Mounjaro vs. Trulicity: A Comparative Analysis for Weight Management

Mounjaro (tirzepatide) and Trulicity (dulaglutide) are injectable medications originally approved to treat type 2 diabetes. Recently, they have also been increasingly prescribed off-label for weight loss purposes.

Both fall under GLP-1 receptor agonists, designed to regulate blood sugar levels. Nevertheless, it's important to note that Mounjaro distinguishes itself by exhibiting GIP receptor agonist activity, making it a dual-acting agent.

In this article, we will compare the approved uses, dosing, side effects, costs, and weight loss results between Mounjaro and Trulicity. Understanding these key differences can inform discussions with your doctor about which medication may be better suited for your individual health and weight loss goals.

1. Approved Uses

First, let's look at what Mounjaro and Trulicity are each approved to treat.

Mounjaro

Mounjaro is approved for use in adults with type 2 diabetes mellitus, in conjunction with diet and exercise, to improve blood sugar levels. The primary goal is to help individuals achieve an A1C of less than 7%.

It's important to note that Mounjaro is not indicated for use in people with type 1 diabetes or those with pancreatitis. Additionally, its safety and effectiveness have yet to be established for children under 18.

Trulicity

Trulicity, is approved for specific medical uses. First and foremost, it is employed in conjunction with diet and exercise to enhance blood sugar control in adults diagnosed with type 2 diabetesmellitus. This injectable diabetes medicine aids in managing blood sugar levels every week.

Furthermore, Trulicity serves a crucial role in cardiovascular risk reduction. It is prescribed for adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors. The goal is to mitigate the risk of major adverse cardiovascular events, including:

• Cardiovascular death
• Non-fatal myocardial infarction
• Non-fatal stroke

It's important to highlight that Trulicity is not approved for treating type 1 diabetes. Its approved uses are specifically tailored to address blood sugar control and reduce cardiovascular risks in the context of type 2 diabetes mellitus.

2. Effectiveness in Weight Loss

Beyond blood sugar control, do Mounjaro and Trulicity also help lose weight? Here's what to know about the effects of weight loss.

Mounjaro

Mounjaro (Tirzepatide) is a promising weight loss solution across various studies. In an 84-week program, participants combining lifestyle changes and tirzepatide lost up to 26% of body weight, echoing consistent results from other trials.

A study spanning 72 weeks reported significant reductions ranging from -15.0% to -20.9% with tirzepatide compared to -3.1% with placebo.

Also, a systematic review encompassing almost 10,000 patients reinforced tirzepatide's weight loss efficacy. It outperformed placebo, GLP-1 receptor agonists, and insulin.

Another study comparing tirzepatide with semaglutide in diabetes patients showcased tirzepatide's superiority in glycated hemoglobin reduction and more significant body weight loss.

Despite these positive findings, it's crucial to consider potential mild gastrointestinal side effects. As Mounjaro is off-label for weight loss, its long-term effects and cost implications merit careful consideration. Consulting with a healthcare professional is essential for personalized guidance on tirzepatide use.

Trulicity

Trulicity (dulaglutide) is not specifically approved as a weight loss drug, but some people may experience weight loss while using it.

One study showed that In patients with type 2 diabetes inadequately controlled by metformin, dulaglutide at doses of 3.0 mg and 4.5 mg demonstrated significant and dose-related reductions in body weight compared to the 1.5 mg dose.

This weight loss effect was observed over 52 weeks, suggesting the sustained efficacy of dulaglutide in promoting weight reduction. Therefore, for individuals with type 2 diabetes seeking a treatment that not only addresses glycemic control but also contributes to weight loss, dulaglutide at higher doses appears to be a promising option.

Another study showed that, on average, individuals taking Trulicity lost two to six pounds, while 15 to 30% gained weight. The weight loss effect may be more prominent in those with a higher starting weight and experiencing more prolonged gastrointestinal side effects.

Trulicity belongs to the GLP-1 receptor agonists class, miming natural incretin hormones in the body. It helps control blood sugar levels, stimulates insulin release, reduces liver glucose production, and promotes a feeling of fullness by slowing gastric emptying.

Research has shown that higher doses of Trulicity may lead to more significant weight loss in individuals with Type 2 diabetes. However, it's important to note that Trulicity is not FDA-approved for weight loss. Medications like Wegovy (semaglutide) and Saxenda (liraglutide) are FDA-approved specifically for weight loss.

If you're considering Trulicity or any other GLP-1 agonist for weight loss, it's crucial to consult with your healthcare provider. They can provide personalized advice based on your health status, medical history, and weight loss goals.

3. Dosage Differences

How do the dosage recommendations compare between Mounjaro and Trulicity? Here are the key details.

Mounjaro

Mounjaro, containing Tirzepatide, is administered through subcutaneous injections. The adult dosage initiation involves a 2.5 mg injection once weekly, not primarily for glycemic control. After four weeks, the dosage increases to 5 mg once weekly. Further adjustments, in 2.5 mg increments, can be made every four weeks based on glycemic needs, with a maximum dosage of 15 mg weekly.

