Top 5 Trulicity Alternatives

If you or a loved one lives with diabetes, you may have heard of a medication called Trulicity. 

Trulicity is a weekly injection under your skin that helps manage type 2 diabetes mellitus in children over 10 and adults. It is not FDA-approved for treating type 1 diabetes or weight management.  

Unfortunately, Trulicity is only available as a brand-name medication, making it costly. Because of this and the potential side effects and/or your medical history, another diabetes medication may be better for you.

This article will take a closer look at Trulicity and its side effects, including weight loss, and also examine five alternative diabetes medications in addition to Trulicity.

What is Trulicity (dulaglutide)?

As mentioned, Trulicity is an FDA-approved weekly injection for managing type 2 diabetes. It mimics the action of your glucagon-like peptide-1 (GLP-1) hormone. Because of this, Trulicity helps control your blood sugar levels by: 

• Increasing insulin secretion from your pancreas 
• Reducing the amount of sugar your liver makes
• Delaying gastric emptying

Trulicity keeps you feeling full for longer, thus reducing your appetite and causing weight loss. Because of this, your healthcare provider may prescribe Trulicity off-label for weight management. 

For those with type 2 diabetes with known heart disease or other cardiovascular risk factors, Trulicity reduces major heart events. These events include heart attacks, strokes, and even death. 

Trulicity is available as pre-filled, single-use pen injectors in four strengths: 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg. You will start at a low dose, and your healthcare provider may slowly increase your dosage based on your goal hemoglobin A1c (HbA1c) and side effects. HbA1c is the 3-month average of your blood sugar levels. The lower the number, the better glycemic control you have.

Possible Side Effects of Trulicity

Nausea is the most common side effect reported when starting Trulicity. As you continue to take Trulicity, nausea may improve. Other common side effects include:

• Abdominal pain
• Diarrhea
• Fatigue
• Indigestion
• Reduced appetite
• Vomiting
• Constipation

Although rare, Trulicity can cause serious side effects, such as: 

• Pancreatitis (inflammation of your pancreas) 
• Diabetic retinopathy complications (changes in your vision) 

Trulicity increases insulin secretion, yet hypoglycemic (low blood sugar) events are uncommon.  If taken with other diabetes medications that can cause low blood sugar, such as sulfonylureas or insulin, there is a higher risk of hypoglycemia. 

You can have an allergic reaction to Trulicity. Signs and symptoms of an allergic reaction include trouble breathing, swelling of your tongue or lips, and severe rash or itching. If you notice any of these symptoms, seek immediate medical attention.

Keep in mind that everyone’s experience with Trulicity will be different. Some may experience severe side effects requiring them to stop taking Trulicity, while others may have none. If you notice changes in your health or any of the above side effects, contact your healthcare provider. 

Top 5 Trulicity Alternatives Compared

Trulicity belongs to a class of medications called GLP-1 receptor agonists. These medications can be expensive. For this reason, and others including side effects or your medical history, Trulicity may not be your best option. Below are five alternatives to Trulicity. 

1. Exenatide (Byetta, Bydureon Bcise)

Exenatide is also an injectable GLP-1 receptor agonist, like Trulicity. It is available in two formulations: immediate and extended-release. The type of formulation determines how often you take it.

• Byetta: twice daily injection before morning and evening meals
• Bydureon Bcise: once weekly injection 

There are no clinical studies directly comparing Trulicity and exenatide formulations. Both medications improve glycemic control and cause weight loss compared to placebo.

Exenatide formulations may cause more injection site reactions (redness or swelling at the injection site) than Trulicity. Those with impaired kidney function may not be able to use exenatide. 

2. Liraglutide (Victoza)

Liraglutide, another GLP-1 receptor agonist, is a daily subcutaneous injection. 

Liraglutide and Trulicity decrease HbA1c by similar amounts, with Trulicity being slightly more effective. But, liraglutide causes more weight loss than Trulicity. Side effects are similar, except for injection site reactions. Trulicity had far fewer injection site reactions than liraglutide. 

3.Semaglutide (Ozempic, Rybelsus)

A third GLP-1 receptor agonist, semaglutide, is another alternative for Trulicity. 

Semaglutide is available under different brand names based on the formulation. Ozempic is a weekly injection, while Rybelsus is an oral tablet taken every day before your first meal. Rybelsus is an excellent alternative to injectable medications.

Ozempic reduces HbA1c better than Rybelsus, but only by a tiny amount. Compared to low doses of Trulicity, both Ozempic and Rybelsus lowered the HbA1c better and caused more weight loss.

4. Tirzepatide (Mounjaro )

Mounjaro is the first medication in this new drug class called glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist. It works just like a GLP-1 agonist but causes more insulin secretion due to GIP action. 

Mounjaro is a weekly injection with similar side effects and safety concerns as Trulicity. Compared to low dose Trulicity, Mounjaro causes more weight loss and better glycemic control. 

5. Metformin (Glucophage)

Metformin has been around for decades and is commonly prescribed for managing type 2 diabetes. It belongs to the biguanide medication class; thus, it works differently than Trulicity. Metformin improves your cells' response to insulin. It also decreases how much insulin your body makes. 

Metformin is an oral tablet and depending on the dose can vary from one to four tablets daily. For those with liver or kidney disease, speak with your healthcare provider about whether metformin is the best choice for you. 

Gastrointestinal (GI) side effects such as nausea, diarrhea, and vomiting are common in those taking metformin.

There are many metformin generic alternatives on the market, making it a cost-effective option.

Trulicity and Weight Loss: Are There Better Alternatives?

GLP-1 receptor agonists reduce your appetite, thus leading to weight loss. Higher doses of GLP-1 receptor agonists cause more weight loss than lower doses. For instance, a weekly Trulicity dose of 4.5 mg causes about a 10 pounds weight loss, which is 2 pounds more than the 1.5 mg dose.  

Wegovy (semaglutide) and Saxenda (liraglutide) are two GLP-1 receptor agonists specifically FDA-approved for chronic weight management in combination with lifestyle changes. One key difference between these two medications is that Wegovy is a weekly injection, while Saxenda requires a daily injection. 

According to a 2022 study, Wegovy causes more weight loss, about 15 pounds, and is better tolerated than Saxenda. However, Mounjaro causes more weight loss than any GLP-1 receptor agonist. 

In another 2022 study, those taking a weekly Trulicity dose of 1.5 mg saw a 6-pound weight loss. That may seem small compared to the 25-pound weight loss seen in those taking Mounjaro 15 mg weekly! However, those taking Mounjaro reported more GI side effects, such as nausea, vomiting, and diarrhea, than those taking Trulicity. 

The amount of weight loss seen in clinical trials may also be influenced by lifestyle changes such as eating a healthy diet and regular physical activity. Since each study is different, some may have implemented more intense lifestyle changes compared to others, affecting the amount of weight loss reported. 

Conclusion

Trulicity is a GLP-1 receptor agonist that helps control blood sugar levels and can help regulate your appetite. Because of this, Trulicity is approved for treating type 2 diabetes and is prescribed off-label for weight management. 

Trulicity isn’t for everyone. Other diabetes medications, such as metformin or Mounjaro, may be better choices for you. When choosing a diabetes medication, you and your healthcare provider will consider your unique medical history, any contraindications to the medications, how well you tolerate it, and the cost of the medication.

If you are wondering if Trulicity or one of its alternatives might be better for you, talk with your healthcare provider or one of our diabetes experts. Our providers are ready to discuss the risks and benefits with you for each medication to determine the best one for managing your diabetes. Sign up today.