SharpyTrulicity vs Ozempic: A1C, Weight Loss, Cost, Side Effects
Ozempic lowered A1C and weight more than Trulicity in the only direct head-to-head trial, SUSTAIN 7: at the higher doses, A1C fell 1.8 points on Ozempic 1 mg vs 1.4 on Trulicity 1.5 mg, and weight fell 6.5 kg vs 3.0 kg. Trulicity still has real strengths: it is approved for kids 10 and older, its heart benefit covers people with risk factors only, and its single-dose pen has no needle to attach. Both are type 2 diabetes drugs with similar stomach side effects, and your prescriber picks between them. Whichever you use, Sharpy keeps your daily protein target and a 20-minute workout in one place so the weight you lose is fat, not muscle.
Trulicity or Ozempic: which works better, and does it matter which one you get? In the one trial that put them side by side, Ozempic (semaglutide) lowered blood sugar and body weight more than Trulicity (dulaglutide) at every dose tested. Trulicity still wins on a few practical points, like approval for kids 10 and up and a pen with a built-in needle. Both are once-a-week shots for type 2 diabetes. Here is how they compare, using the FDA labels and the SUSTAIN 7 trial.
Trulicity vs Ozempic at a glance
| Trulicity | Ozempic | |
|---|---|---|
| Generic name | Dulaglutide | Semaglutide |
| Maker | Eli Lilly | Novo Nordisk |
| How often | Once a week | Once a week |
| Label doses | 0.75, 1.5, 3, 4.5 mg | 0.25 (start), 0.5, 1, 2 mg |
| Ages | Adults and kids 10+ with type 2 diabetes | Adults with type 2 diabetes |
| Heart indication | Established heart disease or multiple risk factors (REWIND) | Established heart disease (SUSTAIN 6) |
| Kidney indication | None | Type 2 diabetes with chronic kidney disease (FLOW) |
| Pen | Single-dose pen, needle built in, 4 per box | Multi-dose pen, you attach a new needle each time |
| Missed dose | Take it if 3 days or more until the next dose | Take it within 5 days of the missed day |
| Approved for weight loss? | No | No (Wegovy is the weight-loss version) |
Trulicity vs Ozempic A1C reduction: the SUSTAIN 7 results
SUSTAIN 7 was a 40-week trial of 1,201 adults with type 2 diabetes who were already on metformin. It was published in The Lancet Diabetes & Endocrinology in 2018 and paid for by Novo Nordisk. People were randomly given a low dose or a high dose of one drug.
| Dose pair | A1C drop | Weight change |
|---|---|---|
| Ozempic 0.5 mg | -1.5 points | -4.6 kg (about -10 lb) |
| Trulicity 0.75 mg | -1.1 points | -2.3 kg (about -5 lb) |
| Ozempic 1 mg | -1.8 points | -6.5 kg (about -14 lb) |
| Trulicity 1.5 mg | -1.4 points | -3.0 kg (about -7 lb) |
Ozempic beat Trulicity by about 0.4 A1C points at both dose levels. That gap is real and statistically clear. Later analyses found the edge held across age, sex, starting A1C and body weight.
One catch: SUSTAIN 7 is old. Trulicity added 3 mg and 4.5 mg doses after it, and Ozempic added 2 mg. No trial has tested Trulicity 4.5 mg against Ozempic 1 mg or 2 mg.
What the higher Trulicity doses add
Lilly tested the bigger doses in AWARD-11, a 36-week trial in 1,842 adults on metformin, published in Diabetes Care in 2021. Compared with 1.5 mg, the 4.5 mg dose lowered A1C a little more (about -1.8 vs -1.5 points) and weight a little more (-4.7 kg vs -3.1 kg). That puts top-dose Trulicity close to the Ozempic 0.5 mg results from SUSTAIN 7, but this is a comparison across two different trials, so treat it as a rough guide only.
Trulicity vs Ozempic weight loss: what to expect
Neither drug is approved for weight loss. If weight is your main goal and you do not have type 2 diabetes, the drugs approved for that are Wegovy (semaglutide) and Zepbound (tirzepatide). Our GLP-1 medication comparison lays those out.
On diabetes doses, expect modest loss: a few kilograms on Trulicity, and roughly double that on Ozempic. Any GLP-1 drug also takes some muscle along with the fat if you eat too little protein and never lift. This matters more for people with diabetes, because muscle is where your body stores and burns much of its blood sugar. A steady protein target and two or three short strength sessions a week help protect it. Sharpy sets that protein number for you and gives you one 20-minute workout a day, so you are not guessing.
Trulicity vs Ozempic side effects
Both labels list the same kind of common side effects, mostly in the stomach:
- Trulicity (5% or more of people): nausea, diarrhea, vomiting, belly pain, less appetite.
- Ozempic (5% or more of people): nausea, vomiting, diarrhea, belly pain, constipation.
In SUSTAIN 7, stomach side effects were most common for both drugs, and overall safety looked similar. In AWARD-11, nausea and vomiting went up as the Trulicity dose went up. Both labels carry the same boxed warning about thyroid C-cell tumors seen in rodents, and both say not to use the drug if you or your family have had medullary thyroid cancer or MEN 2. Both list warnings for pancreatitis, gallbladder problems, kidney injury from dehydration and eye problems in people with diabetic retinopathy. If nausea is the issue, our guide to managing nausea on GLP-1 drugs has practical steps.
Heart and kidney benefits
Both drugs have an FDA-approved heart benefit, but for slightly different people.
