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Rybelsus vs Trulicity

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Type 2 diabetes
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  • Type 2 diabetes
Get Trulicity for only
$49 per month
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Summary

Brand name: Rybelsus
Brand name: Trulicity
Manufacturer: Novo Nordisk
Manufacturer: Eli Lilly
Active ingredient: semaglutide
Active ingredient: dulaglutide
Indication: Type 2 diabetes
Indication: Type 2 diabetes

Side Effects

Most common

  • Feeling sick
  • Being sick (vomiting)
  • Diarrhea
  • Stomach (abdominal) pain
  • Constipation
  • Decreased appetite

More serious

  • Thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma
  • Changes in your vision
  • Very low blood sugar (hypoglycemia)
  • Inflammation of the pancreas (pancreatitis)

Most common

  • Feeling sick
  • Being sick (vomiting)
  • Diarrhea
  • Stomach (abdominal) pain
  • Constipation
  • Reduced appetite

More serious

  • Thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma
  • Kidney problems, including kidney failure
  • Inflammation of the pancreas (pancreatitis) – severe stomach problems, including pain, nausea, and vomiting
  • Severe allergic reactions
  • Very low blood sugar (hypoglycemia)

Drug Interactions

Severe Interactions
  • Antibiotics for bacterial infections such as gatifloxacin
  • Bexarotene used to treat skin cancer
Serious interactions
  • Any other diabetes medications, like insulin or sulfonylureas
  • Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
  • Corticosteroids such as cortisone and prednisolone
  • Beta 2-stimulants, taken to treat asthma – salmeterol
  • Antipsychotics – clozapine
  • Estrogen containing drugs including birth control and hormone replacements
Moderate Interaction
  • Steroids used topically (on the skin) such as betamethasone, clobetasol, hydrocortisone, and mometasone
Severe Interactions
  • Antibiotics for bacterial infections such as gatifloxacin
  • Bexarotene used to treat skin cancer
Serious interactions
  • Any other diabetes medications, like insulin or sulfonylureas
  • Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
  • Corticosteroids such as cortisone and prednisolone
  • Fenofibrate, taken to lower blood triglyceride levels
  • Beta 2-stimulants, taken to treat asthma – salmeterol
  • Antidepressants, including monoamine oxidase inhibitors and selective serotonin reuptake inhibitors – phenelzine, selegiline, sertraline
  • Disopyramide, taken to treat heart rhythm problems
  • Estrogen containing drugs including birth control and hormone replacements
Moderate Interactions
  • Steroids used topically (on the skin) such as betamethasone, clobetasol, hydrocortisone, and mometasone

Warnings

You should not use Rybelsus if you:

  • Are allergic to the active ingredient semaglutide
  • Are allergic to any of the other ingredients in Rybelsus
  • Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or if anyone in your family has
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Have pancreatitis (inflammation of your pancreas)
  • Have type 1 diabetes (Rybelsus is for type 2 diabetes only)
  • Are under 18 years of age

You should talk to your doctor before using Rybelsus if you:

  • Are taking any of the medications that could interact with Rybelsus
  • Have had any problems with your pancreas
  • Have had any problems with your kidneys
  • Have or have ever had any problems with your eyes, including cataracts or glaucoma
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Trulicity if you:

  • Are allergic to the active ingredient dulaglutide
  • Are allergic to any of the other ingredients in Trulicity
  • Have Type 1 diabetes (Trulicity is for Type 2 diabetes only)
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Have or anyone in your family has had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
  • Have diabetic ketoacidosis
  • Are under 18 years of age

You should talk to your doctor before using Trulicity if you:

  • Are taking any of the medications that could interact with Trulicity
  • Have or have had any problems with your liver
  • Have or have had any problems with your pancreas
  • Have or have had any problems with your kidneys
  • Have severe stomach or intestinal problems
  • Have a history of diabetic retinopathy
  • If you have been sick or have diarrhea
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

Dosage

Once daily

0.75mg once weekly
1.5mg once weekly
3mg once weekly
4.5mg once weekly

Cost

30, 3 mg Rybelsus oral tablet will cost around $950

0.75 mg/0.5 ml pre-filled Trulicity Pen costs $891 on average for 2 milliliters

FAQs

Rybelsus and Trulicity are FDA-approved brand-name glucagon-like peptide-1 receptor agonist drugs used for diabetes treatment to achieve blood sugar control. Rybelsus is a once-a-day oral medication whereas Trulicity is a once-a-week injection.

If you have type 2 diabetes and metformin is not achieving glycemic control, your healthcare provider may prescribe either Rybelsus or Trulicity. In clinical trials, both Rybelsus and Ozempic were effective at treating type 2 diabetes and lowering blood sugar levels.

