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Semaglutide VS. Trulicity for Weight Loss: Which is the Better Treatment?

Semaglutide and Trulicity are commonly prescribed to control blood sugar levels and prevent or manage type 2 diabetes. Aside from this, many patients also rely on these treatment options to set them up for success in weight reduction. However, many also wonder if these solutions are just the same or which is the better option. Choosing the most suitable weight loss medication helps you control your body weight, promoting overall wellness.

So which is the better treatment between semaglutide and Trulicity? Semaglutide was reported to be more potent and effective in weight reduction than Trulicity or dulaglutide, according to clinical trials. However, semaglutide has risks of developing diabetic retinopathy, unlike dulaglutide.

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Is Semaglutide the Same as Trulicity?

Proper weight management with a healthy lifestyle can be challenging if you're starting with an impaired metabolism. That’s why obese and overweight patients rely on medications to jump-start their healthy lifestyles and control their body weight.

Semaglutide and Trulicity are some drugs also used to help patients lose weight. They’re also both medications for preventing and treating type 2 diabetes mellitus as they help lower blood sugar levels. Many may assume they’re just the same type of drugs, but they’re actually two different medications – semaglutide is the generic name of brands like Wegovy, Rybelsus, and Ozempic, while Trulicity is a brand of dulaglutide drugs.

Because semaglutide and dulaglutide (the generic name of Trulicity) are different drugs, they would have varying chemical compositions and other pharmacological properties. These differences are necessary considerations for choosing the most suitable weight loss medication for you, even if they have notable similarities, like:

1. Drug Class

Semaglutide and dulaglutide both belong to the same class of drugs, called incretin mimetics, sometimes called GLP-1 receptor agonists or GLP-1 analog. A GLP-1 drug, or glucagon-like peptide, mimics the function of incretin hormones. These types of hormones send signals to your pancreas to secrete the right amount of insulin, promoting glycemic control.

2. Use

Semaglutide and dulaglutide also have similar uses – they’re initially prescribed to diabetic patients to control their blood glucose levels and manage type 2 diabetes mellitus. Non-diabetic obese and overweight patients may also take them for weight reduction because of their effects on appetite and digestion.

3. Drug Form

Semaglutide and dulaglutide also come in similar drug forms – semaglutide brands, specifically Ozempic and Wegovy, and dulaglutide or Trulicity are once-weekly subcutaneous injections. However, they have varying doses per brand, so your healthcare provider will prescribe the most suitable weight loss medication according to your bodily needs. Unlike dulaglutide, semaglutide can also come in an oral medication with Rybelsus for type 2 diabetes.

4. Mechanism of Action

Because semaglutide and dulaglutide belong to the same drug class, they also have similar mechanisms of action for blood sugar control, mimicking incretin hormones to send signals to the pancreas to release insulin.

The intestines produce incretin hormones naturally in response to the food we eat. These hormones prompt the pancreas to release the right amount of insulin and glucagon that the body needs relative to the food it just consumed. The islet of Langerhans, a region in the pancreas, will receive the signals the incretin hormones have released. The islet of Langerhans contains the: alpha and beta cells.

  • Alpha cells - releases glucagon in response to the body having low blood sugar. Glucagon stimulates the liver to release glycogen into the bloodstream to increase blood glucose levels.  
  • Beta cells - release insulin to lower blood sugar levels by sending signals to the liver and fat and muscle cells to absorb glucose from the bloodstream. Incretin mimetics, like semaglutide and dulaglutide, stimulate the GLP-1 receptors present in the beta cells to elevate insulin secretion.

The alpha and beta cells play a significant role in blood sugar control and energy production. Incretin mimetics, like semaglutide and dulaglutide, can help control the functions of these cells and stabilize blood glucose levels, even with type 2 diabetes mellitus. They do this by stimulating insulin release while controlling glucagon secretion.

