Dulaglutide vs Semaglutide: Which One Should You Choose?

Dulaglutide and semaglutide are two drugs used to manage diabetes and weight loss. These medicines are part of a group called GLP-1 receptor agonists, which are used to treat type 2 diabetes and obesity. When choosing between dulaglutide and semaglutide, it's essential to understand their differences and how they may be suited to your specific health needs. This article explores these medications, focusing on their uses, efficacy, and safety.

‍

Both dulaglutide and semaglutide are used to improve blood sugar control in individuals with type 2 diabetes. Additionally, semaglutide has been approved for chronic weight management in certain populations. They differ in dosing schedules, side effects, and cost. This article compares dulaglutide and semaglutide, looking at how well they work, their safety, and practical issues to think about. 

‍

The effectiveness and suitability of these medications vary based on individual health conditions. Discuss with your healthcare provider to determine the best treatment for your needs. The information provided here is for educational purposes and should not replace professional medical advice. Always consult with a healthcare provider for personalized recommendations.

‍

Key Takeaways

• Dulaglutide (Trulicity®) and semaglutide (Ozempic®, Rybelsus®, Wegovy®) are GLP-1 receptor agonists used to treat type 2 diabetes [6].

• Both medications are approved to reduce major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease [8].

• Semaglutide (Wegovy®) is FDA-approved for chronic weight management in obese and overweight patients, including adolescents 12 years and older [11].

• Dulaglutide is available as a once-weekly subcutaneous injection, while semaglutide has both injectable and oral formulations [11].

• Both drugs require dose titration to reach the recommended dose [10].

• Semaglutide has a slightly higher genetic similarity (94%) to human GLP-1 compared to dulaglutide (90%) [10].

• A clinical trial showed semaglutide to be superior to dulaglutide in improving glucose control and achieving weight loss greater than 5% in type 2 diabetic adults.

‍

What Is Semaglutide?

Semaglutide (the active ingredient in Ozempic^®) is a drug that belongs to a group called GLP-1 receptor agonists. These drugs copy the effects of glucagon-like peptide-1 (GLP-1), a hormone found in the body. Semaglutide influences the pancreas to make insulin and lowers the hunger hormone ghrelin, which can reduce appetite. This process helps to lower blood sugar levels and leads to weight loss [4].

‍

Doctors first okayed semaglutide to treat type 2 diabetes in 2017. Since then, it has proven effective in clinical studies. Research shows it can drop the diabetes control marker hemoglobin A1C by two percentage points on average. Patients who took semaglutide had a better chance of reaching an A1C goal under 7% than those using other drugs [4].

‍

You need a prescription from a doctor to get compounded semaglutide for both the injectable semaglutide and oral semaglutide. Your doctor will decide if semaglutide is right for you and which type: either the injectable form of semaglutide (Wegovy^®, Ozempic^®) or one of the oral forms of semaglutide (Rybelsus^®, SubMagna™).

‍

Semaglutide has an impact on more than just blood sugar levels:

1. Weight Management: Semaglutide, when used as part of a comprehensive treatment plan, has been shown to assist with weight loss in adults who are obese or overweight, particularly those with related health conditions. This medication should be used under the guidance of a healthcare provider [5].

2. Heart Health: Research shows that semaglutide lowers the chance of serious heart problems. These include heart attacks and strokes in overweight or obese adults. This applies to people with known heart disease, whether they have diabetes or not [4].

3. Kidney Health: Semaglutide has shown potential kidney benefits in clinical studies, particularly in reducing the risk of chronic kidney disease in people with type 2 diabetes. These effects should be discussed with a healthcare provider to understand the risks and benefits specific to your situation. This might slow down the onset of chronic kidney disease in people with type 2 diabetes [4].

4. Heart Failure Improvement: Semaglutide may help people with certain types of obesity-related heart failure feel better. It can reduce tiredness, make breathing easier, and decrease swelling. Studies show it also boosts exercise tolerance and lessens physical limitations [4].

‍

Individual results may vary, and weight loss should be pursued under the guidance of a healthcare provider to ensure safety and effectiveness. All medications carry the risk of side effects. It's important to consult with a healthcare provider to understand these risks and to monitor for any adverse reactions. 

‍

Semaglutide has a boxed warning about the risk of thyroid C-cell tumors. People with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) should not use this medicine [5].

‍

It's essential to understand semaglutide dosages and guidelines. Follow your healthcare provider's instructions carefully and report any side effects or concerns you may experience while using semaglutide.

