Trulicity vs. Farxiga

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

Key Takeaways

  • Trulicity is a once-weekly injected GLP-1 that lowers blood sugar and reduces cardiovascular risk in adults with type 2 diabetes.

  • Farxiga is a once-daily pill approved for type 2 diabetes, heart failure, and chronic kidney disease, even in people without diabetes.

  • Both treat type 2 diabetes but differ in form, mechanism, and the specific heart or kidney conditions they're approved to address.

Trulicity vs. Farxiga Drug Summary

Trulicity

Trulicity (dulaglutide) is a GLP-1 receptor agonist used to manage blood sugar in adults and children 10 and older with type 2 diabetes. It also lowers the risk of major cardiovascular events in adults with type 2 diabetes and existing heart disease or multiple risk factors. It's injected once a week using a prefilled pen.

Farxiga

Farxiga (dapagliflozin) is an SGLT2 inhibitor taken as a once-daily tablet. It's approved for blood sugar control in type 2 diabetes, and also to reduce heart failure hospitalization, treat heart failure directly, and slow chronic kidney disease progression. It works by helping the kidneys remove excess glucose through urine.

Trulicity vs. Farxiga Side Effects

Trulicity

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

Farxiga

Most common
Female genital mycotic infections (up to 6.9%)
Nasopharyngitis (up to 6.3%)
Urinary tract infections (up to 4.3%)
Back pain (up to 4.2%)

Trulicity vs. Farxiga Dosage

Trulicity

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.75 mg once weekly Weeks 1-4
Maximum dose 4.5 mg once weekly If needed
Dose changes 3 increases Every 4 weeks

Farxiga

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose 10 mg once daily If needed
Dose changes 1 increase As tolerated

Trulicity vs. Farxiga Indications

Trulicity

Trulicity is FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes. It's also approved to reduce the risk of heart attack, stroke, and cardiovascular death in adults with type 2 diabetes who have heart disease or multiple risk factors. Some prescribers also use it off-label for weight loss in people without diabetes.

  • Blood sugar control in type 2 diabetes (ages 10+)

  • Reduces risk of major cardiovascular events

  • Approved for pediatric type 2 diabetes (age 10+)

  • Off-label use for weight loss (not FDA-approved)

Farxiga

Farxiga is FDA-approved for blood sugar control in adults and children 10 and older with type 2 diabetes. It's also approved to reduce heart failure hospitalization, treat heart failure directly, and slow chronic kidney disease progression, regardless of diabetes status. This gives it a broader range of approved uses than most diabetes medications.

  • Blood sugar control in type 2 diabetes (ages 10+)

  • Reduces heart failure hospitalization risk

  • Treats heart failure to lower cardiovascular death

  • Slows chronic kidney disease progression

Trulicity vs. Farxiga Pros and Cons

Trulicity

Trulicity has strong outcomes data for lowering cardiovascular risk in people with type 2 diabetes and existing heart disease. It's delivered as a weekly injection rather than a daily pill, and gastrointestinal side effects are common during the first weeks of use. It also carries a boxed warning for thyroid C-cell tumors seen in animal studies.

Pros

  • Reduces cardiovascular events in people with existing heart disease

  • Approved for pediatric type 2 diabetes patients (age 10+)

  • Only one injection needed per week, not a daily dose

Cons

  • Requires an injection rather than a pill

  • Gastrointestinal side effects (nausea, diarrhea, vomiting) are common

  • Boxed warning for thyroid C-cell tumors

  • Costs more than Farxiga (roughly $987 to $1,065 vs $400 to $785 monthly, before savings programs)

Farxiga

Farxiga is taken as a once-daily pill and is approved across diabetes, heart failure, and chronic kidney disease, giving it use beyond blood sugar control alone. It carries risks of genitourinary infections and, rarely, ketoacidosis even when blood sugar looks normal. It isn't recommended for glycemic control in people with more advanced kidney impairment.

Pros

  • Taken as a once-daily oral tablet, no injections needed

  • Approved to treat heart failure directly, not just reduce risk

  • Approved to slow chronic kidney disease progression, even without diabetes

Cons

  • Increases risk of genital yeast infections and urinary tract infections

  • Small risk of serious infections, including Fournier's gangrene

  • Risk of ketoacidosis even when blood sugar levels look normal

  • Not recommended for blood sugar control in advanced kidney impairment

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