It is not always easy to know how these medications work and the differences between them. Your doctor will prescribe you the most appropriate medication for your needs, but it is still important to better understand the diabetes drugs available to you. Read on to find out about their similarities and differences.

Understanding GLP-1 receptor agonists

Rybelsus and Trulicity belong to a drug class called GLP-1 (glucagon-like peptide-1) receptor agonists. When you eat and drink, your body produces digestive hormones called incretins. GLP-1 is one of these incretin hormones.

GLP-1 incretin hormones help lower your blood glucose levels when you digest food in three ways. They:

  • Stimulate your body to produce more insulin
  • Prevent the release of glucagon
  • Slow down how quickly your body digests food

Rybelsus and Trulicity act in the same way as GLP-1 incretin hormones. By stimulating the same receptors, they cause your body to release more insulin, less glucagon, and digest food slower.

Rybelsus and Trulicity are more active when you have consumed food and are digesting it. They become less active when you stop eating or drinking. They help to ensure your blood glucose levels do not fall too low causing hypoglycemia. Rybelsus and Trulicity can not be used to treat type 1 diabetes.

What are the similarities and differences between Rybelsus and Trulicity?

Both are GLP-1 receptor agonist medications used to treat type 2 diabetes so they work in the same way. The active ingredients they contain are one of the main differences between Rybelsus and Trulicity. Rybelsus contains a GLP-1 receptor agonist called semaglutide, whilst Trulicity contains a GLP-1 receptor agonist called dulaglutide. Semaglutide and dulaglutide do work in similar ways, but they are not identical and you may respond to them differently.

Both drugs are indicated to be used alongside diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes. However, Trulicity can also reduce the risk of serious heart problems, such as strokes or heart attacks in people with heart disease or who have risk factors for cardiovascular disease.

A major difference between the two drugs is the route of administration. Trulicity is given as an injection under the skin (subcutaneous injection) using a self-injecting pen device. Rybelsus on the other hand is an oral semaglutide.

The doses prescribed for each drug also vary. The dose of Rybelsus is 3 mg once daily for 30 days. After 30 days on the 3 mg dose, the dose of Rybelsus normally increases to 7 mg once daily. Trulicity is a once-weekly injection delivered in prefilled pens prescribed in 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg doses.

Rybelsus is manufactured by Novo Nordisk and Trulicity is manufactured by Eli Lilly.

How effective is Rybelsus vs Trulicity?

The American Diabetes Association (ADA) include Rybelsus or Trulicity in their guidelines to treat adults with type 2 diabetes. There are no head-to-head trials between these drugs but there are clinical trials showing both these drugs are effective.

Trulicity

A clinical trial called the Award-3 study compared the efficacy of dulaglutide monotherapy vs metformin with over 800 patients. At week 26 treatment with dulaglutide 0.75 mg or 1.5 mg once weekly resulted in a reduction of HbA1C similar to metformin.

A clinical trial called the Award-6 study compared once-weekly dulaglutide 1.5 mg and daily liraglutide 1.8 mg in type 2 diabetes patients on metformin. The mean change in HbA1c was −1.42 and −1.36 in the dulaglutide and liraglutide groups meaning the drugs were effective as each other. Both groups resulted in 68% of patients achieving an A1C of <7%. Weight reduction was significantly greater in the liraglutide groups compared with dulaglutide.

Rybelsus

A clinical trial called the Pioneer 4 study involving 711 patients was carried out to compare oral semaglutide with subcutaneous liraglutide and placebo in patients with type 2 diabetes. The participants of the study were divided into four groups: metformin alone, metformin plus Rybelsus 14mg, metformin plus liraglutide 1.8mg subcutaneous, and metformin plus placebo. The primary endpoint was a change from baseline to week 26 in HbA1c. Oral semaglutide was effective as subcutaneous liraglutide in decreasing HbA1c. There were no significant differences in percentage of patients achieving an A1C target of less than 7% between oral semaglutide and liraglutide (67.6% vs 61.8%).

A clinical trial called the Pioneer 3 study involving over 1800 patients, tested the effectiveness of Rybelsus to Januvia. Januvia is another oral diabetes drug but from a different drug class to Rybelsus. Patients were divided into four different groups: metformin alone, metformin plus a sulfonylurea, and then randomized into a group with either Rybelsus 7mg, Rybelsus 14mg, or Januvia 100mg. Among adults with type 2 diabetes uncontrolled with metformin with or without sulfonylurea, the 7mg and 14mg doses of semaglutide were superior to sitagliptin in reducing HbA1c from baseline at week 26.

