• Longer track record (approved earlier)

These structural differences explain why semaglutide produces greater effects despite both being weekly GLP-1 medications.

Blood Sugar Control Comparison

For patients with Type 2 diabetes, glucose control is the primary indication for both medications.

Head-to-Head Trial: SUSTAIN 7

The most direct comparison comes from the SUSTAIN 7 trial, which directly compared semaglutide and dulaglutide:

Study design:

• 1,201 patients with Type 2 diabetes
• Compared semaglutide 0.5mg vs. dulaglutide 0.75mg
• Compared semaglutide 1.0mg vs. dulaglutide 1.5mg
• 40-week treatment duration

HbA1c results:

Comparison	Semaglutide	Dulaglutide	Difference
Lower doses	-1.5%	-1.1%	0.4% advantage semaglutide
Higher doses	-1.8%	-1.4%	0.4% advantage semaglutide

Patients achieving HbA1c <7%:

Comparison	Semaglutide	Dulaglutide
Lower doses	68%	52%
Higher doses	79%	67%

Semaglutide consistently produced better glucose control at both dose comparisons.

What the Numbers Mean

0.4% HbA1c difference: This may sound small but is clinically meaningful. Each 1% reduction in HbA1c is associated with significant reductions in diabetes complications. A 0.4% additional reduction translates to meaningfully better glucose control.

More patients at target: The higher proportion of patients reaching HbA1c <7% (the standard treatment target) means more successful treatment outcomes with semaglutide.

Consistent advantage: The semaglutide advantage was consistent across both dose comparisons, suggesting it’s not simply a dosing difference but a genuine potency difference.

Fasting Glucose Comparison

Beyond HbA1c, fasting glucose also showed differences:

SUSTAIN 7 fasting glucose reduction:

• Semaglutide 0.5mg: -41 mg/dL
• Dulaglutide 0.75mg: -28 mg/dL
• Semaglutide 1.0mg: -49 mg/dL
• Dulaglutide 1.5mg: -35 mg/dL

Semaglutide produced approximately 40% greater fasting glucose reduction at comparable dose levels.

Real-World Implications

For diabetic patients, the blood sugar control difference matters:

Reaching treatment targets: More patients achieve their glycemic goals with semaglutide.

Medication intensification: Better control may reduce need for additional diabetes medications.

Complication prevention: Better long-term glucose control reduces risk of diabetes complications.

A1c above target on Trulicity: Patients not achieving goals on dulaglutide may benefit from switching to semaglutide.

Weight Loss Comparison

For many patients, weight loss is as important as blood sugar control, and this is where the medications differ most dramatically.

Head-to-Head Weight Loss: SUSTAIN 7

The same SUSTAIN 7 trial that showed glucose control differences also demonstrated significant weight loss differences:

Weight loss results:

Comparison	Semaglutide	Dulaglutide	Difference
Lower doses	-4.6 kg (10.1 lbs)	-2.3 kg (5.1 lbs)	2x more with semaglutide
Higher doses	-6.5 kg (14.3 lbs)	-3.0 kg (6.6 lbs)	2x more with semaglutide

Semaglutide produced approximately twice the weight loss of dulaglutide at both dose comparisons.

Percentage Weight Loss

Expressed as percentage of body weight:

Semaglutide (diabetes doses):

• Average: 4-6% weight loss at 1.0mg dose
• At 2.0mg dose: 6-8% weight loss
• At weight-loss doses (Wegovy 2.4mg): ~15% weight loss

Dulaglutide:

• Average: 2-3% weight loss at 1.5mg dose
• At 4.5mg dose: 3-5% weight loss

Weight Loss at Maximum Doses

Comparing maximum approved doses:

Trulicity 4.5mg: Approximately 4.5 kg (10 lbs) or 3-5% body weight

Ozempic 2.0mg: Approximately 6-8 kg (13-18 lbs) or 6-8% body weight

Wegovy 2.4mg (semaglutide for weight loss): Approximately 15% body weight

For patients prioritizing weight loss, semaglutide offers substantially greater benefit.