The secondary effects of a GLP-1 receptor agonist medicine have made it a reliable solution for controlling body weight among obese and overweight patients. This type of weight loss medication slows down gastric emptying and controls your appetite.

5. Treatment Plan

As GLP-1 analog drugs, semaglutide and dulaglutide can only set you up for success in weight reduction by controlling your appetite and slowing down digestion. But the significant part of your weight loss journey will depend on your lifestyle. Many obese and overweight patients find it challenging to get active and observe a proper diet because of their impaired metabolism, making them easily tired and hungry, craving salty, sugary food.

With incretin mimetics, patients can jump-start a healthy lifestyle. They only take these medications with a comprehensive weight management plan – they must increase physical activity and follow a healthy diet with reduced calorie intake. Patients tend to feel sick and nauseous when eating more food than they’re used to when under semaglutide or dulaglutide medications.

Difference Between Semaglutide and Dulaglutide

a woman injects semaglutide in her belly

Semaglutide and dulaglutide may have several similarities due to coming from the same drug class and being formulated for the same use, but they are still different from each other altogether. Their primary difference lies in their drug types, resulting in varying molecular structures and pharmacological effects. The difference between semaglutide and dulaglutide is based on the following:

1. Brand

Semaglutide and Trulicity are often confused with each other due to having similar uses and drug classes. But they actually vary by generic name and brand. Semaglutide is a generic name for a line of diabetes drug brands, like Wegovy, Ozempic, and Rybelsus. On the other hand, Trulicity is the brand name for a type of incretin mimetic called dulaglutide.

The brand names under semaglutide are formulated by Novo Nordisk, while Trulicity (dulaglutide) is developed by Eli Lilly and Company. But among these treatment options, only Wegovy is approved for losing body weight. Trulicity has been used as a weight loss medication for off-label use.

This difference in generic name, brand, and developer results in varying biological effects. Because of this, the nuances between semaglutide and Trulicity mustn't be overlooked. Patients must seek a reliable healthcare provider to receive the prescription most suitable for their needs.

2. Molecular Structure

While coming from the same drug class, semaglutide and dulaglutide differ from each other by their molecular structure. Because of this, their biological effects may also differ, making one more potent than the other. The distinction of semaglutide from dulaglutide based on molecular structure lies on:

Type of GLP-1 DrugSemaglutideDulaglutide
Chemical formulaC187H291N45O59C2646H4044N704O836S18
Average molecular weight4113.641 Da59669.81 Da
Peptide sequenceH-His-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Val-Ser-Ser-Tyr-Leu-Glu-Gly-Gln-Ala-Ala-Lys(C18diacid-γ-Glu-OEG-OEG)]-Glu-Phe-Ile-Ala-Trp-Leu-Val-Arg-Gly-Arg-Gly-OHHGEGTFTSDVSSYLEEQAAKEFIAWLVKGGGGGG
Similarities to naturally-occuring GLP-194% similarity to endogenous GLP-1, enough to prevent immunogenicity90% similarity to endogenous GLP-1

While having similar uses and drug class, differences in molecular structure will also result in varying biological effects – every peptide or amino acid present in the GLP-1 medication will cause changes in your body. 

3. Half-Life

Determining a drug’s half-life is necessary to measure the time it takes before the medicine reaches a stable level in the body from the first time it’s taken. It’s a reliable gauge to determine the right dose a patient needs. It also indicates withdrawal and adverse reactions – a shorter half-life may have more withdrawal problems, while a longer half-life involves fewer withdrawal effects.

Semaglutide has a half-life of 7 days per 0.5 to 1 mg, while dulaglutide is at 5 days per 0.75 to 1.5 mg. Semaglutide has a longer half-life than dulaglutide because of its albumin binding, allowing a lower renal clearance.

4. Dose

Because they don’t have the same molecular structure, semaglutide and dulaglutide have varying prescribed doses for weight reduction. But you can expect both weight loss medications to be once-weekly subcutaneous injections.

