Dulaglutide is a once-weekly GLP-1 receptor agonist made by Eli Lilly and sold as Trulicity. It is a fully approved prescription medicine in the UK, US and EU for type 2 diabetes, and is licensed in the US to reduce major cardiovascular events in adults with T2D. It is not approved as a weight-loss product (unlike its cousin Wegovy), although weight loss is a known on-treatment effect.
Semaglutide is a GLP-1 receptor agonist made by Novo Nordisk and sold as Ozempic (type 2 diabetes), Wegovy (chronic weight management) and Rybelsus (oral tablet for diabetes). It is a fully approved prescription medicine in the UK, US and EU, with large randomised trials showing meaningful weight loss and reduced cardiovascular and kidney events. It is not a research chemical.
Both peptides share an evidence grade of A. The right choice depends less on the data and more on what you're trying to do, Dulaglutide for type 2 diabetes, Semaglutide for type 2 diabetes.
FDA-approved in 2014 and EMA-approved in 2014 as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes. Now also licensed in the US for paediatric T2D in patients aged 10 years and older.
Following the REWIND trial (2019), the FDA expanded the Trulicity label in 2020 to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have either established cardiovascular disease or multiple cardiovascular risk factors. This is on-label in the US.
Dulaglutide produces a modest dose-dependent weight reduction (mean roughly 3-5 kg at standard doses, up to ~5 kg at 4.5 mg in AWARD-11). It is not approved as a weight-loss medicine. Off-label use for weight loss occurs in practice, but in head-to-head comparisons newer agents (semaglutide 2.4 mg, tirzepatide) produce substantially larger weight loss.
FDA-approved 2017 and EMA-approved 2018 as Ozempic; oral Rybelsus approved 2019. Indicated alongside diet and exercise to improve glycaemic control in adults with type 2 diabetes.
Wegovy (semaglutide 2.4 mg) is FDA-approved (2021) and EMA-approved (2022) for chronic weight management in adults with obesity, or overweight with at least one weight-related comorbidity. NICE recommends it within specialist services for up to two years.
Approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes plus established cardiovascular disease (Ozempic), and, based on SELECT, in adults with obesity or overweight plus established cardiovascular disease without diabetes (Wegovy, 2024).
The commonest side effects are gastrointestinal: nausea, vomiting, diarrhoea, constipation and abdominal pain, typically worst in the first few weeks of treatment or after a dose increase, and easing over time. Most are mild to moderate; a minority of patients discontinue because of them. More serious risks on the label include pancreatitis (rare), gallbladder disease (cholelithiasis and cholecystitis), and acute kidney injury usually mediated by dehydration from vomiting. The FDA label carries a boxed warning for thyroid C-cell tumours based on rodent data; whether this translates to humans is unresolved, but the medicine is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome. Not for use in pregnancy or breastfeeding. Injection-site reactions are common but typically mild. The long half-life means that, unlike liraglutide, side effects can persist for a couple of weeks after stopping.
The commonest side effects are gastrointestinal, nausea, vomiting, diarrhoea, constipation, abdominal pain, typically worst during dose escalation and easing over time. Most are mild to moderate; a minority of patients discontinue because of them. More serious risks on the label include pancreatitis (rare), gallbladder disease (semaglutide modestly increases the rate of cholelithiasis), and acute kidney injury usually mediated by dehydration from vomiting. The FDA label carries a boxed warning for thyroid C-cell tumours based on rodent data; whether this translates to humans is unresolved, but the medicine is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome. The EMA confirmed in 2025 that NAION (a rare optic-nerve condition causing sudden vision loss) is a very rare side effect. Not for use in pregnancy or breastfeeding. Counterfeit semaglutide and unregulated compounded versions have caused serious harm, only use a regulated pharmacy supply.
Both peptides share an evidence grade of A. The right choice depends less on the data and more on what you're trying to do, Dulaglutide for type 2 diabetes, Semaglutide for type 2 diabetes.
Pepwyse comparison pages are generated from the same structured data behind each peptide profile. Want a different head-to-head? Use the compare picker or ask Dulaglutide directly via the Ask-Peppy button. Not medical advice, see how we grade evidence.