What This Means Practically

For someone weighing 220 pounds:

On Trulicity (maximum dose):

• Expected loss: 7-11 pounds
• End weight: 209-213 pounds

On Ozempic (maximum diabetes dose):

• Expected loss: 15-18 pounds
• End weight: 202-205 pounds

On Wegovy (weight loss dose):

• Expected loss: 33 pounds
• End weight: 187 pounds

The difference between Trulicity and higher-dose semaglutide is substantial for patients with significant weight to lose.

Weight Loss Summary

Medication	Average % Weight Loss	Pounds Lost (220 lb start)
Trulicity 4.5mg	3-5%	7-11 lbs
Ozempic 2.0mg	6-8%	13-18 lbs
Wegovy 2.4mg	15%	33 lbs

Cardiovascular Benefits

Both medications have proven cardiovascular benefits, which is important given the high cardiovascular risk in patients with Type 2 diabetes.

Trulicity Cardiovascular Data (REWIND Trial)

The REWIND trial studied dulaglutide in patients with Type 2 diabetes:

Study population: 9,901 patients with Type 2 diabetes, broader population including those without prior cardiovascular events

Results:

• 12% reduction in major adverse cardiovascular events (MACE)
• Statistically significant cardiovascular protection
• Benefit seen in both primary and secondary prevention

Ozempic Cardiovascular Data (SUSTAIN 6 and SELECT)

SUSTAIN 6 trial (diabetes population):

• 26% reduction in MACE in patients with Type 2 diabetes and high cardiovascular risk
• Significant cardiovascular protection

SELECT trial (obesity population):

• 20% reduction in MACE in patients with obesity and established cardiovascular disease
• Studied for cardiovascular outcomes regardless of diabetes status

Cardiovascular Comparison

Factor	Trulicity (REWIND)	Ozempic (SUSTAIN 6)
MACE reduction	12%	26%
Population studied	Broader diabetes population	High-risk diabetes population
Statistical significance	Yes	Yes

Both medications provide cardiovascular protection. The trials studied somewhat different populations, making direct comparison imperfect. However, semaglutide’s 26% reduction versus dulaglutide’s 12% reduction suggests potentially greater cardiovascular benefit, though the different study populations warrant caution in direct comparison.

Cardiovascular Bottom Line

Both Trulicity and Ozempic provide proven cardiovascular protection, making them preferred options for diabetic patients with cardiovascular disease or risk factors. Either is substantially better than diabetes medications without cardiovascular benefit.

For patients where cardiovascular protection is the primary concern, both are reasonable choices, though semaglutide’s data may suggest greater benefit.

Side Effect Comparison

Since both medications work through the same GLP-1 pathway, their side effect profiles are similar.

Common Side Effects

Trulicity common side effects:

• Nausea (12-21%)
• Diarrhea (8-12%)
• Vomiting (6-12%)
• Abdominal pain (7-10%)
• Decreased appetite (5-9%)
• Indigestion (5-8%)

Ozempic common side effects:

• Nausea (15-20%)
• Vomiting (5-10%)
• Diarrhea (8-10%)
• Abdominal pain (6-8%)
• Constipation (3-5%)
• Decreased appetite (intended effect)

Side Effect Comparison Table

Side Effect	Trulicity	Ozempic
Nausea	12-21%	15-20%
Diarrhea	8-12%	8-10%
Vomiting	6-12%	5-10%
Abdominal pain	7-10%	6-8%
Constipation	4-7%	3-5%
Injection site reactions	0.5-2%	0.2-1%

The rates are broadly similar, with individual variation determining which medication a particular patient tolerates better.

Serious Risks

Both medications carry similar rare but serious risks:

Pancreatitis: Can occur with either medication. Severe abdominal pain requires immediate medical attention.

Gallbladder disease: Weight loss increases gallstone risk. Both medications can contribute.

Thyroid concerns: Animal studies showed thyroid tumors with both medications. Human risk is uncertain. Both are contraindicated with personal/family history of medullary thyroid carcinoma or MEN2.

Hypoglycemia: Low risk with either medication alone. Risk increases if combined with insulin or sulfonylureas.

Tolerability Differences

Potential Trulicity advantage: Some patients report fewer GI effects, possibly due to different formulation or dosing patterns. Trulicity’s device may reduce injection-related anxiety.

