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Trulicity vs. Orlistat

Published on 
February 3, 2025
Virta Team

Trulicity and Orlistat have distinct mechanisms and purposes. Trulicity, a GLP-1 receptor agonist, is for type 2 diabetes management, providing HbA1c reductions and modest weight loss. Orlistat, a lipase inhibitor, blocks fat absorption and achieves modest weight loss without affecting glucose levels. Trulicity commonly causes nausea, while Orlistat is associated with gastrointestinal issues such as oily stools. Trulicity costs $875/month, significantly more than Orlistat’s $100/month. Neither drug currently faces shortages.

How Trulicity Works

Slows gastric emptying, reduces appetite, and enhances feelings of fullness, leading to lower calorie intake. It also stimulates insulin release and reduces glucagon secretion, improving blood sugar control.

Common Side Effects

Nausea, diarrhea, vomiting, fatigue, and decreased appetite.

Serious Potential Side Effects

Pancreatitis, thyroid tumors (potential risk), gallbladder issues, kidney problems, and serious allergic reactions

How Orlistat Works

Blocks the breakdown and absorption of dietary fat in the intestines. Unabsorbed fat is excreted in the stool, reducing calorie intake and promoting weight loss.

Common Side Effects

Oily or fatty stools, frequent bowel movements, flatulence with discharge, and abdominal discomfort.

Serious Potential Side Effects

Rare liver damage and malabsorption of fat-soluble vitamins (A, D, E, K), kidney problems, and severe allergic reactions

Brand Name

Trulicity
Orlistat

Generic Name

Dulaglutide
Orlistat

Overview

GLP-1 receptor agonist for type 2 diabetes that helps regulate blood sugar levels and may contribute to modest weight loss by slowing digestion and reducing appetite. Also used for cardiovascular event risk reduction in patients with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors.
Blocks fat absorption in the intestine, helping with weight loss and weight maintenance by reducing the calories absorbed from dietary fat.

Year Approved

2014
1999

Category

GLP-1
Other

Indicated for

Type 2 diabetes management; reducing risk of major cardiovascular events in adults with type 2 diabetes, known cardiovascular disease, or multiple cardiovascular risk factors
Weight loss in overweight or obese adults; weight maintenance to prevent regain after weight loss

Administration type

Injectable
Oral

Also used (but not approved) for

Weight Management

Frequency

Once / week
Up to 3x / day

Typical dose range

0.75–4.5 mg
120 mg 3x day

Average cost per month

$875
$60–$100

Availability

No current shortages
No current shortages