Januvia vs. Trulicity

See how Januvia and Trulicity compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Januvia is a once-daily pill that lowers blood sugar, while Trulicity is a once-weekly injection that also lowers cardiovascular risk in people with heart disease.

  • Trulicity causes more gastrointestinal side effects like nausea and vomiting, while Januvia's most common effects are nasopharyngitis and swelling.

  • Trulicity carries a boxed warning for thyroid tumors seen in animal studies, a risk Januvia does not carry.

Januvia vs. Trulicity Drug Summary

Januvia

Januvia (sitagliptin) is a DPP-4 inhibitor used to control blood sugar in adults with type 2 diabetes. It is taken as a single oral tablet once a day alongside diet and exercise.

Trulicity

Trulicity (dulaglutide) is a GLP-1 receptor agonist used to control blood sugar in people 10 and older with type 2 diabetes. It is injected once a week and is also approved to lower the risk of major cardiovascular events in adults with heart disease or multiple risk factors.

Januvia vs. Trulicity Side Effects

Januvia

Most common
Nasopharyngitis (up to 11.0%)
Peripheral edema (up to 8.3%)
Headache (up to 5.5%)
Diarrhea (up to 3.0%)

Trulicity

Most common
Nausea (up to 21.1%)
Diarrhea (up to 13%)
Vomiting (up to 13%)
Abdominal pain (up to 13%)

Januvia vs. Trulicity Dosage

Januvia

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once daily At the start
Maximum dose 100 mg once daily If needed
Dose changes 2 increases As tolerated

Trulicity

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.75 mg once weekly Weeks 1-4
Maximum dose 1.5 mg once weekly Week 5 onward
Dose changes 1 increase Every 4 weeks

Januvia vs. Trulicity Indications

Januvia

Januvia is approved to improve blood sugar control in adults with type 2 diabetes when used with diet and exercise. It is not approved for type 1 diabetes or diabetic ketoacidosis.

  • Approved for adults with type 2 diabetes

  • Used alongside diet and exercise

  • Not approved for type 1 diabetes or DKA

  • Dose adjusted for reduced kidney function

Trulicity

Trulicity is approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes. It is also approved to lower the risk of major cardiovascular events in adults with established heart disease or multiple cardiovascular risk factors.

  • Approved for adults and children 10+ with type 2 diabetes

  • Also reduces risk of major cardiovascular events

  • Sometimes used off-label for weight loss without diabetes

  • Not approved for type 1 diabetes or DKA

Januvia vs. Trulicity Pros and Cons

Januvia

Januvia offers a simple oral option without an injection or a boxed warning, and it tends to be weight-neutral rather than causing weight loss or gain. It has a lower typical list price than Trulicity, though it has not been shown to reduce cardiovascular risk.

Pros

  • Oral tablet, no injection needed

  • No boxed warning

  • Weight-neutral profile

  • Roughly $330 to $730 per month without insurance, before savings programs

Cons

  • Not shown to reduce cardiovascular events

  • Less weight loss benefit than Trulicity

  • Severe joint pain reported with this drug class

  • Dose must be adjusted for kidney function

Trulicity

Trulicity is injected only once a week and has FDA-backed evidence for lowering major cardiovascular events, plus it is approved for children 10 and older. It carries a boxed warning for thyroid tumors and typically costs more than Januvia.

Pros

  • Reduces risk of major cardiovascular events

  • Approved for children 10 and older

  • Greater weight loss effect than Januvia

  • Only needs to be injected once a week

Cons

  • Boxed warning for thyroid C-cell tumors

  • Contraindicated with personal or family history of MTC or MEN 2

  • Roughly $987 to $1,065 per month without insurance, before savings programs

  • Requires a subcutaneous injection instead of a pill

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