- What is Trulicity?
- What are the side effects of Trulicity?
- Pharmaceutical alternatives to Trulicity
- Is there a generic for Trulicity?
- Is there an oral alternative to Trulicity?
- Natural alternatives to Trulicity
- Reasons people might stop taking Trulicity
- Are there any side effects of stopping Trulicity?
- Stopping Trulicity safely
- Conclusion
- Source
Trulicity is one of the several non-insulin injectable medications to treat type 2 diabetes.
Navigating your different options for diabetes medications can be overwhelming.
In this article, we’ll break down the alternatives to Trulicity for you to consider.
What is Trulicity?
Trulicity is a brand name for the medication dulaglutide and was approved by the Food and Drug Administration in 2014. Dulaglutide is part of a class of medications called GLP-1 receptor agonists and is used to treat type 2 diabetes. Trulicity isn’t meant to be taken by people with type 1 diabetes.
Trulicity is a non-insulin injection that comes in a pen injector (a device that contains and injects the medication). The common dosages for Trulicity range from 0.75 milligrams to 4.5 milligrams weekly.
GLP-1 receptor agonists like Trulicity work to lower blood sugar levels by boosting the levels of GLP-1, a hormone that increases insulin levels. Trulicity also slows stomach emptying and works on appetite hormones to increase satiety and reduce appetite, which is why it can also result in weight loss.
Since Trulicity is meant to help improve your blood sugar levels, it’s ideal to follow a healthy diet to help Trulicity do its job better. Therefore, there are certain foods to avoid while taking Trulicity that you may want to cut out or limit in order to improve the effectiveness of the drug.
Effectiveness of Trulicity
A 40-week clinical trial assessed the effectiveness of Trulicity compared to another diabetes medication (Ozempic). 1201 patients with type 2 diabetes who were at least 18 years old were included in the study. The participant’s A1cs ranged from 7-10.5%.
The group receiving 0.75 milligrams weekly of Trulicity reduced their A1c by an average of 1.1% compared to their baseline. The participants receiving 1.5 milligrams of Trulicity lowered their A1c by an average of 1.3%.
Another study looked at Trulicity’s ability to lower blood sugar. The average reduction in hemoglobin A1c was 1.2% taking 1.5 milligrams weekly and 1.4% taking 3 milligrams weekly (over 18 weeks).
Trulicity can also promote modest weight loss. Studies on Trulicity weight loss results found an average weight loss of around 4.6 pounds taking .75 milligrams weekly.
What are the side effects of Trulicity?
There are potential side effects and risks that come with taking Trulicity. While some side effects are minor, there are risks for more serious health issues.
The most common side effects you may experience with Trulicity are:
- Nausea
- Diarrhea
- Vomiting
- Abdominal Pain
- Decreased appetite
- Indigestion
- Fatigue
More rarely, Trulicity may increase your risk of more severe health problems like:
Thyroid cancer
Trulicity and other GLP-1 receptor agonists have caused thyroid cancer in rodents. There is a chance that Trulicity could increase your risk of thyroid cancer, but the risk isn’t quite clear in humans since the dose used in rodents was much higher than a typical human dose.
You shouldn’t take Trulicity or other GLP-1 receptor agonists if you have a history of thyroid cancer or a thyroid tumor. If anyone in your family has a history of medullary thyroid carcinoma, a type of thyroid cancer, you also shouldn’t take Trulicity.
You should also avoid taking Trulicity if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN2), a rare disorder that causes tumors to form on glands such as your thyroid.
If you experience any of these symptoms while taking Trulicity, you should alert your healthcare provider immediately:
- A lump in your neck, sometimes growing quickly
- Swelling in your neck
- Pain in the front of your neck, sometimes going up to your ears
- Hoarseness or other voice changes that do not go away
- Trouble swallowing
- Trouble breathing
- A constant cough that is not due to a cold
Pancreatitis
According to a case study, Trulicity may cause pancreatitis, a painful inflammation of your pancreas. You shouldn’t take Trulicity or other GLP-1 receptor agonists if you have a history of pancreatitis.
