Trulicity vs Ozempic: Which Works Better for A1C and Weight Loss?

Trulicity® and Ozempic® are both once-weekly GLP-1 injections for type 2 diabetes, but they are different medicines from different companies. Trulicity is dulaglutide, made by Eli Lilly; Ozempic is semaglutide, made by Novo Nordisk. In SUSTAIN 7, the trial that compared them directly, Ozempic 1 mg lowered A1C by 1.8 points and weight by 14.3 lb over 40 weeks, compared with 1.4 points and 6.6 lb on Trulicity 1.5 mg (Lancet Diabetes & Endocrinology, 2018). Neither is FDA-approved for weight loss. As of November 2026, Trulicity costs $389 a month self-pay from LillyDirect at every strength, and Ozempic costs $349 a month up to 1 mg, or $499 for 2 mg, from NovoCare.

Ozempic has the stronger effect on blood sugar and weight, but Trulicity still fits some people better. It is approved for children 10 and older, its heart approval covers adults with risk factors but no diagnosed heart disease, and its pen has the needle built in. Here is how the two compare, with the numbers and their sources.

Trulicity vs Ozempic at a Glance

Sources: the FDA labels on DailyMed for Trulicity and Ozempic; Drugs@FDA; SUSTAIN 7; LillyDirect and NovoCare. Prices as of November 2026.

Is Trulicity the Same as Ozempic?

No. Trulicity and Ozempic belong to the same drug class, GLP-1 receptor agonists, but they contain different molecules. Trulicity is dulaglutide, a GLP-1-like peptide fused to a fragment of an antibody, with a half-life of about 5 days. Ozempic is semaglutide, a GLP-1-like peptide that binds to albumin in the blood, with a half-life of about 1 week, according to each label.

So Trulicity is not a semaglutide, and it is not a tirzepatide either; tirzepatide is the medicine in Lilly's Mounjaro® and Zepbound®. Our guide to Trulicity vs tirzepatide covers that comparison. Both drugs help the pancreas release insulin when blood sugar is high, lower the hormone glucagon, slow stomach emptying and reduce appetite. The difference is how strongly they do it at their approved doses.

Which Lowers A1C More, Trulicity or Ozempic?

Ozempic, at the doses that have been compared. SUSTAIN 7 randomly assigned 1,201 adults with type 2 diabetes on metformin to one of four groups for 40 weeks: Ozempic 0.5 mg, Trulicity 0.75 mg, Ozempic 1 mg or Trulicity 1.5 mg. Everyone had an A1C between 7.0% and 10.5% at the start.

Source: SUSTAIN 7, PubMed abstract. The trial was open label and funded by Novo Nordisk, which makes Ozempic.

SUSTAIN 7 has one big limit: it stopped below today's top doses. Both drugs now go higher, Trulicity to 3 mg and 4.5 mg (approved in September 2020) and Ozempic to 2 mg (approved in March 2022), and no trial has compared those doses head to head. What the separate trials show:

• Trulicity 3 mg and 4.5 mg (AWARD-11): in 1,842 adults on metformin, A1C fell 1.5, 1.6 and 1.8 points and weight fell 3.0, 3.8 and 4.6 kg (about 7, 8 and 10 lb) on 1.5, 3 and 4.5 mg over 36 weeks, according to the Trulicity label.
• Ozempic 2 mg (SUSTAIN FORTE): A1C fell 2.2 points on 2 mg vs 1.9 on 1 mg over 40 weeks, in people whose A1C started higher, at about 8.9% (PubMed).
• An indirect comparison of the top doses: a 2022 analysis that combined those trials estimated that semaglutide 2 mg lowers A1C about 0.3 points more and weight about 2.6 kg (5.7 lb) more than dulaglutide 4.5 mg (J Clin Endocrinol Metab). It was written with Novo Nordisk authors and is an estimate, not a trial.

These results belong to Trulicity and Ozempic, the brand products studied. They have not been shown for compounded semaglutide.

Is Trulicity or Ozempic Better for Weight Loss?

Neither is FDA-approved for weight loss, but Ozempic produces more of it. In SUSTAIN 7, people lost about twice as much weight on Ozempic as on Trulicity at each dose pair. Lilly's own Trulicity site puts it plainly: "Trulicity is not a weight loss drug." It says weight change in its studies ranged from a 0.4 lb gain on 0.75 mg to a 10.1 lb loss on 4.5 mg. In the trials on Ozempic's label, adults with type 2 diabetes lost an average of 7 to 14 lb over 30 to 56 weeks.