Potential Ozempic advantage: The gradual titration schedule may help patients adjust more smoothly. Lower starting doses (0.25mg) allow gentler introduction.

Overall: Most patients tolerate both medications reasonably well with proper titration. Neither has a clear tolerability advantage for the majority of patients.

Discontinuation Rates

Clinical trial discontinuation rates due to adverse events are similar:

Trulicity: 5-8% discontinuation due to adverse events

Ozempic: 5-7% discontinuation due to adverse events

Neither medication has a significant dropout advantage.

Device and Administration

One area where Trulicity has historically been considered advantageous is its injection device.

Trulicity Device

Design features:

• Single-use, pre-filled pen
• Hidden needle (never seen by patient)
• One-button activation
• Automatic injection process
• No dose dialing required

User experience:

• Often described as very easy to use
• Good for needle-phobic patients
• Minimal steps: attach, press, hold
• Automatic needle insertion and retraction

Potential limitations:

• Fixed dose per pen (less flexibility)
• More waste (entire device discarded)
• Must match prescription to available pen strengths

Ozempic Device

Design features:

• Multi-dose pen (typically 4-week supply)
• Requires attaching needle
• Dose must be dialed
• Manual injection process
• Visible needle (though small)

User experience:

• More steps required than Trulicity
• Requires dose selection
• Needle attachment needed
• More typical of traditional insulin pens

Potential advantages:

• More flexible dosing
• Less packaging waste
• May be easier to verify dose delivery

Device Comparison

Factor	Trulicity	Ozempic
Needle visibility	Hidden	Visible (small)
Dose dialing	No (preset)	Yes
Needle attachment	Pre-attached	User attaches
Steps to inject	Fewer	More
Dose flexibility	Fixed pen doses	Dial any dose
Waste	Higher (single use)	Lower (multi-dose)

Does Device Matter?

For some patients, yes:

• Needle-phobic patients may strongly prefer Trulicity’s hidden needle
• Patients with dexterity issues may find Trulicity’s simpler operation easier
• Some find the one-button process less intimidating

For most patients, not significantly:

• Both devices are manageable with brief instruction
• Most patients adapt to either device quickly
• Device preference rarely outweighs efficacy differences

The bottom line: Device preference shouldn’t typically override the substantial efficacy difference between medications. Both devices work well for most patients with minimal practice.

Cost and Insurance

Cost considerations can influence medication choice, particularly when insurance coverage differs.

List Prices

Trulicity:

• List price: ~$900-1,000/month
• Available doses: 0.75mg, 1.5mg, 3.0mg, 4.5mg

Ozempic:

• List price: ~$900-1,000/month
• Available doses: 0.25mg, 0.5mg, 1.0mg, 2.0mg

List prices are essentially equivalent.

Manufacturer Programs

Trulicity (Eli Lilly):

• Savings card programs available for commercially insured patients
• May reduce cost to $25-100/month for eligible patients

Ozempic (Novo Nordisk):

• NovoCare savings programs
• Cash-pay program: $349/month without insurance
• May reduce cost to $25-100/month for eligible patients

Compounded Options

Trulicity: No compounded version available (proprietary formulation)

Semaglutide: Compounded versions available

• TrimRx: $199/month for compounded semaglutide
• Contains same active ingredient

The availability of compounded semaglutide provides a cost advantage not available with dulaglutide.

For detailed pricing, see our guide on compounded semaglutide costs.

Insurance Coverage

Trulicity:

• Often on diabetes medication formularies
• May be preferred due to established relationships with Eli Lilly
• Prior authorization typically required

Ozempic:

• Also commonly covered for diabetes
• May face step therapy requirements
• Prior authorization typically required

Coverage varies by plan: Some plans prefer one medication over the other based on rebate agreements. Your specific formulary determines which is more accessible.

Cost Comparison Summary

Factor	Trulicity	Ozempic/Semaglutide
List price	~$950/month	~$950/month
Best manufacturer price	~$25-100/month	$349/month (cash-pay)
Compounded option	Not available	$199/month
Insurance coverage	Variable	Variable

The availability of compounded semaglutide provides an access option that doesn’t exist for dulaglutide, potentially making semaglutide more accessible for patients without insurance coverage.