‍

What Is Dulaglutide And Who Is It For?

Dulaglutide is a medicine that belongs to a group of drugs called GLP-1 receptor agonists. It aims to improve blood sugar control in adults with type 2 diabetes mellitus alongside diet and exercise [6]. This treatment copies the effects of the incretin hormone, the human glucagon-like peptide-1 (GLP-1) [6].

‍

Dulaglutide's primary way of working involves several steps:

1. Boosting insulin release when glucose levels are high

2. Reducing glucagon release

3. Slowing down stomach emptying to lower after-meal blood sugar levels [6]

‍

Dulaglutide turns on the GLP-1 receptor, a receptor on cell surfaces linked to adenylyl cyclase in pancreatic beta cells. By boosting cyclic adenosine monophosphate inside these cells, dulaglutide triggers insulin release that depends on glucose levels [7].

‍

Dulaglutide has an amino acid sequence that's 90% identical to the human GLP-1 fragment 7-37 [7]. This likeness enables it to copy the natural hormone's effects in the body.

‍

Who is dulaglutide for? Dulaglutide is indicated for adults with type 2 diabetes mellitus who need to control their blood sugar beyond diet and exercise [6].

‍

Dulaglutide has specific cases where it shouldn't be used:

• Doctors don't recommend it for people with type 1 diabetes

• You shouldn't take it if you have diabetic ketoacidosis

• People with severe gut problems should stay away from it

• We don't know much about how it works in patients who've had pancreatitis before or when used with basal insulin [7]

‍

Dulaglutide requires a weekly shot under the skin of the belly, thigh, or upper arm [7]. Adults can start with 0.75 mg once a week, which doctors can bump up to 4.5 mg if needed [8]. 

‍

Dulaglutide doesn't just help control blood sugar. It also has an impact on reducing the chances of serious heart problems. Doctors prescribe it to lower the risk of heart attacks, strokes, or death in grown-ups with type 2 diabetes. This applies to those who already have heart disease or might develop it [9].

‍

Semaglutide Compared To Dulaglutide

Semaglutide and dulaglutide are GLP-1 receptor agonists that doctors use to treat type 2 diabetes. These drugs boost insulin production, cut down glucagon release, and slow stomach emptying, all based on glucose levels [1]. This process helps reduce blood sugar while keeping the chances of low blood sugar to a minimum.

‍

Dosing and Administration

Both medicines require a subcutaneous injection (shot under the skin) once a week [10]. But they have different dosing plans:

• Dulaglutide (Trulicity^®): Doctors start with 0.75 mg weekly. They can bump it up to 1.5 mg to control blood sugar better [1].

• Semaglutide (Ozempic^®): Patients start with 0.25 mg each week for 4 weeks. Then, the dose goes up to 0.5 mg. If needed, it can rise to 1 mg weekly after 4 weeks at the 0.5 mg dose (Learn more: how to reconstitute 5mg semaglutide).

‍

Efficacy in Glycemic Control

Studies show both drugs work well to lower HbA1c levels. But semaglutide seems to have a bit more significant results:

• The SUSTAIN 7 trial showed semaglutide 0.5 mg had a bigger impact on HbA1c reduction than dulaglutide 0.75 mg (-1.4% vs -1.1%, p=0.002) [1].

• Semaglutide 0.5 mg helped more patients reach HbA1c levels below 7% at week 40 than dulaglutide 0.75 mg (65% vs 51%, p<0.0001) [1].

• Semaglutide 1.0 mg lowered HbA1c more than dulaglutide 3.0 mg (ETD: -0.24%-points) and showed similar reductions to dulaglutide 4.5 mg [2].

‍

Weight Loss Effects

Semaglutide has shown more significant weight loss effects than dulaglutide:

• Semaglutide 1.0 mg caused a larger drop in body weight than both dulaglutide 3.0 mg (ETD: -2.65 kg) and 4.5 mg (ETD: -1.95 kg) [2].

‍

Cardiovascular Benefits

Both medicines have an impact on heart health:

• Dulaglutide lowers the chance of major adverse cardiac events (MACE) by 12% in people with heart disease or heart disease risk factors [10].

• Semaglutide cuts the risk of MACE by 26%, but this applies to people who already have heart disease [10].

‍

Safety Considerations

While dulaglutide and semaglutide share similar safety profiles, there are important distinctions. For example, semaglutide includes an additional warning for diabetic retinopathy. Patients should have a thorough discussion with their healthcare provider about the potential risks and benefits.