If you experience any of these symptoms of pancreatitis while taking Trulicity, you should let your healthcare provider know right away:
- Upper abdominal pain
- Abdominal pain that radiates to your back
- Tenderness when touching your abdomen
- Fever
- Rapid pulse
- Nausea
- Vomiting
Due to the side effects of Trulicity, some people look for alternatives to treat their diabetes. Below, we discuss 15 Trulicity alternatives.
Pharmaceutical alternatives to Trulicity
Ozempic
Ozempic is a brand name for an injectable form of semaglutide. The FDA approved ozempic in 2017. The typical dose of Ozempic is between 0.5-2 milligrams weekly.
According to studies, Ozempic lowered the average A1c of 8% by around 1 -1.5% over 30-56 weeks. In addition, participants of studies lost as much as 15-18% of their starting body weights while taking the maximum weekly dose of Ozempic.
Losing weight often improves glycemic control, which is why this weight loss from Ozempic is considered significant. Ozempic isn’t approved as a weight loss drug, though.
According to some clinical studies, Ozempic lowered A1c and caused greater weight loss than Trulicity and Bydureon (another GLP-1 receptor agonist).
When comparing Trulicity vs Ozempic, Ozempic is more likely to cause retinopathy and vision changes than Trulicity, which is one potential advantage Trulicity has over Ozempic.
Rybelsus
The main difference between Trulicity vs Rybelsus is that Trulicity is an injectable medication, and Rybelsus is oral. Rybelsus is an oral form of the drug semaglutide, a GLP-1 receptor agonist. Unlike Trulicity, Rybelsus is taken daily, not weekly.
The United States FDA approved Rybelsus in 2019 to treat type 2 diabetes. Rybelsus comes in 3-, 7-, and 14-milligram tablets, with a typical dosing range between 7 and 14 milligrams daily. It’s currently the only oral GLP-1 receptor agonist on the market.
One study noted that Rybelsus is just as effective as injectable forms of semaglutide. According to studies, Rybelsus lowered hemoglobin A1c levels by over 1% over a six-month period (average starting A1c was 8%).
Bydureon BCise
Bydureon BCise is the brand name for exenatide, yet another GLP-1 receptor agonist. This is a weekly injectable medication to treat type 2 diabetes, with a recommended dose of 2 milligrams every 7 days (weekly).
In two clinical studies lasting 28 weeks in adults with type 2 diabetes, Bydureon BCise lowered A1C levels by an average of 1.1% and 1.4% (average starting A1cs were 8.4% and 8.5%, respectively.
When comparing Trulicity vs Bydureon, Bydureon doesn’t seem to promote as much weight loss as Trulicity, with average weight loss averaging three pounds (1.4 kilograms).
Victoza
Victoza is the brand name for liraglutide, another GLP-1 receptor agonist. The Food and Drug Administration (FDA) approved Victoza in 2010 for use in people with type 2 diabetes who are ten years of age and older.
One difference between Trulicity vs Victoza is that Victoza is a once-daily injectable medication, whereas Trulicity is weekly. Typical doses of Victoza are 1.2 and 1.8 milligrams.
According to a 52-week study, Victoza reduced participants’ A1cs (mean baseline value of 8.2%) by 0.84% with a dose of 1.2 milligrams and by 1.14% with a dose of 1.8 milligrams.
A review of 13 randomized controlled trials was done in 2011, showing that Victoza lowered hemoglobin A1c values by 0.84%-1.5%, which is around the typical range for Trulicity.
In addition, Victoza promoted a 34% to 118% increase in insulin release, which is the primary way it acts to lower blood glucose levels.
Metformin
Next, we’ll discuss Trulicity vs metformin. Metformin is considered a first-line therapy for type 2 diabetes and has been used frequently since the FDA approved it in 1994.
Metformin is in a drug class called biguanides, so it works differently than Trulicity and other GLP-1 receptor agonists. Biguanides help reduce the amount of sugar your liver makes while improving insulin sensitivity, which helps reduce high blood sugar.
There are two types of metformin – regular and extended-release (XR). Extended-release metformin is taken once daily, whereas regular metformin is taken 2-3 times a day.
Metformin typically lowers A1c levels by around 1% and can be safely used with many other types of diabetes medications. Some of the major benefits of metformin are its safety, tolerance, affordability, and the fact that it doesn’t cause low blood sugar (hypoglycemia).
