Trulicity vs Ozempic: Dulaglutide and Semaglutide Compared

Trulicity vs Ozempic compares two once-weekly GLP-1 receptor agonists that are both FDA-approved for type 2 diabetes. Trulicity contains dulaglutide, made by Eli Lilly and first approved in September 2014. Ozempic contains semaglutide, made by Novo Nordisk and first approved in December 2017. Both improve blood sugar control and both lower the risk of major cardiovascular events in defined groups of adults with type 2 diabetes. Ozempic also has a kidney indication, while Trulicity is approved for children 10 and older. In the only head-to-head trial, SUSTAIN 7, semaglutide lowered HbA1c and body weight more than dulaglutide. Neither drug is FDA-approved for weight management.

Peptide Labs does not sell Trulicity, Ozempic or any prescription drug. This article is general information, not medical advice. Which medicine, if any, suits a person is a decision for a licensed prescriber. For background on the hormone both drugs copy, see what GLP-1 is.

Trulicity vs Ozempic at a glance

The table uses the current U.S. labels: Trulicity revised in March 2026 and Ozempic revised in May 2026.

Dulaglutide vs semaglutide: how the molecules differ

Natural GLP-1 lasts only a minute or two in the blood, so both drugs are engineered to resist the enzyme DPP-4 and to stay in the body for days. They get there in different ways. According to the Trulicity label, dulaglutide is a large fusion protein of about 63 kilodaltons: two identical GLP-1 analog chains, each linked to part of a modified human antibody (the Fc fragment of IgG4). Its GLP-1 portion is 90% identical to human GLP-1. Semaglutide is a much smaller peptide with a fatty side chain that binds it to albumin, a blood protein, which the Ozempic label names as the main reason it lasts so long.

The labels give dulaglutide a half-life of about 5 days, with peak blood levels 24 to 72 hours after each weekly injection and steady levels within 2 to 4 weeks. Semaglutide has a half-life of about one week, peaks 1 to 3 days after each injection and reaches steady levels after 4 to 5 weeks; see how long Ozempic takes to work. Both labels raise the strength gradually over weeks to limit digestive side effects, but Trulicity’s starting strength can also be kept long term, while Ozempic’s first step is only for starting.

Approved uses on the 2026 labels

• Trulicity: with diet and exercise, to improve blood sugar control in adults and children 10 and older with type 2 diabetes; and to lower the risk of cardiovascular death, heart attack or stroke in adults with type 2 diabetes who have established heart disease or multiple cardiovascular risk factors.
• Ozempic: with diet and exercise, to improve blood sugar control in adults with type 2 diabetes; to lower the risk of major cardiovascular events in adults with type 2 diabetes and established heart disease; and, since January 28, 2025, to lower the risk of kidney function decline, kidney failure and cardiovascular death in adults with type 2 diabetes and chronic kidney disease.

The Trulicity heart indication covers a wider group because its outcome trial enrolled many people without known heart disease, as described below.

SUSTAIN 7: the head-to-head trial

SUSTAIN 7, published in The Lancet Diabetes and Endocrinology in 2018, is the only randomized trial comparing the two drugs directly. It enrolled 1,201 adults with type 2 diabetes whose blood sugar was not controlled on metformin alone, at 194 sites in 16 countries. Participants were assigned to one of four groups: a lower and a higher strength of each drug, so the comparison was made in two pairs. It ran for 40 weeks, was open-label, meaning participants knew which drug they were taking, and was funded by Novo Nordisk, the maker of Ozempic.

Both differences were statistically significant, and the authors described the safety profiles as similar. Both labels now include higher strengths than SUSTAIN 7 tested, and Ozempic vs Trulicity has not been retested head to head at those strengths.

