tirzepatide vs Dulaglutide
updated
tirzepatide (tier S) vs dulaglutide (tier S): what each is, half-life and source counts side by side.
the difference
checked
SURPASS-CVOT randomized 13,299 people with type 2 diabetes and atherosclerotic cardiovascular disease to tirzepatide or dulaglutide; among the 13,165 analyzed, cardiovascular death, heart attack or stroke occurred in 12.2% versus 13.1%, which met the trial's noninferiority test and did not show superiority.
dulaglutide is FDA-approved as Trulicity for blood-sugar control in type 2 diabetes, in adults and children 10 and older, and to lower cardiovascular risk in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors; weight management is not one of its labeled uses.
tirzepatide is FDA-approved as Mounjaro for type 2 diabetes, including lowering cardiovascular risk in adults at high risk, and as Zepbound for long-term weight reduction and for obstructive sleep apnea in adults with obesity.
- Mounjaro prescribing information, DailyMed (revised 8/2026)
- Zepbound prescribing information, DailyMed (revised 8/2026)
tirzepatide · tier S
A dual GIP and GLP-1 receptor agonist with distinct Zepbound and Mounjaro labels.
tier rationale
Tirzepatide is in S tier because large randomized trials have shown weight loss, improved blood-sugar control and reduced sleep-apnea severity. Zepbound and Mounjaro have US approvals for these uses.
Dulaglutide · tier S
Dulaglutide (TRULICITY) is an FDA-approved once-weekly injectable for type 2 diabetes, with phase 3 AWARD trials and REWIND, a 9,901-person cardiovascular outcomes trial. Its weight effect is modest and not a labeled use, and no obesity-indication trial was found.
tier rationale
S fits an approved drug used for its approved purposes. TRULICITY has been FDA-approved since 2014 with a phase 3 program, a 9,901-person cardiovascular outcomes trial over a median 5.4 years and a pediatric indication. The grade covers glycemic control and cardiovascular risk reduction in the labeled populations, not weight loss, which is not a labeled indication and has no obesity-indication trial behind it.
at a glance
| tirzepatide | Dulaglutide | |
|---|---|---|
| tier | S | S |
| category | weight loss | weight loss |
| sources | 20 | 9 |
| claims evaluated | n/a | 1 |
| half-life | ~5 days | Elimination half-life about 5 days |
| dosing data | yes | yes |
reptides grades the research record and cites the literature behind every call. research reference only; not medical advice.