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
Trulicity
Januvia vs. Trulicity Dosage
Januvia
Trulicity
| 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 |
| 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
| 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
| 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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