It is important to note that people respond to medications differently. This means some people will get better results from Trulicity and some from Rybelsus.

How to use Trulicity

Trulicity is usually taken once a week by injecting it under your skin using a prefilled injection pen. Each Trulicity pen holds one single dose of the drug. Use a new pen for each weekly dose. You can inject your dose of Trulicity into your upper arm, abdomen, or thigh. It is important to change the injection site every week. You can inject Trulicity whether you’ve eaten or not.

You may store the opened medicine pen or prefilled syringe in the refrigerator, or at room temperature for up to 14 days.

How to use Rybelsus

Rybelsus is usually taken once a day on an empty stomach when you first wake up. Take with no more than 4 ounces of plain water. Wait 30 minutes before eating, drinking, or taking other oral medications.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not store in the bathroom.

Rybelsus and Trulicity warnings & precautions

Don’t take Rybelsus or Trulicity if you:

  • Are allergic to the active ingredient semaglutide or dulaglutide
  • Are allergic to any of the other ingredients in Rybelsus or Trulicity
  • Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or have a family history
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Have pancreatitis (inflammation of your pancreas)
  • Have type 1 diabetes (Rybelsus and Trulicity are for type 2 diabetes only)
  • Are under 18 years of age

Talk to your doctor before taking Rybelsus or Trulicity if you:

  • Are taking any of the medications that could interact with Rybelsus or Trulicity see drug interactions below
  • Have had any problems with your pancreas
  • Have had any problems with your kidneys
  • Have or have ever had any problems with your eyes, including cataracts or glaucoma
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

It is possible that you may lose weight while taking Rybelsus, however, the medication isn’t intended to be used for weight loss.

Common side effects of Rybelsus and Trulicity

Rybelsus and Trulicity both belong to the same class of medication hence, they both have similar common gastrointestinal side effects such as:

  • Fatigue
  • Nausea
  • Constipation
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Indigestion
  • Heartburn
  • Burping
  • Weight loss

Decreased appetite was seen with Rybelsus only and injection site reactions occurred with Trulicity only.

In rare instances, Rybelsus and Trulicity can cause more serious side effects, including:

  • An increased risk of thyroid tumors, symptoms such as hoarseness, a lump or swelling in the throat
  • Kidney problems, including kidney failure
  • Serious allergic reactions cause swelling under your skin, normally in your eyelids, lips, hands, or feet. Swelling of your mouth, tongue, or throat leading to shortness of breath
  • Inflammation of your pancreas (pancreatitis). Symptoms of pancreatitis include severe abdominal pain, nausea, and vomiting that doesn’t stop
  • Changes in your vision
  • Very low blood sugar (hypoglycemia)

For medical advice about side effects, talk with your health care provider and also read the medication guide and instructions for use that comes with Rybelsus and Trulicity.

Rybelsus and Trulicity drug interactions

  • Any medications you take orally to reduce the risk of blood clots (oral anticoagulants) like warfarin
  • Insulin – Rybelsus and Trulicity can be used alongside insulin, but your doctor may change the dose of insulin you take and/or how often you use insulin
  • Any other medications that are taken to treat type 2 diabetes such as sulfonylureas

Always speak to your healthcare provider for medical advice regarding drug interactions, taking supplements, taking over-the-counter medications, and drinking alcohol when using Rybelsus or Trulicity. Healthcare professionals are the most reliable and accurate source of drug information.

Are Trulicity and Rybelsus the same?

Trulicity and Rybelsus are both GLP-1 receptor agonist medications used to treat type 2 diabetes mellitus. Although similar, they are different medications that contain different active ingredients. Dulaglutide in Trulicity and semaglutide in Rybelsus. The two medications may also affect you differently.

Is Rybelsus better than Trulicity?

Rybelsus and Trulicity are similar medications that can help to reduce your blood sugar levels in the same way. It is important to note that people respond to medications differently. This means some people will get better results from Rybelsus and some from Trulicity.

What drug is comparable to Trulicity?

Trulicity belongs to a class of Type 2 diabetes medications called GLP-1 receptor agonists. Other GLP-1 receptor agonists include BydureonByettaOzempicRybelsus (oral version of Ozempic), Tanzeum, and Victoza.

Are Rybelsus and Ozempic the same?

Rybelsus is an oral medication containing semaglutide. Ozempic is a subcutaneous injection containing semaglutide. They are the same drug but in different forms.

How long can you stay on Trulicity?

Trulicity can be taken over the long term. It is important to note that you may need to stop using Trulicity if it causes you severe side effects, or if it does not work effectively for you.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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