Trulicity vs. Victoza: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Trulicity and Victoza are two prescription injectable drugs indicated in the treatment of Type 2 diabetes mellitus (T2DM). In the United States, approximately 1 in 10 people have a form of diabetes, and it is estimated that 90% of those are Type 2 diabetes. People with Type 1 diabetes are unable to produce insulin, a hormone needed to maintain blood sugar balance in their cells for energy. Type 2 diabetics are able to produce insulin, but their body doesn’t respond to it appropriately. This allows blood sugar levels to get too high. There are serious health consequences associated with high blood sugar including heart disease, kidney disease, and vision loss.

Trulicity (dulaglutide) and Victoza (liraglutide) belong to a class of medications known as glucagon-like peptide-1 receptor agonists, often referred to as GLP-1s. This is a relatively new class of medications in the treatment of Type 2 diabetes. Other options in this class include Bydureon (exenatide), Byetta (exenatide), and Ozempic (semaglutide). For the purposes of this review, we will specifically compare Trulicity and Victoza

What are the main differences between Trulicity vs. Victoza

Trulicity (dulaglutide) is a glucagon-like peptide-1 receptor agonist. It is a once-weekly injectable subcutaneous drug produced by Eli Lilly available only by prescription. GLP-1s work by mimicking the structure of naturally occurring hormones in the human body known as incretin hormones. When you eat food, your stomach releases these hormones, and they, in turn, stimulate the release of insulin from the pancreas. Insulin helps control blood sugar levels by helping cells absorb glucose to be used for energy. T2DM patients often lack enough incretin hormones to stimulate this process, and that is why the GLP-1 receptor agonists are effective at helping them manage their blood sugar. Trulicity is available in 4 different doses: 0.75 mg/0.5 ml, 1.5 mg/0.5 ml, 3 mg/0.5 ml, and 4.5 mg/0.5 ml. Trulicity is provided in single-use injection pens and is intended for once-weekly injections only.

Victoza (liraglutide) is a once-daily GLP-1 agonist produced by Novo Nordisk which is also a subcutaneous injectable and available by prescription only. Both Trulicity and Victoza are considered long-acting GLP-1 agonists, but the biggest difference is that Trulicity is given once weekly and Victoza is given once daily. Victoza is available in 18 mg/3 ml pens that can be used to administer 3 different doses: 0.6 mg, 1.2 mg, and 1.8 mg.

Main differences between Trulicity and Victoza
	Trulicity	Victoza
Drug class	Glucagon-like peptide-1 receptor agonist (GLP-1 RA)	Glucagon-like peptide-1 receptor agonist (GLP-1 RA)
Brand/generic status	Brand only	Brand only
What is the generic name?	dulaglutide	liraglutide
What form(s) does the drug come in?	Once-weekly single-use injection pens	Once-daily multi-dose injection pens
What is the standard dosage?	1.5 mg once weekly	1.8 mg once daily
How long is the typical treatment?	Long term	Long term
Who typically uses the medication?	Adults	Children and adolescents age 10 and up, adults

Conditions treated by Trulicity and Victoza

Trulicity and Victoza are both indicated in the treatment of Type 2 diabetes mellitus. They each also carry an additional indication for reducing cardiovascular events and cardiovascular mortality in patients who have Type 2 diabetes mellitus. This includes stroke and myocardial infarction. The active ingredient in Victoza, liraglutide, is also marketed under the brand name Saxenda which is approved by Food and Drug Administration (FDA) for weight loss as a component in the treatment of obesity.

Condition	Trulicity	Victoza
Type 2 diabetes mellitus	Yes	Yes
Reduction of cardiovascular mortality	Yes	Yes

Is Ozempic or Victoza more effective?

The AWARD-6 trial was a randomized clinical trial comparing Trulicity and Victoza. The results concluded that both were relatively equal in lowering hemoglobin A1C (HbA1C), a lab value that is indicative of long-term blood glucose levels. Both were also similarly safe and tolerable. The decision to choose one over the other may come down to preference of once weekly or once-daily injections. Only your physician can decide what is best for you.