Heart and kidney outcome trials

Each drug has its own large outcome trial, funded by its maker and compared with placebo, not with the other drug:

• REWIND (dulaglutide, The Lancet 2019): 9,901 adults aged 50 and older with type 2 diabetes, followed for a median of 5.4 years. Only 31.5% had established heart disease; the rest had risk factors. Cardiovascular death, nonfatal heart attack or nonfatal stroke occurred in 12.0% on dulaglutide and 13.4% on placebo. Funded by Eli Lilly.
• SUSTAIN-6 (semaglutide, NEJM 2016): 3,297 adults with type 2 diabetes over 104 weeks. The same combined outcome occurred in 6.6% vs 8.9%. The trial was designed to show semaglutide was no worse than placebo, and diabetic eye complications were more frequent with semaglutide. Funded by Novo Nordisk.
• FLOW (semaglutide, NEJM 2024): 3,533 adults with type 2 diabetes and chronic kidney disease. It was stopped early, at a planned interim analysis, after a median of 3.4 years. Major kidney events or death from kidney or cardiovascular causes were 24% less likely with semaglutide. This trial supports Ozempic’s kidney indication. Funded by Novo Nordisk.

Children and teens

On November 17, 2022, the FDA approved Trulicity for blood sugar control in children 10 and older with type 2 diabetes. The approval rested on AWARD-PEDS, a 26-week Lilly-funded trial in 154 young people aged 10 to 17 published in NEJM in 2022. HbA1c fell by 0.6 and 0.9 points on the two dulaglutide strengths and rose by 0.6 points on placebo; body mass index did not differ between groups. Ozempic is not approved for anyone under 18. Liraglutide also has pediatric approvals; see liraglutide vs semaglutide.

Pens and pill forms

Trulicity comes only as single-use pens, each holding one weekly amount with the needle already inside under a base cap; the pen is used once and thrown away. Ozempic comes in multi-use pens that hold several weekly amounts, with a new needle attached each time. Ozempic pens must never be shared, even with a new needle. Semaglutide also comes as a daily tablet for type 2 diabetes, sold since 2026 as Ozempic tablets; our Ozempic tablets guide explains that product. There is no oral form of dulaglutide.

Side effects and shared warnings

Because they act on the same receptor, the two labels share their main warnings. Both carry a boxed warning about thyroid C-cell tumors seen in rodents and say the drug must not be used by people with a personal or family history of medullary thyroid carcinoma or with Multiple Endocrine Neoplasia syndrome type 2. Both warn about pancreatitis, low blood sugar when combined with insulin or a sulfonylurea, serious allergic reactions, kidney injury from dehydration, severe digestive reactions, diabetic eye complications, gallbladder disease and inhaling stomach contents during anesthesia or deep sedation.

The most common Trulicity side effects are nausea, diarrhea, vomiting, abdominal pain and decreased appetite; in its placebo-controlled trials nausea affected 12.4% and 21.1% on the two original strengths vs 5.3% on placebo. Ozempic’s most common side effects are nausea, vomiting, diarrhea, abdominal pain and constipation, with nausea in 15.8% and 20.3% vs 6.1%. These figures come from different trials and cannot be compared directly. Our guides to semaglutide side effects and GLP-1 side effects across the class go into detail.

Weight loss: neither drug is approved for it

Weight loss was measured in the diabetes trials of both drugs, but neither Trulicity nor Ozempic is FDA-approved for weight management. The semaglutide brand approved for that use is Wegovy; our Wegovy vs Ozempic guide explains the difference. Lilly’s weight-management drugs are Zepbound (tirzepatide) and Foundayo (orforglipron), not dulaglutide. For the full list of approved options, see Ozempic alternatives.

Supply and unapproved versions

Both drugs were hard to find during the GLP-1 shortages that began in 2022. On February 21, 2025, the FDA declared the semaglutide shortage resolved and said dulaglutide was still in shortage, with some presentations available. A pharmacist can confirm current supply. Products sold online as semaglutide “for research” or as salt forms are not FDA-approved; our guide to compounded semaglutide and tirzepatide explains the rules.

Frequently Asked Questions

Peptide Labs does not sell these drugs. This article is general information, not medical advice. Read the Medication Guide that comes with a prescription, and ask a pharmacist or prescriber how this information applies to you.

Last reviewed September 2026.

Related guides: Wegovy vs Ozempic: Same Semaglutide, Different Labels, Liraglutide vs Semaglutide: Daily vs Weekly GLP-1 Drugs Compared, Semaglutide Side Effects: What the Ozempic, Wegovy and Rybelsus Labels Say, Trulicity Side Effects: Label Rates, Warnings and Weight.