• Both have a boxed warning about the risk of thyroid C-cell tumors. Doctors can't prescribe them to patients who have had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) or whose family members have had these conditions [1].

• Semaglutide has an extra warning for diabetic retinopathy, which dulaglutide doesn't mention. Doctors should keep an eye on patients with a history of diabetic retinopathy to check if it gets worse when they use semaglutide [1].

‍

Safety profiles are unique to each patient. Always consult with your healthcare provider to ensure the chosen treatment aligns with your health status and goals. Semaglutide and dulaglutide both work well to treat type 2 diabetes, but semaglutide seems to do a bit better in controlling blood sugar and helping with weight loss. 

‍

Some studies suggest that semaglutide may offer slightly more significant glycemic control and weight loss benefits compared to dulaglutide. The choice between these medications should be based on individual health needs and a discussion with a healthcare provider. The effectiveness of these medications can vary based on individual factors. Discuss with your healthcare provider to determine the best treatment option.

Still, picking between the two should depend on what's best for each patient, and people should talk to their doctor to decide.

‍

‍

Dulaglutide vs Semaglutide: Which One Should You Choose?

‍

When choosing between dulaglutide and semaglutide, you need to think about several things that have an impact on which medicine suits a person's needs better. These drugs are both GLP-1 receptor agonists, which doctors prescribe to treat type 2 diabetes [1]. They work to make the body produce insulin, reduce glucagon production, and slow down how fast the stomach empties. 

All of this happens based on glucose levels, which helps to lower the chance of blood sugar getting too low [1].

‍

Dosing and Administration

For the injectable form(s), doctors administer both medicines as shots under the skin once a week, but they follow different general schedules:

• Dulaglutide (Trulicity^®): Doctors start with 0.75 mg each week. They can raise this to 1.5 mg to control blood sugar better [1].

• Semaglutide (Ozempic^®): Patients start with 0.25 mg each week for 4 weeks. Then, the dose goes up to 0.5 mg. If needed, it can increase to 1 mg weekly after 4 weeks at the 0.5 mg dose [1].

‍

Semaglutide comes in pill form and sublingual suspension semaglutide, too. This might suit patients better if they don't want to give themselves semaglutide injections [11].

‍

How Well They Control Blood Sugar

Both drugs work to lower HbA1c levels, but semaglutide seems to have a more significant impact:

• The SUSTAIN 7 study found that semaglutide 0.5 mg cut HbA1c more than dulaglutide 0.75 mg (-1.4% vs -1.1%, p=0.002) [1].

• Semaglutide 0.5 mg helped more patients reach HbA1c levels below 7% at week 40 compared to dulaglutide 0.75 mg (65% vs 51%, p<0.0001) [1].

‍

Heart Health Advantages

Both drugs have shown benefits for heart health:

• Studies show that dulaglutide and semaglutide can lower the chances of serious heart problems like heart attacks, strokes, and deaths from heart issues [11].

• Semaglutide seems to have a bigger impact on heart health [11].

‍

Weight Loss Effects

Semaglutide has shown more significant results in weight loss than dulaglutide. This can make a big difference for patients who need to shed pounds [11].

‍

Safety Considerations

The safety profiles of both drugs are quite alike, but they do have a few key differences:

• Both come with a boxed warning about the risk of thyroid C-cell tumors. Doctors should not prescribe them to patients who have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) [1].

• Semaglutide comes with an extra warning for diabetic retinopathy, which dulaglutide doesn't have. Providers should keep an eye on patients with a history of diabetic retinopathy to check for any worsening when they use semaglutide [1].

‍

Both medicines often cause stomach-related side effects. Patients might feel sick, throw up, or have diarrhea [11].

‍

Semaglutide and dulaglutide both work well to treat type 2 diabetes, but semaglutide seems to have a slight edge in controlling blood sugar and helping with weight loss. Still, the right choice depends on each person's unique situation. Patients should talk to their doctor to decide which medicine best fits their needs, likes, and overall health [11].

‍

Semaglutide: Quick Facts

Sticking to semaglutide safety guidelines will help you cut down on possible side effects and get the best results as you work to manage your weight. Mild stomach issues are the most common side effects. But some rare and serious reactions have been seen, including:

·   Low blood sugar

·   Pain in joints and back

·   Swelling of the pancreas

·   Sudden kidney problems

·   Eye problems in people with diabetes

·   Allergic responses

·   Sudden gallbladder issues

·   Faster heart rate

‍

Like with any drug, you should talk to a doctor to check your own risks and benefits.