Your healthcare provider will prescribe you the right dose for taking any of these GLP-1 agonist drugs. They will also assess your body and medical history to determine the right weight loss medication and dose for you. The common doses prescribed for each type of drug are:

DurationWegovy (semaglutide)Trulicity (dulaglutide)
Week 1 to 40.25 mg0.75 mg
Weeks 5 to 80.5 mg1.5 mg
Weeks 9 to 121 mg3 mg
Weeks 13 to 161.7 mg4.5 mg
Maintenance Dose2.4 mg0.75 to 4.5 mg, depending
on your healthcare provider

These are the only recommended doses for these GLP-1 RA medications. Your healthcare provider will still observe the effects of each medicine on you and will advise you in increasing or decreasing the dose or delaying its escalation.

5. Effectiveness Based on Clinical Trials

Several studies have compared the effectiveness of semaglutide and dulaglutide medications. Because they differ in molecular structure, they will also have varying effects, making one more effective than the other.

A clinical trial reported that 1.0 mg semaglutide has been more effective than 3.0 mg and 4.5 mg dulaglutide in reducing body weight in patients with type 2 diabetes mellitus. 1.0 mg semaglutide has caused more body weight reduction than 3.0 mg dulaglutide by an estimated difference of -2.65 kg (95% confidence interval [CI] -3.57, -1.73) and 4.5 dulaglutide by -1.95 kg (95% CI -2.87, -1.03).

Another clinical trial has compared the effectiveness of semaglutide and dulaglutide in reducing HbA1c and body weight. Patients with type 2 diabetes are given 0.5 mg and 1.0 mg semaglutide and 0.75 mg and 1.5 mg dulaglutide at random by a ratio of 1:1:1:1. 

From its body weight baseline mean, patients have reported weight reduction by 4.6 kg (SE 0.28) with 0.5 mg semaglutide, compared with 2.3 kg (0.27) with 0.75 mg dulaglutide (ETD −2.26 kg [–3.02 to −1.51]; p<0·0001). 1.0 mg semaglutide has caused more weight loss from baseline, by 6.5 kg (0.28), compared with 1.5 mg dulaglutide at 3.0 kg (0.27) (ETD −3·55 kg [–4·32 to −2·78]; p<0·0001)

While both GLP-1 receptor agonist medications have clinical effects, semaglutide has caused a greater reduction in body weight and even HbA1c than dulaglutide. This is because of their differences in molecular structure, resulting also in variations in pharmacokinetic profiles.

6. Adverse Reactions

As semaglutide and dulaglutide have many similar adverse reactions, which may possibly be due to them belonging to the same drug class. Patients taking these diabetic medications can expect the following side effects:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Constipation
  • Hypoglycemia
  • Decreased appetite
  • Fatigue
  • Dyspepsia or indigestion

Semaglutide may be more potent and effective than dulaglutide, but it comes with the risk of developing diabetic retinopathy, according to the warnings, precautions, and clinical trials. On the other hand, dulaglutide doesn’t include diabetic retinopathy in its labeled warnings.

Schedule an Appointment at Dr. V Medical Aesthetics to Learn More About Semaglutide Medications

Dr. V

Semaglutide and dulaglutide might be similar due to belonging to the same drug class, but they differ in terms of molecular structure and pharmacological properties. Semaglutide was reported to be more effective as a weight loss medicine. However, it also has a risk of diabetic retinopathy, unlike dulaglutide. Because of this, you should seek a reliable healthcare provider to prescribe you the best treatment solution.

Dr. V Medical Aesthetics is one of the most reputable clinics for providing customized treatment options for beauty in wellness in Florida. They offer a comprehensive weight management solution with semaglutide injections, helping you jump-start your weight loss journey with a healthy and active lifestyle. Get started in achieving your goal weight today with semaglutide injections and book an appointment with us.


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