If weight loss is the main goal, each company has a brand approved for it. Novo Nordisk sells semaglutide for weight management as Wegovy, at higher doses than Ozempic (2.4 mg a week, or 7.2 mg as Wegovy HD). Our guide to Ozempic vs Wegovy compares the two semaglutide brands. Eli Lilly's weight-management brand is Zepbound, which is tirzepatide, not dulaglutide. In SURMOUNT-5, Zepbound produced more weight loss than Wegovy, and our guide to Zepbound vs Wegovy has the numbers. Prescribing Trulicity or Ozempic for weight alone is off-label, and insurers usually won't pay for it.

Do Trulicity and Ozempic Have Different Side Effects?

Their side effects are alike: nausea, diarrhea, vomiting and stomach pain are the most common for both, mostly while the dose is rising. In SUSTAIN 7, stomach side effects affected 33% to 48% of people on Trulicity and 43% to 44% on Ozempic. These are the label rates from each drug's placebo-controlled diabetes trials, with placebo in parentheses:

Sources: Trulicity label, Table 1, and Ozempic label, Table 1 (DailyMed, as of November 2026). Both labels say rates from different drugs' trials can't be directly compared.

At Trulicity's higher doses, nausea affected 13.4%, 15.6% and 16.4% of people on 1.5, 3 and 4.5 mg in AWARD-11, and vomiting 5.6%, 8.3% and 9.3%.

What Is the Downside of Trulicity?

Trulicity's main downside is a smaller effect: less A1C lowering and less weight loss than Ozempic at the doses compared. Beyond that, its risks are the class risks it shares with Ozempic. Both labels carry a boxed warning that the drugs caused thyroid C-cell tumors in rodents, and neither should be used if you or a family member has had medullary thyroid carcinoma or if you have MEN 2. Both warn about pancreatitis, low blood sugar when combined with insulin or a sulfonylurea, serious allergic reactions, kidney injury from dehydration, severe stomach problems (neither is recommended with severe gastroparesis), worsening diabetic eye disease in people with diabetic retinopathy, gallbladder disease, and inhaling stomach contents during anesthesia. On November 9, 2026, the FDA also required new warnings on all GLP-1 medicines about NAION, a rare cause of sudden vision loss in one eye.

Talk to your provider about any side effect that is severe or doesn't settle, and get care right away for severe stomach pain that won't go away or sudden vision loss.

Which One Is Approved for Heart Disease, Kidney Disease or Children?

Both lower heart risk in type 2 diabetes, but for different groups, and only Ozempic has a kidney approval while only Trulicity is approved for children.

• Heart. Trulicity is approved to lower the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes who have heart disease or multiple risk factors. In REWIND, 9,901 adults, most of them without diagnosed heart disease, were followed for a median of 5.4 years: 12.0% on Trulicity had a major heart event vs 13.4% on placebo. Ozempic's heart approval covers adults with type 2 diabetes and established heart disease. In SUSTAIN 6, 6.6% on Ozempic had a major heart event vs 8.9% on placebo over about 2 years. The two trials enrolled different people and can't be compared directly.
• Kidneys. Since January 28, 2025, Ozempic has been approved to lower the risk of kidney decline, kidney failure and cardiovascular death in adults with type 2 diabetes and chronic kidney disease, based on FLOW, where the main kidney outcome was 24% lower than on placebo. Trulicity has no kidney indication.
• Children. Trulicity is approved for children 10 and older with type 2 diabetes, at up to 1.5 mg, since November 2022. Ozempic's label says its safety and effectiveness in children have not been established.

How Do Trulicity and Ozempic Doses and Pens Compare?

Both are weekly shots that start low and rise every 4 weeks or more, but the pens and a few rules differ. These are the label facts:

Sources: Trulicity and Ozempic labels on DailyMed, as of November 2026.

There is no official Trulicity-to-Ozempic dose conversion, and the milligrams aren't comparable: a milligram of dulaglutide and a milligram of semaglutide are different medicines on different scales. Our semaglutide dosage chart shows each Ozempic step.

How Much Do Trulicity and Ozempic Cost?

Without insurance, Ozempic is $40 a month cheaper up to 1 mg, and Trulicity is $110 cheaper than Ozempic 2 mg. As of November 2026, these are the makers' prices:

Sources: LillyDirect, Trulicity savings card terms, NovoCare. Savings cards exclude Medicare, Medicaid and other government coverage.

List prices matter if you have a deductible or coinsurance. Novo Nordisk says Ozempic's list price will drop to $675 a month on January 1, 2027, about 35% lower, with no change to its self-pay prices. Neither drug is part of Medicare's weight-management GLP-1 Bridge, which covers only weight-loss brands, and people with type 2 diabetes get GLP-1 coverage through their Part D plan instead (CMS). Which drug your plan prefers often decides the choice; our guide to weight-loss drugs covered by insurance explains how plans decide.

Is Trulicity Still in Short Supply?

