Dulaglutide vs Semaglutide: SUSTAIN 7 and Labels
App Library Tools Pricing Download
[GLP-1 · Comparison]

Dulaglutide vs semaglutide: what did the head-to-head trial show?

SUSTAIN 7 · Label dosing · Half-life · Heart trials

Short answer: Both are weekly GLP-1 injections for type 2 diabetes. In SUSTAIN 7, semaglutide lowered HbA1c by 1.5 and 1.8 points versus 1.1 and 1.4 for dulaglutide at matched low and high doses, with weight loss of 4.6 and 6.5 kg versus 2.3 and 3.0 kg at 40 weeks.1 The trial used doses below today's label maximums.

Dulaglutide is sold as Trulicity. Semaglutide is sold as Ozempic (diabetes), Wegovy (weight) and Rybelsus (tablet). This page compares Trulicity with Ozempic, the two weekly diabetes injections.

How do dulaglutide and semaglutide compare side by side?

From the current US Trulicity and Ozempic labels unless noted.
Dulaglutide (Trulicity)Semaglutide (Ozempic)
How the molecule lastsGLP-1 analog fused to an antibody (IgG4 Fc) fragment2GLP-1 analog with a fatty acid chain that binds albumin3
Approved usesType 2 diabetes, adults and ages 10 and up; lowering heart risk in type 2 diabetes with heart disease or several risk factors2Type 2 diabetes; heart risk with heart disease; kidney decline with chronic kidney disease3
Label doses0.75 mg weekly; 1.5 mg after 4 weeks; then up by 1.5 mg every 4 or more weeks to a max of 4.5 mg20.25 mg for 4 weeks, then 0.5 mg; 1 mg and 2 mg if needed; max 2 mg3
PensSingle-dose pens: 0.75, 1.5, 3 and 4.5 mg2Multi-dose pens (4 doses) and single-dose syringes (0.25, 0.5, 1 mg)3
Half-lifeabout 5 days (label: about 5 days)2about 7 days (label: about 1 week)3
Time to peakMedian 48 hours at steady state (24 to 72)21 to 3 days3
Absorbed from the shot65% (0.75 mg) and 47% (1.5 mg)289% (Wegovy label, same molecule)4
Missed doseTake it if at least 3 days remain before the next dose; otherwise skip2Take within 5 days; otherwise skip3
Heart outcome trialREWIND: 9,901 people, 1.5 mg vs placebo, hazard ratio 0.882SUSTAIN 6: 3,297 people, 0.5 or 1 mg vs placebo, hazard ratio 0.743

Reviewed . Half-life figures are shown only where the value Dose Track uses agrees with the cited source.

What did SUSTAIN 7 find?

SUSTAIN 7 was an open-label trial in 1,201 adults with type 2 diabetes on metformin. People took semaglutide 0.5 mg, dulaglutide 0.75 mg, semaglutide 1 mg or dulaglutide 1.5 mg once weekly for 40 weeks.1

  • HbA1c: −1.5 vs −1.1 points at the low doses, −1.8 vs −1.4 at the high doses.1
  • Body weight: −4.6 vs −2.3 kg at the low doses, −6.5 vs −3.0 kg at the high doses.1
  • Side effects: gastrointestinal problems were the most common, in 43% and 44% on semaglutide and 33% and 48% on dulaglutide, and the main reason people stopped either drug.1

What SUSTAIN 7 did not test

The trial used dulaglutide up to 1.5 mg and semaglutide up to 1 mg. Both labels now go higher: Trulicity to 3 and 4.5 mg, Ozempic to 2 mg.23 SUSTAIN 7 says nothing about those higher doses against each other.

The heart outcome trials in the table, REWIND and SUSTAIN 6, each compared one drug with placebo in different groups of people over different lengths of time. Their hazard ratios are not a direct comparison. Dulaglutide 1.5 mg was also the comparison drug in SURPASS-CVOT, the tirzepatide heart trial.5

How do the half-lives differ?

Both last long enough for weekly dosing: about 5 days for dulaglutide and about a week for semaglutide.23 The longer half-life is one reason the Ozempic late-dose window (5 days) is wider than Trulicity's (take it only if at least 3 days remain before the next dose).

Semaglutide vs liraglutide: what is the difference?Weekly vs daily, STEP 8 and SUSTAIN 10, generics Rybelsus vs Ozempic: how does the pill compare with the shot?Daily tablet vs weekly shot, absorption, PIONEER Switching from semaglutide to tirzepatide: is there a conversion?What the labels and trials say about starting doses

Frequently asked questions

Is Ozempic better than Trulicity?+
In SUSTAIN 7, semaglutide lowered HbA1c and weight more than dulaglutide at both dose pairs tested (0.5 vs 0.75 mg and 1 vs 1.5 mg) over 40 weeks. Higher label doses of both have not been compared head to head in that trial.1
What is the half-life of dulaglutide vs semaglutide?+
About 5 days for dulaglutide and about 1 week for semaglutide, per the Trulicity and Ozempic labels.23
What is the highest dose of Trulicity?+
4.5 mg once weekly in adults, reached in 1.5 mg steps at least 4 weeks apart. In children 10 and older the maximum is 1.5 mg.2
Is Trulicity approved for weight loss?+
No. Trulicity is approved for type 2 diabetes and heart risk reduction in type 2 diabetes. Among semaglutide brands, Wegovy carries the weight indication.24
Can I track dulaglutide or semaglutide in Dose Track?+
Yes. Both are built in with their half-lives, so you can log weekly shots, see estimated levels and set reminders.

Sources

  1. Pratley RE, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7). Lancet Diabetes Endocrinol. 2018;6:275-286.
  2. Trulicity (dulaglutide) injection prescribing information. DailyMed, revised March 2026.
  3. Ozempic (semaglutide) injection prescribing information. DailyMed, revised June 2026.
  4. Wegovy (semaglutide) injection and tablets prescribing information. DailyMed, revised June 2026.
  5. Mounjaro (tirzepatide) prescribing information. DailyMed, revised August 2026.

All compound comparisons · Dulaglutide guide · Semaglutide guide · All compound guides