Ozempic Alternatives: 5 Options to Consider

By Irmanie Hemphill, MD, FAAFP
Medically reviewed checkmarkMedically reviewed
February 10, 2023

Key takeaways

  • Ozempic (Semaglutide) is a prescription GLP-1 agonist that helps lower blood sugar when used with diet and exercise.

  • GLP-1 agonists also help lower the risk of cardiovascular events in people with heart disease. Many people also experience weight loss, although these medications are not FDA-approved for weight loss.

  • When it comes to choosing GLP-1 agonist medications, there are several available alternatives to Ozempic, including Bydureon (exenatide), Victoza (liraglutide), and Trulicity (dulaglutide).

Ozempic is a great option for adults with type 2 diabetes looking for an additional way to manage their blood sugar. GLP-1 agonists tend to decrease A1C, a person’s average blood sugar level for the past 2-3 months. They also help decrease the risk of cardiovascular events in people who have heart disease. However, Ozempic is not the only GLP-1 agonist in its class. Several other GLP-1 agonists are available for people with type two diabetes. 

Read on to learn more about Ozempic and several alternatives for managing blood sugar and decreasing your A1C. 

What is Ozempic (Semaglutide)?

Ozempic is a prescription medication designed to work with diet and exercise to help people with type 2 diabetes keep their blood sugar in a healthy range. It is a glucagon-like peptide-1 (GLP-1) agonist. It works by decreasing the amount of glucagon the liver releases, encouraging insulin secretion from the pancreas, and slowing digestion. The medication comes in pre-filled pens that a person injects into their thigh, upper arm, or abdomen once a week. You can take Ozempic with or without food. 

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Ozempic is FDA-approved to help people with type 2 diabetes manage their blood sugar and lower their A1C. It works alongside diet and regular physical activity. Another benefit is Ozempic lowers the risk of cardiovascular events such as heart attack or stroke for people with type 2 diabetes who also have heart disease. People who take Ozempic tend to lose weight. However, it is not FDA-approved as a weight loss medication.  

Side Effects

The most common side effects of Ozempic include nausea, vomiting, and diarrhea. Some people also experience redness at the injection site. Serious side effects of Ozempic may include:

  • Allergic reaction: rash, itching, swelling of the face, tongue, mouth, or throat, difficulty breathing or swallowing
  • Pancreatitis: ongoing pain in the mid-abdomen that may spread to the back with or without vomiting
  • Hypoglycemia: cold and clammy skin, feeling faint or dizzy
  • Gallbladder disease: pain in the upper stomach, yellowing of the skin or eyes, clay-colored stools, fever, rapid heartbeat
  • Acute kidney injury: decreased urination, swelling of the feet, ankles, or legs
  • Diabetic retinopathy complications: changes with vision

The FDA has issued a “black box” warning for Ozempic. This is the most serious warning they give medications that alert doctors and patients to a possible serious side effect. During clinical trials, Ozempic increased the risk of thyroid tumors in mice and rats. Currently, it is unknown if Ozempic would have the same effect on humans. People with a family or personal history of thyroid cancer or multiple endocrine neoplasia syndrome type 2 should avoid taking Ozempic unless otherwise advised by their medical doctor. 

Ozempic Alternatives

Below are several alternatives to Ozempic. Most of these medications are also GLP-1 agonists and work in a similar manner to lower blood sugar levels. GLP-1 agonists act to:

  • Decrease secretion of glucagon from the liver
  • Stimulate the pancreas to release more insulin when blood sugar levels rise
  • Slow down the rate food leaves the stomach during digestion

Be aware that all GLP-1 agonists can cause low blood sugar, and they carry the same black box warning as Ozempic. 

People with the following should avoid using GLP-1 agonists:

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

When a person takes a GLP-1 agonist along with following their healthcare provider’s suggestions of an appropriate diet and exercise plan, they tend to keep their blood sugar in a healthy range and may lose weight. Reading through each of the following medications will help you understand the subtle differences between them and help you make informed decisions about your health. 