No. Both Trulicity and Ozempic were hard to find during the GLP-1 shortages, but as of November 2026, the FDA drug shortage database lists the dulaglutide shortage as resolved, and the FDA declared the semaglutide shortage over on February 21, 2025. A pharmacy may still be out of a strength on a given day, so ask before your refill is due.

Can You Switch From Trulicity to Ozempic?

Yes, with a new prescription, and your prescriber decides the dose and timing. People usually switch for a stronger effect on A1C or weight, or because their plan changed its preferred drug. What to expect:

• No conversion chart. The Ozempic label has one starting schedule, 0.25 mg for 4 weeks and then 0.5 mg. Whether you start there depends on your current Trulicity dose and how well you tolerate GLP-1 medicines, and that is your prescriber's call.
• Watch your blood sugar. Check it more often during the switch. If you also take insulin or a sulfonylurea, your prescriber may lower that dose to prevent low blood sugar.
• Expect some stomach side effects again. Nausea is most common while a new GLP-1 dose is rising.
• The reverse works too. Moving from Ozempic to Trulicity is a normal step if Ozempic's side effects are hard to manage or your plan prefers Trulicity.

Can You Take Trulicity and Ozempic Together?

No. Both are GLP-1 receptor agonists that act on the same receptor, so a switch replaces one with the other. Taking both raises the risk of nausea, vomiting, dehydration and low blood sugar, with no proven benefit. If you see more than one prescriber, make sure each one has your full medication list.

What If Your Goal Is Weight Loss, Not Diabetes?

Then neither Trulicity nor Ozempic is the brand made for you. Wegovy (semaglutide) and Zepbound (tirzepatide) are the FDA-approved weight-management brands, and our guide to semaglutide vs tirzepatide compares the two medicines across every brand.

If you're paying cash, there is also compounded semaglutide, $89/mo flat through MaxLife. Compounded semaglutide is prepared by a licensed pharmacy for one patient's prescription and is not FDA-approved, which means the FDA hasn't reviewed it for safety, effectiveness or quality. It is not Ozempic, it is not a generic of it, and the trial results in this article have not been shown for compounded semaglutide. The FDA says a compounded drug "might be appropriate if a patient's medical need cannot be met by an FDA-approved drug" (FDA). It is offered for weight management, not as a treatment for type 2 diabetes: if you have diabetes, keep your diabetes care with the clinician who manages it. Our guide to compounded semaglutide vs Ozempic explains the differences.

Here is how MaxLife works. MaxLife is a telehealth patient management platform, not a pharmacy or drug maker. The online intake takes about 2 minutes. A licensed provider reviews your online intake, health history and clinical records, usually within 24 hours, can follow up with questions, and you can ask for a video visit. The provider considers everything in your record, including diabetes and your other medicines, and decides case by case. If compounded semaglutide is right for you, a licensed partner pharmacy prepares it and ships it with free expedited shipping, in all 50 states. It costs $89/mo flat: all-inclusive (the provider's review and follow-up, the medicine if prescribed, and supplies), the same price at every dose, with no membership fee. No insurance is needed, and HSA and FSA funds may be eligible.

Trulicity or Ozempic: Which Should You Ask About?

Your health, your plan's formulary and your goals decide. Use this as a starting point with your prescriber:

• The biggest A1C and weight effect: Ozempic, based on SUSTAIN 7 and the dose-range trials.
• Type 2 diabetes with chronic kidney disease: Ozempic is the one with a kidney approval.
• Heart risk factors, but no diagnosed heart disease: Trulicity's heart approval includes adults with multiple risk factors.
• A child 10 to 17 with type 2 diabetes: Trulicity is the approved option of the two; that choice belongs with a pediatric specialist.
• You'd rather not handle needles: Trulicity's single-dose pen has the needle built in. Ozempic also comes as a daily pill for type 2 diabetes.
• Stomach side effects have been hard for you: neither is clearly gentler, so a slow dose increase matters more than the brand.
• Your plan covers only one: the covered brand usually wins; both are effective diabetes medicines.
• Paying cash for diabetes care: compare Trulicity at $389 with Ozempic at $349 (up to 1 mg) or $499 (2 mg). If you are weighing tirzepatide, see Mounjaro vs Ozempic.

The Bottom Line

Trulicity (dulaglutide, Eli Lilly) and Ozempic (semaglutide, Novo Nordisk) are different weekly GLP-1 injections for type 2 diabetes. In SUSTAIN 7, Ozempic lowered A1C more (1.8 vs 1.4 points) and produced about twice the weight loss (14.3 vs 6.6 lb) at the higher doses compared, and newer analyses suggest the gap persists at the top doses. Trulicity keeps real advantages: approval for children 10 and older, a heart approval that covers people with risk factors only, and a simple single-dose pen. Neither is approved for weight loss. As of November 2026, Trulicity costs $389 a month self-pay and Ozempic $349 to $499. Never take them together, and let your health, your plan and your prescriber decide.