Who Should Choose Each Medication?

Despite Ozempic’s advantages, certain situations might favor Trulicity.

Reasons to Consider Trulicity

Insurance/formulary requirements:

• Your insurance covers Trulicity but not Ozempic
• Step therapy requires trying Trulicity first
• Formulary preference makes Trulicity significantly less expensive

Device preference:

• Strong needle phobia that Trulicity’s hidden needle addresses
• Significant dexterity limitations making Trulicity’s device easier
• Preference for simpler device operation

Provider familiarity:

• Your provider is more experienced with Trulicity
• Established care relationship involves Trulicity

Previous experience:

• Known tolerance of dulaglutide
• Previous success with Trulicity
• Concerns about switching established treatment

Specific circumstances:

• Part of a comprehensive treatment plan designed around dulaglutide
• Provider has specific clinical reasons to prefer dulaglutide

Reasons Ozempic Is Usually Better

Greater effectiveness:

• Approximately 0.4% better HbA1c reduction
• Approximately twice the weight loss
• Higher proportion of patients reaching treatment targets

Weight loss priority:

• Significant weight to lose
• Metabolic benefits of weight loss important
• Weight-related health conditions (sleep apnea, joint pain, etc.)

Cardiovascular considerations:

• Potentially greater cardiovascular protection (26% vs. 12% event reduction)
• High cardiovascular risk where maximum protection matters

Access to higher doses:

• Wegovy (semaglutide 2.4mg) available for weight management
• Maximum Ozempic dose (2.0mg) produces more weight loss than maximum Trulicity dose (4.5mg)

Compounded option:

• Budget constraints where compounded semaglutide ($199/month) provides access
• Insurance doesn’t cover either and cash-pay needed

The General Recommendation

For most patients: Ozempic (semaglutide) is the preferred choice due to:

• Superior glucose control
• Substantially greater weight loss
• Potentially stronger cardiovascular protection
• Equivalent convenience (both weekly)
• Availability of compounded option for cost-conscious patients

Trulicity remains reasonable: When insurance strongly favors it, device preference is compelling, or specific circumstances warrant, but it’s generally the less effective option.

Switching Between Medications

Many patients consider switching from Trulicity to Ozempic, and this is commonly done.

Why Patients Switch

Common reasons to switch from Trulicity to Ozempic:

• Inadequate blood sugar control despite maximum Trulicity dose
• Desire for greater weight loss
• Wanting to try the more potent option
• Insurance change favoring Ozempic
• Access to compounded semaglutide

Common reasons to switch from Ozempic to Trulicity:

• Insurance change favoring Trulicity
• Intolerable side effects on Ozempic (trying alternative)
• Device preference
• Provider recommendation

How to Switch

From Trulicity to Ozempic:

1. Stop Trulicity (no taper needed)
2. Begin Ozempic at starting dose (0.25mg)
3. Follow standard titration schedule
4. Can start Ozempic the week after last Trulicity dose

From Ozempic to Trulicity:

1. Stop Ozempic (no taper needed)
2. Begin Trulicity at appropriate dose
3. Provider may start at maintenance dose given GLP-1 experience
4. Can start Trulicity the week after last Ozempic dose

What to Expect When Switching

Transitioning to Ozempic:

• GI side effects may recur during titration even if tolerating Trulicity
• Full Ozempic effect takes several weeks to months (titration period)
• Greater appetite suppression and potential weight loss as reaching higher doses
• Some providers use accelerated titration for patients switching from other GLP-1s

Transitioning to Trulicity:

• Similar GI adjustment period possible
• May notice less appetite suppression compared to Ozempic
• Blood sugar may change during transition; monitor closely
• Weight may stabilize or increase compared to Ozempic trajectory

Provider Involvement

Switching between GLP-1 medications should involve your healthcare provider:

• Appropriate dosing decisions
• Timing of transition
• Monitoring blood sugar during switch
• Adjustment of any concurrent diabetes medications
• Follow-up to assess response to new medication

Special Populations

Certain patient groups may have specific considerations when choosing between these medications.