Semaglutide comes in pill form, as a sublingual suspension, and as an injection. Each type has its pros and cons, and there are several factors to consider when deciding between semaglutide tablets vs injections:

‍

Oral forms (tablets and sublingual suspension):

·   No needles needed

·   You take them every day

·   Can make you feel sick, throw up, or have stomach pain

·   You should take them in the morning before eating and wait 30 minutes before having food

‍

Shots:

·   You need to use needles

·   You take them once a week

·   Might cause reactions where you inject

·   You can take them whether you've eaten or not

‍

As with any other weight loss medication, there are pros and cons of semaglutide for weight loss.

‍

Pros:

·   Clinical trials show it works

·   It makes your overall health better

·   It cuts down on hunger

·   It helps control blood sugar

·   It gives you a way to manage weight without surgery

‍

Cons:

·   It can cause problems with your stomach and gut

·   It costs a lot even more if you don't have insurance

·   You need to take it for a long time to keep seeing results

·   You might gain weight back if you stop taking it

‍

In order to get approved for semaglutide, there are some minimum requirements that need to be met:

1. To lose weight (Wegovy^®): A BMI of 30 or above, or a BMI of 27 or above with at least one health problem related to weight

2. To manage diabetes (Ozempic^®, Rybelsus^®): A diagnosis of type 2 diabetes

‍

You’ll need to talk to a doctor to find out if you can take semaglutide and if it's right for you.

The semaglutide costs can add up quickly if your insurance doesn't cover it. Prices can change based on your insurance plan, where you buy the semaglutide, and other factors. Research shows patients might pay up to 68% of the cost themselves for weight loss drugs.

(Read more on: Where to find the cheapest semaglutide without insurance)

Semaglutide can be prescribed through telehealth services, but it's important to ensure that the medication is obtained from a reputable source to guarantee its safety and authenticity. Always verify the legitimacy of online pharmacies and consult your healthcare provider before purchasing medications online.

You can get semaglutide prescriptions online through telehealth services, making it possible for you to get semaglutide online. Getting semaglutide from reputable sources like Eden ensures its authenticity and safety.

‍

If you don't have insurance coverage, you have a few options when it comes to how to get semaglutide without insurance:

1. Novo Nordisk, which makes semaglutide products, has programs to help eligible people.

2. You can get discounts at different pharmacies using services like Optum Perks.

3. Some pharmacies also make their own version of semaglutide that costs less.

‍

Without insurance, semaglutide can cost significantly more than the cost with insurance. Prices can change based on the pharmacy and where you live, but the cost of semaglutide without insurance can still be expensive. Some online coupons or discount programs can help cut the cost of semaglutide treatments.

Many people have lost weight using this drug, along with a healthy diet and exercise plan. These semaglutide success stories show how semaglutide can help people lose weight and boost their overall health. Always talk to your doctor to figure out the best way to treat your condition.

‍

Dulaglutide vs Semaglutide: Final Thoughts

Picking between dulaglutide and semaglutide to manage type 2 diabetes depends on what each patient needs. These drugs both help control blood sugar and protect the heart, but semaglutide seems to have a more significant effect on losing weight and lowering HbA1c. When deciding, it's crucial to think about how often you take the medicine, how you give it, and what side effects it might cause. 

‍

Semaglutide may provide more significant weight loss and glycemic control for some patients. Still, the decision to use semaglutide or dulaglutide should be made in consultation with a healthcare provider, considering the patient's overall health and treatment goals. Medication decisions should always be guided by a healthcare professional based on individual health assessments.

‍

Patients and their doctors should talk it over to decide whether dulaglutide or semaglutide is the better choice. By looking at the good and bad points of each drug and thinking about personal health goals, patients can find the best option to handle their diabetes well. 

If you are considering other options, check some of our other comparisons:

• Lipotropic Injections vs Semaglutide
• Semaglutide vs. Tirzepatide
• Semaglutide Tablets vs Injection
• Metformin vs Semaglutide
• Saxenda vs Semaglutide:

‍

FAQ

‍

1. Which medication is more effective, Semaglutide or Dulaglutide?

Semaglutide, the active ingredient in Ozempic^®, has been found to be more effective than Dulaglutide, the active ingredient in Trulicity^®, for improving blood sugar levels.

‍

2. Between Ozempic^® and Trulicity^®, which is more beneficial for weight loss?

Individuals using the starting doses of Ozempic^® experienced significantly greater weight loss, with an average loss of about 14 pounds, compared to those on the 1.5 mg dose of Trulicity^®, who lost about 6 pounds. Overall, Ozempic^® users lost more than twice the weight of those on Trulicity^®.