Bydureon (exenatide)

Bydureon is a once-weekly injection that offers people with type 2 diabetes the opportunity to manage their blood sugar better. A 2015 study shows that Bydureon offered glycemic control to people who previously had inadequately controlled blood sugar. The study also shows that after six years of taking Bydureon, people are still experiencing healthy blood glucose management when they use it along with diet and exercise. 

The other version of exenatide is Byetta. Byetta is an immediate-release version taken twice daily before meals. Doctors prescribe either of these medications after other forms of blood glucose control have been tried. The same is true of Ozempic. These medications can be taken along with other medications for diabetes, such as metformin. However, it has not been tested with insulin. 

A common side effect of Bydureon is nausea which tends to lessen over time. Other side effects may include:

  • Vomiting
  • Diarrhea or constipation
  • Dizziness or headaches
  • Allergic reaction

Victoza (liraglutide)

Victoza is a once-daily injection for children over ten years of age and adults with type 2 diabetes. It helps with keeping blood sugar in a healthy range and lowers A1C. Similar to Ozempic, Victoza also helps decrease the risk of major cardiovascular events such as stroke and heart attack. During clinical trials, many adults with type 2 diabetes lost an average of 6.2 pounds. However, some adults gained weight. With your doctor’s guidance, you may be able to continue taking insulin while using Victoza. 

Common side effects include nausea and vomiting. Victoza may also increase your heart rate. 

Mounjaro (tirzepatide)

Mounjaro is for managing blood sugar in adults with type 2 diabetes. It is slightly different from Ozempic because it is not a GLP-1 agonist. Mounjaro is a dual GIP/GLP-1 agonist. This means it directly activates both glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 pathways to regulate blood sugar. During studies, up to 90% of people using Mounjaro decreased their A1C below 7% and lost up to 25 pounds. 

Mounjaro has the same warnings and contraindications as Ozempic. Common side effects of Mounjaro include:

  • Nausea or indigestion
  • Diarrhea or constipation
  • Decreased appetite
  • Vomiting
  • Stomach pain

Tanzeum (albiglutide)

Tanzeum is a once-weekly GLP-1 agonist to help adults control blood glucose levels alongside diet and exercise. During clinical trials, it was tested and found to be safe as a single therapy and in combination with other diabetes medications such as metformin, thiazolidinedione, and insulin glargine. The most common side effects are:

  • Upper respiratory tract infection
  • Diarrhea
  • Nausea
  • Injection site reaction

Trulicity (dulaglutide)

Trulicity is a once-weekly injection for adults with type 2 diabetes. After four doses, 50-60% of people who took Trulicity during clinical trials lowered their A1C to below 7%. People who took Trulicity during the study also tended to lose up to ten pounds. However, Trulicity is not FDA-approved for weight loss. 

Common side effects include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Decreased appetite

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When to See a Medical Provider

Talk with your doctor if you have type 2 diabetes and are looking for additional help managing your blood sugar. Ozempic and other GLP-1 agonist medications may be the solution you are looking for. These medications tend to be simple to administer and many people enjoy not having to take them daily. 

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Frequently Asked Questions

Is there a cheaper substitute for Ozempic?
Victoza (liraglutide) is another GLP-1 agonist that is similar to Ozempic but is less expensive. Other diabetes medications are also much less expensive, such as metformin, glipizide, or insulin.
What medicine is the same as Ozempic?
Rybelsus is another medication that uses the ingredient semaglutide to treat type 2 diabetes. The difference between Rybelsus and Ozempic is that Rybelsus is a once-a-day oral medication, while Ozempic is a once-a-week medication.
What is similar to Ozempic over-the-counter?
Currently, Alli is the only over-the-counter medication FDA-approved to help with weight loss. Other natural substitutes are available for purchase. However, those have not undergone approved testing for safety and weight loss and are not regulated or approved by the FDA.
Is there a generic option for Ozempic?
Semaglutide is the ingredient in Ozempic. However, there is currently no generic version of Ozempic available.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Irmanie Hemphill, MD, FAAFP

Dr. Hemphill is an award winning primary care physician with an MD from Florida State University College of Medicine. She completed her residency at Halifax Medical Center.

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