Ozempic, Trulicity, and More: 11 GLP-1 Drugs and How to Navigate Your Options

Ozempic, Trulicity, and Victoza: these Type 2 diabetes medications have been growing in popularity over the last several years. And they all belong to the same class — glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 drugs work by triggering insulin release, reducing glucose (sugar) production in your liver, and making you feel full.

Researchers have taken interest in how these medications work to not only manage blood sugar, but help people lose weight. Today, there’s a long list of GLP-1 drugs available on the market — with more on the way.

But with all of these options, how do you decide which is right for you? Let’s get to know some of the differences between 11 GLP-1 drugs.

Branded GLP-1 Medications: What Are Your Options?

There are way more GLP-1 medications than you may realize.

1. Ozempic

Ozempic (semaglutide) is a once-weekly injection for adults with Type 2 diabetes. It comes in a multi-dose pre-filled pen. You can inject Ozempic at any time of day, with or without food. But you should inject it on the same day each week.

If you have Type 2 diabetes, your prescriber may recommend Ozempic based on your treatment goals, risk factors, and health history. Three examples of these indicators include:

• Heart disease: If you also have heart disease, Ozempic can help lower the risk of major adverse cardiovascular events (heart attack, stroke, or cardiovascular-related death), or MACE.

• Chronic kidney disease: If you also have chronic kidney disease (CKD), Ozempic can help lower the risk of kidney disease worsening, kidney failure, and cardiovascular death.

• Weight loss: Ozempic isn’t approved for weight loss. But you may notice weight loss while using it, which may help you meet your treatment goals. On average, those using Ozempic lost 8 lbs to 10 lbs at 30 weeks during initial clinical trials. Wegovy, a higher-dose product, is approved specifically for weight loss.

Semaglutide, the main ingredient in Ozempic, Wegovy, and Rybelsus, is being studied for a variety of other health conditions. Additional uses may be approved over the coming years.

2. Rybelsus

Don’t like injections? Rybelsus is an oral version of semaglutide used for Type 2 diabetes. It's also approved to lower the risk of MACE in adults with Type 2 diabetes at increased risk for these events. It comes in two forms: the original R1 formulation (sold as Rybelsus) and the newer R2 formulation (now sold under the Ozempic brand name).

Rybelsus is taken by mouth once daily. To get the best results, take it first thing in the morning with no more than 4 ounces of water. Wait 30 minutes before eating, drinking, or taking other medications. This will allow the medication to be fully absorbed.

It’s possible to switch from Ozempic injections to Rybelsus (and vice versa). But if your Ozempic dose is 1 mg or greater, this may not be an option for you.

3. Wegovy and Wegovy HD injection

The Wegovy injection is another once-weekly semaglutide injection. It comes in a single-dose pen. Unlike Ozempic, Wegovy is specifically approved for weight loss in certain adults and adolescents ages 12 and older. It’s not used to treat diabetes, and you don’t need to have a diabetes diagnosis to use it. You can inject Wegovy at any time of day.

Wegovy is approved for adults and adolescents who are considered to be obese. It’s also approved for adults considered overweight who have one or more weight-related health conditions (such as high blood pressure, high cholesterol, diabetes). A higher-dose version of Wegovy (called Wegovy HD) is also available for adults who require additional weight loss.

In clinical trials, adults receiving Wegovy had an average weight loss of nearly 15% of their initial body weight. And adolescents had an average weight loss of almost 15% of their initial body weight. Adults receiving Wegovy HD had an average weight loss of 19%. For the best results, combine Wegovy with a nutritious diet and regular exercise.

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Wegovy is also approved to lower the risk of MACE in adults with heart disease and a larger body size. During a recent clinical trial, Wegovy lowered the risk of MACE by 20% compared to placebo (an injection without medication in it).

Most recently, Wegovy was also approved to treat adults with metabolic dysfunction-associated steatohepatitis (MASH) who have moderate-to-advanced liver scarring (fibrosis) — but not cirrhosis — along with a reduced-calorie diet and increased physical activity.

4. Wegovy pill

Wegovy also comes as a pill for weight loss. Similar to Rybelsus, you take the Wegovy pill every day. It has the same timing instructions to allow proper absorption — first thing in the morning on an empty stomach with no more than 4 oz of plain water. Wait at least 30 minutes before eating, drinking other fluids, or taking other medications.

Unlike the Wegovy injection, the Wegovy pill is approved for weight loss in adults only. In clinical trials, people in the Wegovy pill group lost on average nearly 14% of their starting body weight. Those who stayed on the medication the entire time lost about 17%.

The Wegovy pill is also approved to lower the risk of MACE in adults with a larger body size and heart disease. But it’s not approved to treat MASH.

5. Trulicity

Trulicity (dulaglutide) is a once-weekly injection for Type 2 diabetes in adults and children ages 10 and older. It comes as a single-use pre-filled pen. You should inject Trulicity on the same day each week at any time of day, with or without food.

Like Ozempic, Trulicity can lower the risk of MACE in adults who also have heart disease. But it can also provide this benefit if you have heart disease risk factors. Trulicity may also have some kidney-related benefits.

Trulicity isn’t approved for weight loss. But some people using it lose weight as a side effect. One study found that adults taking the highest Trulicity dose (4.5 mg) were able to lose up to 10 lbs over 9 months.