‍

3. What are the potential disadvantages of using Trulicity^®?

Common side effects of Trulicity^® include nausea, diarrhea, and stomach pain. Although rare, severe side effects such as pancreatitis or gallbladder disease can occur. It is important to consult with your healthcare team to prevent or manage these side effects effectively.

‍

4. Which dosage of Semaglutide is the most effective?

In clinical trials, the 2.4 mg dose of semaglutide (the maximum dose of Wegovy^®) was shown to cause more weight loss compared to the 1 mg dose (the typical maintenance dose of Ozempic^®). Medication decisions should always be guided by a healthcare professional based on individual health assessments.

‍

References

‍

1. Patel S. Comparing Semaglutide Versus Dulaglutide. Pharmacy Times. Published February 6, 2020. Accessed August 15, 2024. https://www.pharmacytimes.com/view/comparing-semaglutide-versus-dulaglutide

‍

2. Pratley RE, Catarig A, Lingvay I, et al. An indirect treatment comparison of the efficacy of semaglutide 1.0 mg versus dulaglutide 3.0 and 4.5 mg. Diabetes, Obesity and Metabolism. 2021;23(11):2513-2520. doi: https://doi.org/10.1111/dom.14497

‍

3. Marshall H, Sheffel E. Ozempic vs. Trulicity: Is one of them right for you? Medical News Today. Published January 25, 2021. Accessed August 15, 2024. https://www.medicalnewstoday.com/articles/drugs-ozempic-vs-trulicity

‍

4. Buss Preszler L. Health benefits of semaglutide — Beyond weight loss - Mayo Clinic Press. Mayo Clinic Press. Published July 2, 2024. Accessed August 15, 2024. https://mcpress.mayoclinic.org/living-well/health-benefits-of-semaglutide-beyond-weight-loss/

‍

5. MedlinePlus. Semaglutide injection: MedlinePlus drug information. medlineplus.gov. Published April 20, 2024. Accessed August 15, 2024. https://medlineplus.gov/druginfo/meds/a618008.html

‍

6. Smith LL, Mosley JF, Parke C, Brown J, Barris LS, Phan LD. Dulaglutide (Trulicity): The Third Once-Weekly GLP-1 Agonist. Pharmacy and Therapeutics. 2016;41(6):357-360. Accessed August 15, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894510/

‍

7. Fala L. Trulicity (Dulaglutide): A New GLP-1 Receptor Agonist Once-Weekly Subcutaneous Injection Approved for the Treatment of Patients with Type 2 Diabetes. American Health & Drug Benefits. 2015;8(Spec Feature):131-134. Accessed August 15, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665063/

‍

8. Merative, Micromedex. Dulaglutide (Subcutaneous Route) Proper Use - Mayo Clinic. Mayo Clinic. Published May 1, 2024. Accessed August 15, 2024. https://www.mayoclinic.org/drugs-supplements/dulaglutide-subcutaneous-route/proper-use/drg-20122526?p=1

‍

9. Medline Plus. Dulaglutide Injection: MedlinePlus Drug Information. medlineplus.gov. Published January 15, 2023. Accessed August 15, 2024. https://medlineplus.gov/druginfo/meds/a614047.html

‍

10. Hoffman S, Cook L. Comparing Trulicity (Dulaglutide) vs. Ozempic (Semaglutide). Verywell Health. Published 2023. Accessed August 15, 2024. https://www.verywellhealth.com/trulicity-vs-ozempic-uses-efficacy-side-effects-7507482

‍

11. Consultant 360. Semaglutide vs Dulaglutide: Which Is Best for Type 2 Diabetes? consultant360.com. Published 2024. Accessed August 15, 2024. https://www.consultant360.com/exclusives/semaglutide-vs-dulaglutide-which-best-type-2-diabetes

‍

Disclaimer: The FDA does not approve compounded medications for safety, quality, or manufacturing. Prescriptions and a medical evaluation are required for certain products. The information provided on this blog is for general informational purposes only. It is not intended as a substitute for professional advice from a qualified healthcare professional and should not be relied upon as personal health advice. The information contained in this blog is not meant to diagnose, treat, cure, or prevent any disease. Readers are advised to consult with a qualified healthcare professional for any medical concerns, including side effects. Use of this blog's information is at your own risk. The blog owner is not responsible for any adverse effects or consequences resulting from the use of any suggestions or information provided in this blog.

‍