Patients With Type 2 Diabetes

Both medications are appropriate as they’re specifically approved for diabetes.

Ozempic advantage: Better glucose control and more patients reaching HbA1c targets.

Consider: If blood sugar is well-controlled on Trulicity, switching may not be necessary. If targets aren’t being met, Ozempic may help.

Patients With Obesity and Diabetes

Ozempic/Wegovy advantage: Substantially greater weight loss makes semaglutide preferred for patients where weight is a significant concern alongside diabetes.

Access consideration: Wegovy (weight loss indication) may have different coverage than Ozempic (diabetes indication).

Patients With Cardiovascular Disease

Both are appropriate with proven cardiovascular protection.

Potential Ozempic advantage: Larger cardiovascular event reduction in SUSTAIN 6 (26%) versus REWIND (12%), though study populations differed.

Either acceptable: For patients where cardiovascular protection is the primary goal, both provide meaningful benefit.

Patients New to GLP-1 Medications

For treatment-naive patients: Starting with the more effective option (Ozempic) makes sense unless specific circumstances favor Trulicity.

No need to try Trulicity first: Unless insurance requires step therapy, there’s no clinical rationale to start with the less effective medication.

Patients on Trulicity With Suboptimal Results

Consider switching to Ozempic: If blood sugar or weight aren’t adequately controlled on Trulicity, semaglutide may produce better results.

Assess adherence first: Ensure suboptimal results aren’t due to missed doses or other factors before switching.

Frequently Asked Questions

Which medication is more effective for blood sugar control, Trulicity or Ozempic?

Ozempic (semaglutide) is more effective for blood sugar control. In the head-to-head SUSTAIN 7 trial, semaglutide produced approximately 0.4% greater HbA1c reduction than dulaglutide at comparable doses. More patients achieved the target HbA1c of less than 7% with semaglutide (79% versus 67% at higher doses). Fasting glucose reduction was also approximately 40% greater with semaglutide. While both medications effectively lower blood sugar, semaglutide consistently provides better glycemic control.

Which medication produces more weight loss, Trulicity or Ozempic?

Ozempic produces substantially more weight loss. In the SUSTAIN 7 trial, semaglutide produced approximately twice the weight loss of dulaglutide at comparable doses. At maximum doses, Trulicity produces approximately 3-5% body weight loss, while Ozempic produces 6-8%, and Wegovy (higher-dose semaglutide) produces approximately 15%. For a 220-pound person, this translates to roughly 7-11 pounds lost on Trulicity versus 15-18 pounds on Ozempic, or 33 pounds on Wegovy. For patients prioritizing weight loss, semaglutide is clearly superior.

Are the side effects the same for both medications?

The side effects are very similar since both work through the same GLP-1 pathway. Both primarily cause gastrointestinal effects: nausea, diarrhea, vomiting, abdominal pain, and constipation. Rates are broadly comparable, typically affecting 10-20% of patients. Both carry the same rare serious risks: pancreatitis, gallbladder disease, and theoretical thyroid tumor concerns. Neither has a clear tolerability advantage for most patients. Individual response varies, and some patients may tolerate one better than the other, but this can only be determined by trying the medications.

Is Trulicity’s injection device easier to use than Ozempic’s?

Many patients find Trulicity’s device easier to use because it features a hidden needle (addressing needle phobia), requires no dose dialing (pre-set doses), and operates with a simple one-button press. Ozempic requires attaching a needle, dialing the dose, and a more traditional injection process. For needle-phobic patients or those with dexterity issues, Trulicity’s device may be advantageous. However, most patients adapt to either device quickly with brief instruction, and device preference typically shouldn’t override the significant efficacy differences between medications.

Can I switch from Trulicity to Ozempic?

Yes, switching from Trulicity to Ozempic is straightforward and commonly done. You would stop Trulicity and begin Ozempic at its starting dose (0.25mg), following the standard titration schedule. There’s no mandatory waiting period between medications. Many patients switch to achieve better blood sugar control or greater weight loss. Expect some GI side effect adjustment during Ozempic titration even if you tolerated Trulicity well. Full benefit of the switch develops over several weeks to months as you reach maintenance doses. Your healthcare provider should guide the transition.