6. Victoza

Victoza (liraglutide) is a once-daily injection for Type 2 diabetes in adults and children ages 10 and older. You can inject your dose at any time of day, without regard to food. Victoza comes in a multi-dose prefilled pen.

Victoza can lower the risk of MACE if you also have heart disease. There’s also evidence that it may help prevent kidney problems from getting worse.

Victoza isn’t approved for weight loss, but some people taking it lose weight. During clinical trials, this was around 5 lbs on average. A higher-dose version called Saxenda is available for weight loss.

One difference between Victoza and most other GLP-1 drugs is that it’s also available as a lower-cost generic. If cost is a barrier to accessing treatment, generic Victoza may be an option to consider.

7. Saxenda

Saxenda is the version of liraglutide approved for weight loss. It also comes in a multi-dose prefilled pen. Like Wegovy, it’s approved for use in adults and adolescents ages 12 and older who are considered obese. Adults considered overweight with at least one weight-related health condition can also qualify.

In a large clinical trial, adults using Saxenda lost an average of 8% of their starting body weight. In a separate trial, adolescents lost a little over 2.5% of their starting body weight on average. Saxenda also works best when combined with a nutritious diet and regular exercise.

But how does Saxenda compare to Wegovy? One head-to-head study showed significantly more weight loss in adults with Wegovy (16%) than Saxenda (6%). You also need to inject Saxenda more frequently (daily vs. weekly). Your prescriber can help you decide on the best option for you.

Similar to Victoza, a generic version of Saxenda is available. Saxenda is the first GLP-1 for weight loss with a generic alternative.

8. Byetta

Byetta (exenatide) was the first FDA-approved GLP-1 drug. It’s used to treat Type 2 diabetes in adults. You need to inject it more often compared to other options — twice daily within an hour before your morning and evening meals.

Your prescriber may recommend Byetta if you’re experiencing blood sugar spikes after meals. And it can also cause weight loss as a side effect. However, Byetta doesn’t have the same proven cardiovascular benefits as other options.

Like Victoza, Byetta is also available as a lower-cost generic. But compared to other GLP-1 drugs, Byetta may be less convenient since it’s injected twice a day around meals.

9. Mounjaro

Mounjaro (tirzepatide) is a once-weekly injection that’s closely related to GLP-1 receptor agonist drugs. It’s part of a brand new class called GLP-1/GIP agonists. It works by mimicking two gut hormones: GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). Mounjaro comes in a single-dose pen, multi-dose pen (KwikPen), and vial.

Mounjaro is approved to treat Type 2 diabetes in adults and children ages 10 and older. It has been studied head-to-head against Ozempic. After 40 weeks, people receiving Mounjaro saw a better reduction in hemoglobin A1C levels (average blood sugar over 3 months) compared to Ozempic. And they lost more weight, too.

Mounjaro is currently under FDA review for MACE risk reduction. And like semaglutide, tirzepatide (the active ingredient in Mounjaro and Zepbound) is being studied for even more uses.

10. Zepbound

Zepbound is the FDA-approved version of tirzepatide for weight loss. It’s also approved to treat moderate-to-severe obstructive sleep apnea (OSA) in people with a larger body size. Similar to Mounjaro, Zepbound comes in a single-dose pen, multi-dose pen (KwikPen), and vial.

Like Wegovy and Saxenda, Zepbound is approved for adults considered obese, or considered overweight with one or more weight-related health conditions. But Zepbound isn’t approved for adolescents yet.

During clinical trials, people receiving Zepbound lost up to nearly 21% of their starting body weight over 72 weeks (about 16.5 months). This was compared to 3% weight loss in people who received a placebo. Compared to Wegovy, a recent head-to-head study showed greater weight loss in people receiving Zepbound. However, Zepbound hasn't been compared to Wegovy HD yet.

11. Foundayo

Foundayo (orforglipron) is the newest FDA-approved GLP-1 medication for weight loss. Other GLP-1s on this list are peptides, which are chains of amino acids (protein building blocks). But Foundayo is a small molecule drug, which means it’s made differently. Because of this, it doesn’t have the same food and water restrictions as peptide GLP-1 pills like Wegovy.

Foundayo is taken once daily by mouth, with or without food. This may make it a more convenient option for people who prefer a pill but want flexibility with when and how they take it.

During clinical trials, people taking the highest Foundayo dose lost an average of about 11% of their starting body weight over 72 weeks.

Ozempic or Mounjaro? Test your knowledge!

How do I find out which GLP-1 drug is right for me?

Finding the Right Diabetes Treatment Plan: Factors to Consider

The right GLP-1 drug for you will likely come down to a few key factors, including:

• Age: All GLP-1 drugs are approved for use in adults. But some can also be used in children as young as 10 years old.

• Treatment goals: Each GLP-1 drug has specific approved uses and potential benefits to help you meet your treatment goals.

• Underlying conditions: If you have existing heart disease or heart disease risk factors, one with proven cardiovascular benefits may be preferred. Certain GLP-1 drugs also have proven benefits for people with CKD, OSA, or liver disease.

• Preferences: Don’t like injections? An oral pill option may be available. If dosage frequency is a concern, there are once-weekly options to choose from.

• Insurance coverage: Your insurance plan may only cover certain GLP-1 drugs. And whether one is covered may depend on why you’re taking it. So, it’s best to check with your specific plan about coverage.