A meta-analysis of clinical studies also compared cardiovascular outcomes of Trulicity and Victoza as well as other GLP-1 agonists. The analysis found that GLP-1 agonists reduced cardiovascular events like heart attack by 12% overall. There was no statistical difference in the amount decreased by Trulicity, Victoza, or other GLP-1 agonists. 

Both Trulicity and Victoza show effectiveness in the treatment of diabetes and the reduction of cardiovascular events. This is not intended to be medical advice. Talk to your endocrinology specialist to determine which may be best for you.

Coverage and cost comparison of Trulicity vs. Victoza

Trulicity is a prescription medication covered by most Medicare and commercial insurance providers. Some insurance companies may prefer one GLP-1 agonist over another. Your pharmacist can help you determine if that is the case. The out-of-pocket cost for Trulicity can be almost $1,300. SingleCare helps you save hundreds of dollars on prescription Trulicity. A SingleCare savings card lowers the cost of Trulicity to approximately $774.

Victoza is a prescription medication covered by most Medicare and commercial insurance plans. Without insurance, Victoza can cost up to $1,330. A SingleCare savings card lowers this price to around $900.

	Trulicity	Victoza
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare Part D?	Yes	Yes
Quantity	4, 1.5 mg/0.5 ml pens	3, 18mg/ 3ml pens
Typical Medicare copay	$0-$1000	$0-$1100
SingleCare cost	$774-$867	$898-$1100

Common side effects of Trulicity vs. Victoza

The most common side effects of GLP-1 agonists are related to the gastrointestinal system, and they include nausea, diarrhea, and vomiting. The prescribing information for Trulicity and Victoza both report that approximately 20% of treated patients will experience nausea and roughly 12% will experience diarrhea. Decreased appetite will occur in about 9% of patients treated with either drug. Due to these side effects, it is not uncommon for patients to experience weight loss when taking either Trulicity or Victoza. Gastrointestinal side effects increase with dosage. Many prescribers will start you at a lower dose and titrate you up slowly to minimize the onset of these side effects.

	Trulicity		Victoza
Side Effect	Applicable?	Frequency	Applicable?	Frequency
Nausea	Yes	21.1%	Yes	20%
Diarrhea	Yes	12.6%	Yes	12%
Vomiting	Yes	12.7%	Yes	9%
Abdominal pain	Yes	9.4%	No	n/a
Decreased appetite	Yes	8.6%	Yes	9%
Dyspepsia	Yes	5.8%	Yes	7%
Fatigue	Yes	5.6%	No	n/a
Headache	No	n/a	Yes	10%
Constipation	No	n/a	Yes	5%
Back pain	No	n/a	Yes	5%

Source: Trulicity (DailyMed) Victoza (DailyMed)

Drug interactions of Trulicity vs. Victoza

Trulicity and Victoza delay gastric emptying and therefore may alter the rate of absorption of oral drugs administered with them. This is especially true for narrow therapeutic index drugs like Coumadin (warfarin) and Synthroid (levothyroxine). This effect is more pronounced at higher doses. 

The risk of serious side effects such as hypoglycemia, or low blood sugar, increases with Trulicity and Victoza when taken with other antidiabetic medications. Your endocrinologist may decrease your doses of oral medications like metformin or your insulin before starting GLP-1 receptor agonists. 

Drug	Drug Class	Trulicity	Victoza
Benazepril Captopril Enalapril Lisinopril Quinapril Ramipril	ACE Inhibitors	Yes	Yes
Azilsartan Candesartan Eprosartan Irbesartan Losartan Olmesartan Valsartan Telmisartan	Angiotensin II receptor blockers (ARBs)	Yes	Yes
Clarithromycin	Antibiotic	Yes	Yes
Aspirin Bismuth salicylate Magnesium salicylate	Salicylates	Yes	Yes
Levothyroxine Liothyronine	Thyroid replacements	Yes	Yes
Estrogen Progesterone Testosterone	Hormones	Yes	Yes

Warnings of Trulicity and Victoza

Do not use Trulicity or Victoza if you have had a history of allergic reactions or hypersensitivity reactions to any GLP-1 receptor agonists. Localized injection site reactions may occur.

