Mounjaro and Trulicity are two of the most talked-about injectable medications for type 2 diabetes right now. Both belong to the GLP-1 receptor agonist family, which means they imitate a natural gut hormone that helps control blood sugar after meals while often reducing appetite and supporting modest weight loss. Patients and doctors frequently compare the two because they share the same weekly injection schedule but deliver noticeably different results in many cases.
The main difference lies in their active ingredients and how powerfully they activate GLP-1 receptors. Trulicity has been available longer and has a well-established safety record, while Mounjaro (with its dual GLP-1 and GIP action) tends to produce stronger blood sugar reductions and greater weight loss in head-to-head studies. These differences influence which one a doctor recommends based on your HbA1c level, weight goals, heart risk, and how well you tolerate the side effects.
Choosing between them is rarely about one being universally “better.” It’s about matching the medication to your personal health profile, insurance coverage, and lifestyle preferences. This article breaks down the key similarities and differences so you can have a more informed conversation with your healthcare provider.
How Mounjaro and Trulicity Work
Both drugs mimic gut hormones to improve blood sugar control. Trulicity contains dulaglutide, a single GLP-1 receptor agonist that stimulates insulin release when glucose is high, suppresses glucagon, slows stomach emptying, and signals the brain to feel full sooner. The long-acting design provides steady coverage after one weekly injection.
Mounjaro contains tirzepatide, which activates both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors. GIP enhances insulin secretion, reduces glucagon in a complementary way, and appears to amplify appetite suppression and weight loss beyond what GLP-1 alone achieves. This dual mechanism is why Mounjaro often outperforms single-agonist drugs in clinical trials.
The shared GLP-1 action explains why both medications cause similar gastrointestinal side effects, especially during dose escalation. The added GIP activity in Mounjaro tends to intensify those effects for some people while delivering stronger overall metabolic benefits.
Is Trulicity the Same as Mounjaro
No, Trulicity and Mounjaro are not the same medication. Trulicity uses dulaglutide (a pure GLP-1 receptor agonist), while Mounjaro uses tirzepatide (a dual GLP-1 and GIP receptor agonist). The addition of GIP receptor activation in Mounjaro creates a more powerful effect on insulin secretion, glucagon suppression, and appetite control.
Because of this dual mechanism, Mounjaro generally produces greater reductions in HbA1c and body weight in head-to-head and indirect comparisons. Trulicity remains highly effective and often better tolerated during the dose-increase phase for patients who are sensitive to gastrointestinal side effects.
Both are once-weekly injections delivered via easy-to-use prefilled pens, but their molecular differences translate into distinct clinical profiles that matter when choosing between them.
Approved Uses and Indications
Trulicity is approved to improve glycemic control in adults with type 2 diabetes as an add-on to diet and exercise, and to reduce the risk of major adverse cardiovascular events (heart attack, stroke, cardiovascular death) in patients with established atherosclerotic cardiovascular disease or multiple risk factors. It is typically added when oral agents alone are insufficient.
Mounjaro is approved for glycemic control in adults with type 2 diabetes as an adjunct to diet and exercise. It also holds an indication for chronic weight management in adults with obesity or overweight with weight-related comorbidities (under the brand name Zepbound). The cardiovascular outcome trial for tirzepatide (SURPASS-CVOT) is ongoing, so a dedicated CV risk reduction label is not yet in place as of 2026.
Both drugs are not approved for type 1 diabetes, diabetic ketoacidosis, or pediatric use (Trulicity is approved down to age 10 for diabetes; Mounjaro is adult-only).
Head-to-Head Effectiveness Comparison
Direct and indirect comparisons consistently favor Mounjaro for both HbA1c reduction and weight loss. In the SURPASS-2 trial (tirzepatide vs. semaglutide 1 mg), tirzepatide 15 mg reduced HbA1c by 2.3% and weight by 11.2 kg versus semaglutide’s 1.9% and 6.9 kg. Indirect comparisons with Trulicity show similar or greater differences.
Real-world studies and network meta-analyses confirm the pattern: tirzepatide (Mounjaro) achieves 1.5–2.4% HbA1c reductions and 7–15 kg weight loss on higher doses, while Trulicity typically delivers 0.7–1.6% HbA1c lowering and 2–7 kg weight loss. Higher Trulicity doses (3.0 mg and 4.5 mg) close the gap but rarely surpass Mounjaro equivalents.
Both drugs outperform most oral agents and many other injectables for glycemic control and weight reduction when used as add-on therapy.