- Trulicity, REWIND trial: 9,901 adults followed for a median 5.4 years. Trulicity 1.5 mg cut the risk of heart attack, stroke or heart death by 12% (hazard ratio 0.88). Most people in REWIND did not yet have heart disease, which is why the label covers people with multiple risk factors, not only those with known disease.
- Ozempic, SUSTAIN 6 trial: 3,297 adults with type 2 diabetes and heart disease. Ozempic cut the same combined risk by 26% (hazard ratio 0.74) over about 2 years.
- Ozempic, FLOW trial: in adults with type 2 diabetes and chronic kidney disease, Ozempic lowered the risk of serious kidney loss, kidney failure or heart death by 24% (hazard ratio 0.76). Trulicity has no kidney indication. Our guide to Ozempic and kidney disease explains FLOW in detail.
Trulicity vs Ozempic cost
| Situation | Trulicity | Ozempic |
|---|---|---|
| Commercial insurance that covers it | Savings card: as little as $25 for a 1-, 2- or 3-month fill | Savings card: as little as $25 for up to a 3-month fill |
| Savings card cap | Up to $150 off per month, $1,950 a year, 13 fills a year | Up to $100 off per month |
| No coverage | No Lilly self-pay price we could confirm | $349 a month (0.25 to 1 mg), $499 (2 mg), $199 for first two starter fills through Dec 31, 2026 |
| Medicare | Savings cards do not apply | Savings cards do not apply |
The savings card terms come from trulicity.com and NovoCare, read on October 31 and October 30, 2026. Novo Nordisk also says Ozempic's list price drops to $675 a month on January 1, 2027. Our Ozempic coupon guide walks through every Ozempic option. For Trulicity without coverage, ask your pharmacy for its cash price and ask your prescriber about plan-covered options.
Which one is right for you?
That is your prescriber's call, but these are the questions that usually decide it:
- Is this for a child or teen? Trulicity is approved from age 10. Ozempic is adults only.
- Do you have chronic kidney disease? Only Ozempic has the kidney indication.
- Is lower A1C or more weight loss the top goal? Ozempic did better head to head.
- Do needles or dose dialing stress you out? Trulicity's pen is single-use with a hidden needle.
- What does your plan cover? Often this decides it before anything else.
Do not switch, stop or combine these drugs on your own. Talk to your prescriber about the starting dose if you change.
The bottom line
Ozempic lowers A1C and weight more than Trulicity, based on the SUSTAIN 7 trial and the doses it tested. Trulicity is still a solid, well-studied choice, especially for kids, for people with heart risk factors but no heart disease yet, and for anyone who wants the simplest pen. On either one, protect your muscle with protein and strength work. Sharpy gives you one protein target, one 20-minute workout and one Shape Score each day, so you can see the weight coming off as fat.
Sources
- Trulicity (dulaglutide) prescribing information, June 2026 (openFDA)
- Ozempic (semaglutide) injection prescribing information, July 2026 (openFDA)
- Pratley et al. SUSTAIN 7, Lancet Diabetes Endocrinol 2018 (Healio summary)
- Frias et al. AWARD-11, Diabetes Care 2021 (PubMed Central)
- Trulicity Savings Card terms (Eli Lilly)
- NovoCare: Ozempic savings and self-pay
Questions people ask
Is Ozempic more effective than Trulicity?
In the SUSTAIN 7 trial, yes. Over 40 weeks in 1,201 adults with type 2 diabetes, Ozempic 0.5 mg lowered A1C by 1.5 points vs 1.1 for Trulicity 0.75 mg, and Ozempic 1 mg lowered it by 1.8 vs 1.4 for Trulicity 1.5 mg. That trial did not test the higher Trulicity doses of 3 mg and 4.5 mg, which came later.
Trulicity vs Ozempic: which is better for weight loss?
Ozempic. In SUSTAIN 7, people lost 4.6 kg (about 10 lb) on Ozempic 0.5 mg vs 2.3 kg on Trulicity 0.75 mg, and 6.5 kg (about 14 lb) on Ozempic 1 mg vs 3.0 kg on Trulicity 1.5 mg. Neither drug is FDA-approved for weight loss. Weight loss is a side benefit of treating type 2 diabetes.
Are Trulicity and Ozempic the same?
No. Both are once-weekly GLP-1 receptor agonist shots for type 2 diabetes, but they are different molecules from different companies. Trulicity is dulaglutide from Eli Lilly. Ozempic is semaglutide from Novo Nordisk, the same molecule as Wegovy.
Can you take Trulicity and Ozempic together?
They are not meant to be combined. Both work on the same GLP-1 receptor, so taking both adds side effect risk without a known benefit. If one is not working well enough, your prescriber would switch you from one to the other, not stack them.
What is the Trulicity to Ozempic dose equivalent?
There is no official conversion chart in either label. SUSTAIN 7 paired Trulicity 0.75 mg with Ozempic 0.5 mg and Trulicity 1.5 mg with Ozempic 1 mg, but those were trial arms, not switching rules. If you change drugs, your prescriber chooses the starting dose.
Is Trulicity or Ozempic cheaper?
With commercial insurance that covers them, both have manufacturer savings cards that can bring the cost to as little as $25. Without coverage, Novo Nordisk sells Ozempic self-pay for $349 a month for most pen doses, with $199 for the first two starter fills through December 31, 2026. We could not confirm a Lilly self-pay program for Trulicity.