Trulicity and Victoza have been linked to thyroid C-cell tumors (adenomas or carcinomas) that were dose and treatment-duration dependent in lab animals. It is unknown if this can happen in humans. Routine monitoring of the thyroid and serum calcitonin is recommended for the detection of thyroid tumors and thyroid cancer. 

Pancreatitis has been reported in patients taking Trulicity and Victoza. Patients should monitor for signs of pancreatitis including severe abdominal pain which may radiate to the back. Vomiting may also accompany these symptoms. 

While Trulicity and Victoza are diabetes medications used to treat hyperglycemia, high blood glucose levels, they may cause hypoglycemia once initiated. This risk is increased with the concurrent use of insulin and oral antidiabetic agents such as sulfonylureas.

Renal function should be monitored in patients taking GLP-1 receptor agonists. Trulicity or Victoza may cause acute renal failure or worsening of chronic kidney problems. Doses may need to be adjusted or the medication may need to be stopped if it worsens.

Frequently asked questions about Trulicity vs. Victoza

What is Trulicity?

Trulicity is a prescription drug classified as a glucagon-1 peptide-like receptor agonist that is indicated in the treatment of Type 2 diabetes mellitus. Trulicity is a once-weekly injection available in single-use pens in dosages of 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg.

What is Victoza?

Victoza is a prescription medication belonging to a class known as glucagon-1 peptide-like receptor agonist that is indicated in the treatment of Type 2 diabetes mellitus. Victoza is a once-daily injection available in multi-dose pens which are capable of administering three approved doses: 0.6 mg, 1.2 mg, and 1.8 mg.

Are Trulicity and Victoza the same?

While Trulicity and Victoza are both glucagon-1 peptide-like receptor agonists, they are not the same medication. Trulicity contains the active ingredient dulaglutide and is once weekly. Victoza contains liraglutide and is once daily.

Is Trulicity or Victoza better?

Trulicity and Victoza have clinically similar outcomes related to the treatment of Type 2 diabetes mellitus and reducing cardiovascular events in Type 2 diabetes mellitus patients. Their safety and tolerability profiles are also similar. Trulicity has the advantage of being only once-weekly, while Victoza is once daily. This may be a factor when your healthcare professional determines which one is right for you.

Can I use Trulicity or Victoza while pregnant?

Adequate studies on the safety of the diabetes drugs Trulicity and Victoza have not been completed with regard to pregnancy and breastfeeding. Your doctor must weigh the potential risks and benefits. There are other proven therapies to treat diabetes in pregnancy, including insulin, which would be preferred.

Can I use Trulicity or Victoza with alcohol?

Alcohol consumption should be limited by anyone with Type 2 diabetes as it affects blood sugar and kidney and liver function. Talk to your physician if you drink regularly before starting Trulicity or Victoza.

What is a good substitute for Victoza?

Victoza may not be the best choice for you if you struggle with daily injections or your insurance company doesn’t prefer it. Check to see if you have better coverage for once-weekly GLP-1 agonists such as Trulicity, Bydureon, or Ozempic.

Is Trulicity cheaper than Victoza?

The out-of-pocket costs for Trulicty and Victoza are similar and upwards of $1300 per month. With a SingleCare discount card, Trulicity is slightly cheaper than the cost of Victoza but you can save hundreds of dollars or both prescriptions versus retail prices.

Is Victoza hard on kidneys?

Victoza can worsen pre-existing chronic renal failure. It can even induce acute renal failure. Kidney functions should be monitored in patients at risk, and the lowest effective dose should be used.