Unlike Trulicity, you’re not as likely to lose significant amounts of weight on metformin, but you shouldn’t gain any, either (it’s considered a “weight-neutral” medication).
Sulfonylureas
Sulfonylureas are a class of medications, including the popular medications glipizide, glyburide, and glimepiride. They are oral medications taken daily to help boost your body’s insulin secretion.
Sulfonylureas come with a risk of hypoglycemia (low blood sugar), especially if you take them with other diabetes medications.
Sulfonylureas are generally less expensive than newer medications like Trulicity because there are generic options.
Insulin
Several types of injectable insulins are used to treat type 1 and type 2 diabetes. Compared to other diabetes medications, insulin comes with the greatest risk of low blood sugar.
Insulin tends to be the most effective at lowering blood sugar because it can be customized to your lifestyle habits and blood sugar response. It does require daily injections, sometimes multiple times daily, which is a drawback to many patients.
Is there a generic for Trulicity?
There aren’t any generic options for Trulicity, which is one of the reasons it’s quite expensive when paying out of pocket. Expect to pay around $700-$800 for a month’s supply of Trulicity at a 1.5 milligram/week dose.
Is there an oral alternative to Trulicity?
There isn’t an oral alternative to Trulicity; it’s only available as an injection. If you’d like an oral GLP-1 receptor agonist, the only one currently on the market is Rybelsus (oral semaglutide).
Natural alternatives to Trulicity
According to a 2021 study, berberine, tea, curcumin, cinnamon, wheat, soybean, resveratrol, and gardenia may all naturally boost GLP-1 concentrations and act as natural alternatives to Trulicity.
Natural alternatives generally aren’t as potent or effective as prescription diabetes drugs, so you shouldn’t stop taking any prescription to try natural alternatives without discussing it with your healthcare provider.
Berberine
Berberine is a compound in some plants and is a natural alternative for treating insulin resistance and high blood sugar. Insulin resistance is associated with weight gain and overweight/obesity.
According to a small study on people with metabolic syndrome (a condition that can lead to type 2 diabetes), berberine improved insulin sensitivity and reduced the waist circumference of participants.
A pilot study compared metformin and berberine directly for their ability to help treat symptoms of type 2 diabetes. The researchers found that berberine produced identical results as metformin in terms of improving blood glucose metabolism.
Cinnamon
According to a meta-analysis of ten randomized controlled trials, cinnamon can significantly reduce blood sugar levels, total cholesterol, LDL “bad” cholesterol, and triglyceride levels while increasing HDL “good” cholesterol. However, cinnamon wasn’t associated with significant reductions in A1c levels among test subjects.
Reasons people might stop taking Trulicity
Side effects
If you can’t tolerate the side effects of Trulicity after several weeks, you may be advised to stop taking it and try another medication.
Complications
If you develop rarer complications from taking Trulicity, you’ll be advised to stop taking it immediately.
Not lowering your blood sugar enough
If Trulicity isn’t lowering your blood sugar levels as much as desired, you may want to try another medication to see if it’s more effective.
Cost
Trulicity is expensive out-of-pocket, which can dissuade many people from taking it if it’s not covered by healthcare or prescription insurance.
Are there any side effects of stopping Trulicity?
The most likely side effect of stopping Trulicity is that your blood sugar levels will increase, especially if you don’t start taking another diabetes medication.
If you were experiencing any adverse side effects while taking Trulicity, they’ll likely gradually diminish once you discontinue Trulicity.
Stopping Trulicity safely
You should work with your healthcare provider to stop taking Trulicity safely. If your blood sugar levels are high, you might be prescribed another medication to start taking once you stop Trulicity.
Trulicity can generally be stopped “cold turkey” without any ill effects. It will take around five days for half of the last dose of Trulicity to leave your system, and several weeks for it to be eliminated from your body.
Conclusion
Trulicity is the brand name for dulaglutide, a GLP-1 receptor agonist meant to treat type 2 diabetes.
Some other prescription alternatives to Trulicity include other GLP-1 receptor agonists, metformin, sulfonylureas, and insulin.
While they may not be as effective, some natural alternatives to Trulicity include berberine, cinnamon, resveratrol, and curcumin, among others.
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