Do both medications provide cardiovascular protection?

Yes, both Trulicity and Ozempic have demonstrated cardiovascular protection in large outcome trials. The REWIND trial showed Trulicity reduces major adverse cardiovascular events by 12% in patients with Type 2 diabetes. The SUSTAIN 6 trial showed Ozempic reduces these events by 26% in high-risk diabetic patients. Both medications are preferred options for diabetic patients with or at risk for cardiovascular disease. While Ozempic’s reduction appears larger, the trials studied somewhat different populations, making direct comparison imperfect. Either medication provides meaningful cardiovascular benefit.

Which medication is cheaper, Trulicity or Ozempic?

List prices are essentially equivalent (approximately $900-1,000/month for either). With manufacturer savings programs, both can be reduced to $25-100/month for eligible commercially insured patients. The key cost difference is that compounded semaglutide is available ($199/month through TrimRx), while no compounded dulaglutide exists. For patients paying cash or without insurance coverage for either medication, compounded semaglutide provides an access option that Trulicity cannot match. Insurance formulary preferences vary by plan and may favor one medication over the other.

Is Trulicity FDA-approved for weight loss?

No, Trulicity is FDA-approved only for Type 2 diabetes, not weight loss. Any weight loss is considered a secondary benefit, not the primary indication. Similarly, Ozempic is approved for diabetes, not weight loss. However, Wegovy (the same semaglutide at higher doses) is FDA-approved specifically for chronic weight management. For patients seeking weight loss treatment, semaglutide offers the advantage of having both diabetes (Ozempic) and weight loss (Wegovy) formulations, plus compounded options for weight loss.

Should I try Trulicity before Ozempic?

Unless your insurance requires step therapy (trying one medication before another), there’s no clinical rationale to try Trulicity first. Since Ozempic is more effective for both blood sugar control and weight loss, starting with the more effective option makes sense for most patients. Some insurance plans do require trying dulaglutide or other medications before approving semaglutide, which would be a practical reason to start with Trulicity. But from a purely clinical standpoint, semaglutide is typically the better first choice.

If I’m doing well on Trulicity, should I switch to Ozempic?

This depends on your treatment goals and current results. If your blood sugar is at target, you’re satisfied with your weight, and you’re tolerating Trulicity well, there may be no compelling reason to switch. However, if you’re not achieving optimal blood sugar control, would like to lose more weight, or want to see if you can do better, switching to Ozempic may produce improved results. The decision should involve your healthcare provider, considering your individual circumstances, goals, and preferences.

Can I take either medication if I have heart disease?

Yes, both Trulicity and Ozempic are appropriate and even preferred for patients with Type 2 diabetes and cardiovascular disease. Both have demonstrated cardiovascular protection in clinical trials. Guidelines recommend GLP-1 medications with proven cardiovascular benefit for diabetic patients with or at high risk for cardiovascular disease. Either medication is a good choice for this population, though Ozempic’s potentially greater cardiovascular protection (26% versus 12% event reduction) may make it slightly preferable for patients where cardiovascular risk is the primary concern.

The Bottom Line

Trulicity and Ozempic are both weekly GLP-1 medications for Type 2 diabetes, but they are not equivalent. Ozempic consistently outperforms Trulicity across key outcomes: approximately 0.4% better HbA1c reduction, roughly twice the weight loss, and potentially greater cardiovascular protection. The side effect profiles are similar, and while Trulicity has a more user-friendly device, this advantage rarely outweighs the significant efficacy differences.

For most patients, Ozempic is the better choice. The greater effectiveness in both glucose control and weight loss, combined with the availability of compounded semaglutide for cost-conscious patients, makes semaglutide the preferred option.

Trulicity remains a reasonable medication when insurance strongly favors it, device preference is compelling, or specific circumstances warrant. But when choosing between these medications based on clinical merit alone, semaglutide is the superior option for most patients.

Ready to explore semaglutide treatment? TrimRx offers consultations with licensed providers who can evaluate your eligibility and prescribe compounded semaglutide at $199/month for qualifying patients.