In cases of a missed dose, Mounjaro should be administered as soon as possible, within four days (96 hours) after the missed dose. If more than four days have passed, patients are advised to skip the missed dose and resume the regular schedule.

Administration instructions emphasize injecting Mounjaro subcutaneously in the abdomen, thigh, or upper arm. Patients are encouraged to rotate injection sites, inspect the solution visually before use, and avoid mixing it with insulin if used concomitantly. Importantly, patients should be trained on the proper injection technique before initiating Mounjaro.

Trulicity

Trulicity, containing Dulaglutide, is also administered subcutaneously. The adult dosage begins with a 0.75 mg injection once weekly, followed by an increase to 1.5 mg once weekly for additional glycemic control after four weeks. In 1.5 mg increments, adjustments can be made every four weeks based on individual needs, with a maximum recommended dosage of 4.5 mg weekly.

If a Trulicity dose is missed, patients are advised to administer it as soon as possible, provided there are at least three days (72 hours) until the next scheduled dose.

Administration instructions for Trulicity include subcutaneous injections in the abdomen, thigh, or upper arm, with rotation of injection sites. Visual inspection before use is recommended, and caution is advised when considering concomitant use with insulin.

4. Side Effects

When taking any medication, being aware of potential side effects is essential. So, what should you know about the side effects of Mounjaro and Trulicity?

Mounjaro

Common side effects:

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Constipation
• Indigestion
• Abdominal pain

Serious side effects:

• Inflammation of the pancreas (pancreatitis)
• Low blood sugar (hypoglycemia)
• Serious allergic reactions
• Kidney problems (kidney failure)
• Severe stomach problems
• Changes in vision
• Gallbladder problems

Trulicity

Common side effects:

• Nausea
• Diarrhea
• Vomiting
• Abdominal pain
• Decreased appetite
• Indigestion
• Fatigue

Serious side effects:

• Inflammation of the pancreas (pancreatitis)
• Low blood sugar (hypoglycemia)
• Serious allergic reactions
• Acute kidney injury
• Severe stomach problems
• Changes in vision
• Gallbladder problems

5. Costs

Finally, cost may also be a consideration when comparing these two diabetes drugs. Here's an overview of the costs associated with Mounjaro and Trulicity.

Mounjaro

The list price for Mounjaro is $1,023.04 per fill. However, your actual cost will depend on your prescription drug insurance plan.

The Mounjaro Savings Card program is available for eligible commercially insured patients, offering the potential to pay as little as $25 for a 1-month or 3-month prescription. Do note that this program excludes governmental beneficiaries.

If you're not eligible for the savings program, you may have to pay close to the list price mentioned above and any additional pharmacy charges based on where you purchase the medicine.

Trulicity

Trulicity comes with a list price of $930.88 per month, but your pay will largely depend on your insurance plan.

If you have insurance through an employer or private individual policy, about 92% of Trulicity prescriptions cost between $0 and $30 per month, with the remaining averaging $239 per month.

For Medicare Part D coverage, out-of-pocket costs vary, with about 70% of prescriptions costing between $0 and $100 per month and the rest averaging $207 per month.

Some Medicare patients may qualify for Extra Help, reducing costs to $4 to $9 per prescription. Medicaid coverage generally costs between $4 and $9 per month, and some states may offer even lower copays or eliminate copays.

If you don't have insurance or Trulicity is not covered, you may have to pay close to the list price, plus any additional pharmacy charges. The Trulicity Savings Card is available, potentially reducing the cost to as little as $25 for a one-month supply, subject to specific terms and maximums.

Final Thoughts

Mounjaro is specifically approved for type 2 diabetes, while Trulicity indicates cardiovascular risk reduction.

The dosages differ, with Mounjaro starting lower but increasing to a higher maximum dose. Both can lead to gastrointestinal side effects.

Costs vary based on insurance coverage, but manufacturer savings programs may reduce out-of-pocket expenses.

Ultimately, considerations like FDA-approved uses, dosing flexibility, side effect risks, costs, and individual treatment goals should guide decisions between these two medications. Regular provider consultations are recommended to determine if Mounjaro or Trulicity is the most suitable.

FAQs on Mounjaro and Trulicity

What medicine can replace Trulicity?

For those considering an alternative to Trulicity, Ozempic, and Victoza are potential options. These drugs, like Trulicity, belong to the same class and function similarly to lower blood sugar levels. All three are administered through injections under the skin, with Ozempic and Trulicity given weekly and Victoza administered daily.

What is the difference between Mounjaro and Ozempic?

Mounjaro and Ozempic differ in their receptor actions—Mounjaro acts on GIP and GLP-1 receptors, while Ozempic acts solely on GLP-1 receptors. Despite this distinction, both drugs effectively treat type 2 diabetes.

What happens if you eat a lot of sugar while taking Trulicity?

Consuming excessive sugar while on Trulicity may lead to rapid spikes in blood sugar levels, potentially undermining the glycemic control provided by the medication. Moreover, high-sugar diets are linked to overeating and weight gain, posing challenges to the dietary changes recommended for Trulicity's optimal efficacy.