Side Effect Profiles Side by Side
Both medications share the GLP-1 class’s hallmark side effects—nausea, vomiting, diarrhea, abdominal discomfort, decreased appetite, and injection-site reactions. These are most prominent during dose escalation and usually improve within 4–12 weeks.
Mounjaro tends to produce more frequent and sometimes more intense gastrointestinal side effects because of its dual GLP-1/GIP action and higher potency. Trulicity’s side effects are often described as milder and more gradual during titration, which some patients find easier to tolerate.
Rare but serious class risks—pancreatitis, gallbladder events, acute kidney injury (usually from dehydration), and thyroid C-cell tumors (boxed warning based on rodent studies)—occur at similar low rates with both drugs. Hypoglycemia is uncommon unless combined with insulin or sulfonylureas.
Practical Considerations When Choosing Between Them
Dosing convenience is identical—both are once-weekly subcutaneous injections. Trulicity pens are single-use with fixed strengths; Mounjaro pens allow titration within the same device (2.5 mg → 5 mg → 7.5 mg → 10 mg → 12.5 mg → 15 mg). Some patients find Mounjaro’s gradual titration easier to tolerate.
Cost and insurance coverage vary by region, plan, and pharmacy. Mounjaro often faces more prior-authorization requirements or step-therapy rules because of its higher list price and newer status, while Trulicity has more established formulary placement in many plans. Manufacturer savings cards can reduce out-of-pocket costs significantly for eligible patients.
Patient preference and individual response are decisive. Some prefer Trulicity’s smoother side-effect profile; others choose Mounjaro for its stronger weight-loss and glucose-lowering effects. A trial period with one agent can help determine the best fit.
Summary
Trulicity and Mounjaro are both GLP-1 receptor agonists used to improve blood sugar control in type 2 diabetes, but they are not the same medication. Trulicity contains dulaglutide (single GLP-1 action), while Mounjaro contains tirzepatide (dual GLP-1 and GIP action), which generally produces greater HbA1c reductions (1.5–2.4% vs. 0.7–1.6%) and more substantial weight loss (7–15 kg vs. 2–7 kg) in clinical comparisons.
Trulicity often has a milder side-effect profile during dose increases and carries an established cardiovascular risk-reduction indication, while Mounjaro excels in weight management and glycemic potency.
Both are once-weekly injections with similar gastrointestinal side effects that usually improve over time. Choice between them depends on your HbA1c target, weight goals, cardiovascular risk, tolerability, insurance coverage, and personal preference. Discuss your priorities with your doctor to select the GLP-1 agonist that aligns best with your needs.
FAQ
Is Trulicity the same medication as Mounjaro?
No. Trulicity contains dulaglutide (a single GLP-1 receptor agonist), while Mounjaro contains tirzepatide (a dual GLP-1 and GIP receptor agonist). The added GIP action in Mounjaro gives it stronger effects on blood sugar and weight.
Which one is better for blood sugar control?
Mounjaro generally lowers HbA1c more effectively (1.5–2.4% reduction) than Trulicity (0.7–1.6%), especially at higher doses. Both are highly effective, but Mounjaro tends to outperform in head-to-head and indirect comparisons.
Which one helps more with weight loss?
Mounjaro typically produces greater weight loss (7–15 kg on higher doses) compared with Trulicity (2–7 kg). The dual GLP-1/GIP mechanism enhances appetite suppression and metabolic effects beyond what Trulicity achieves.
Are the side effects the same for Trulicity and Mounjaro?
Both cause similar gastrointestinal side effects—nausea, vomiting, diarrhea, abdominal discomfort—but Mounjaro often produces more frequent and intense symptoms because of its higher potency. Trulicity’s side effects are frequently described as milder and easier to tolerate during dose increases.
Do both reduce the risk of heart problems?
Trulicity has a proven cardiovascular risk-reduction indication (reduced heart attack, stroke, and CV death) from the REWIND trial. Mounjaro’s cardiovascular outcome trial (SURPASS-CVOT) is ongoing, so it does not yet have the same formal label, though early data are promising.
Is one easier to tolerate than the other?
Many patients find Trulicity easier to tolerate during dose escalation because side effects tend to build more gradually. Mounjaro can feel more intense initially due to its dual action and higher potency, but tolerance often improves significantly after the adjustment period.
Which one is less expensive—Trulicity or Mounjaro?
Cost varies by insurance plan, pharmacy, and region. Trulicity often has more favorable formulary placement and lower prior-authorization requirements in many plans, while Mounjaro’s higher list price can lead to more restrictions. Manufacturer savings cards can reduce out-of-pocket costs for both when eligible. Check with your pharmacy and insurer for current pricing.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.