Ozempic Alternatives: Options to Consider

Ozempic is a medication used to manage type 2 diabetes in adults. GLP-1 agonists help decrease a person’s blood sugar levels and lower their A1C (the average blood sugar levels over the last three months). The medication also protects against cardiovascular events such as heart attack and stroke in people who have diabetes and heart disease. 

Ozempic is not the only medication in its class. Several other GLP-1 agonists exist which help manage blood sugar and sometimes encourage weight loss. 

Read on to learn more about Ozempic and other alternative GLP-1 agonist medications.

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What Is Ozempic?

Ozempic is a prescription medication that works alongside lifestyle and dietary changes to keep blood sugar in a healthy range for people with type 2 diabetes. It comes from the class of glucagon-like peptide-1 (GLP-1) agonists. 

GLP-1 agonists have several mechanisms of action in the body. They work by: 

• Decreasing the number of hormones the liver releases to control blood sugar.
• Slowing the rate at which food leaves the stomach during digestion.
• Stimulating the pancreas to release insulin when blood sugar levels start to increase.

Ozempic is a once-weekly medication that is self-injectable into the upper arm, thigh, or abdomen. You can take it with or without food, and it is important to take it at the same time each week.

People who take Ozempic also tend to experience weight loss. A 2022 study of 175 people taking semaglutide, the active ingredient in Ozempic, showed an average weight loss of 5.9% at three months and 10.9% at six months of their starting weight.

During clinical trials, participants taking Ozempic lost an average of 8—14 lbs. 

Side Effects

According to the prescribing information, Ozempic has several side effects. These may be intense when first starting the medication, but they should decrease over time while the body adjusts. People starting Ozempic take a smaller dose that gradually increases over time.

The most common side effects of Ozempic include nausea, diarrhea, and vomiting. Redness at the injection site is another common side effect. 

Serious side effects may include:

• Hypoglycemia: low blood sugar levels which can lead to feeling faint, cold, and clammy skin.
• Allergic reaction: itching, rash, swelling of the face, mouth, tongue, or throat, trouble breathing or swallowing.
• Pancreatitis: inflammation of the pancreas with symptoms of mid-abdominal pain that may spread to the back with or without vomiting.
• Gallbladder disease: upper stomach pain, fever, rapid heartbeat, yellowing of the eyes or skin, clay-colored stools.
• Diabetic retinopathy complications: damage to delicate blood vessels which results in vision changes.
• Acute kidney injury: swelling of the legs, ankles, or feet, decreased urination.

The FDA assigns  “black box” warnings to medications to alert patients and medical professionals to a serious possible side effect. Ozempic has a black box warning for the possible increased risk of thyroid tumors. During clinical trials, mice and rats experienced more thyroid tumors while on Ozempic. Currently, experts do not know if this risk applies to humans. 

Speak to your doctor about Ozempic if you have a personal or family history of thyroid cancer or multiple endocrine neoplasia syndrome type 2. 

Alternatives to Ozempic

Several other medications are also GLP-1 agonists and work similarly to Ozempic. 

It is important to note that all GLP-1 agonists have the same black box warning as Ozempic and are not appropriate for everyone. People with the following medical conditions should avoid taking GLP-1 agonists:

• History of pancreatitis.
• Kidney failure.
• Type 1 diabetes.
• Breastfeeding or pregnant.
• Diabetic ketoacidosis.
• Multiple endocrine neoplasia syndrome type 2 (MEN 2).
• Family or personal history of medullary thyroid carcinoma (MTC).

At this time, all GLP-1 agonist medications are brand-name medications. No generic versions are currently available. The cost of brand-name medication can be high. However, there are ways to help decrease the cost. Coupons are available online and some manufacturers have programs people can apply to when they need help paying for their prescriptions. 

Byetta

Byetta (exenatide) is an immediate-release GLP-1 agonist. It differs from Ozempic in that it is taken twice daily, 60 minutes prior to the morning or evening meal or the two main meals of the day. Byetta was the first medication of its kind in the GLP-1 agonist class. 

Byetta can be taken in conjunction with other 2 diabetes medications, such as metformin. Always discuss all your medications with your doctor. It is important to continue monitoring blood sugar levels daily and A1C twice a year while taking Byetta.

Common side effects include nausea, vomiting, indigestion, and changes to bowel movements.

Victoza

Victoza (liraglutide) is a once-daily injection. It differs from Ozempic in that the FDA approves Victoza for children with type 2 diabetes over ten years of age and adults with type 2 diabetes. During clinical trials, participants taking liraglutide lost an average of 8.1–11.6 pounds between 5–16 weeks. 

Common side effects include nausea, vomiting, diarrhea, decreased appetite, and constipation. Victoza may also cause your heart rate to increase. 

Trulicity

Trulicity (dulaglutide) is a GLP-1 agonist for adults with type 2 diabetes to take as a once-weekly injection. 50–60% of participants in clinical trials lowered their A1C to below 7%. They also lost an average of ten pounds. However, this medication is not a weight loss medication.

Common side effects include nausea, diarrhea, vomiting, and abdominal pain.

Tanzeum

Tanzeum (albiglutide) is a once-weekly injection that helps adults manage blood glucose alongside lifestyle changes. Clinical trial testing found it to be safe as monotherapy or in combination with other medications such as insulin glargine, metformin, and thiazolidinedione.

Common side effects include upper respiratory tract infection, nausea, diarrhea, and injection site reaction. 

Mounjaro

Mounjaro (tirzepatide) is a once-weekly injection medication for adults with type 2 diabetes. It is a newer GLP-1 agonist and clinical trials show that it helps decrease blood sugar levels.

Many participants in the trials lost 20% of their starting weight. Because of this, some doctors prescribe Mounjaro as a weight loss medication. However, this is an off-label use as the FDA has not given approval as a weight loss medication. The FDA is currently reviewing it as a possible weight-loss medication.

Common side effects include nausea, diarrhea, vomiting, and constipation.

Takeaways

Ozempic is used for better blood sugar control in people with type 2 diabetes. This once-weekly injection is a convenient way to improve blood sugar levels, lower A1C, and possibly experience weight loss. Ozempic works alongside lifestyle and dietary changes. 

Other GLP-1 agonists work the same way and can help keep blood sugar in a healthy range. Talk to a weight loss nutritionist through Nourish can get it covered by insurance.

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