Dulaglutide vs Tesofensine
Side-by-side comparison of key properties, dosing, and research.
GLP-1 / Weight Loss Agonists
DulaglutideFat Loss & Metabolic
Tesofensine- Summary
- Dulaglutide (brand name Trulicity) is a once-weekly GLP-1 receptor agonist approved by the FDA for type 2 diabetes management and cardiovascular risk reduction. It consists of two GLP-1 analog chains fused to a modified IgG4 Fc fragment, extending its half-life to approximately 5 days. While primarily a diabetes medication, it produces meaningful weight loss and has established cardiovascular outcomes data from the REWIND trial.
- Tesofensine is a triple monoamine reuptake inhibitor (TMRI) that blocks reuptake of serotonin, dopamine, and norepinephrine. Originally developed for Alzheimer's and Parkinson's disease, it was repurposed as a potent weight loss agent after clinical trials demonstrated substantial fat loss via appetite suppression and increased energy expenditure.
- Half-Life
- ~5 days
- 8-10 days (exceptionally long; accumulates over weeks)
- Admin Route
- SubQ
- Oral
- Research
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- —
- Typical Dose
- 0.75 mg → 1.5 mg
- 0.25-0.5 mg per day
- Frequency
- Once weekly
- Once daily
- Key Benefits
- FDA-approved for type 2 diabetes
- Once-weekly subcutaneous dosing via auto-injector pen
- Reduces HbA1c by approximately 1.1–1.6%
- Modest weight loss of 1.5–3 kg at approved doses
- Demonstrated cardiovascular risk reduction (REWIND trial)
- Established long-term safety profile
- Renal protective effects in CKD
- Potent appetite suppression via triple monoamine reuptake inhibition
- Significant weight loss (8-12% body weight in phase II trials at 0.5 mg)
- Increases basal metabolic rate and energy expenditure
- Reduces fat mass preferentially over lean mass
- Potential cognitive benefit via dopaminergic and noradrenergic enhancement
- Longer half-life than sibutramine allows once-daily dosing
- Side Effects
- Nausea (most common, typically transient)
- Diarrhea
- Vomiting
- Decreased appetite
- +3 more
- Elevated heart rate and blood pressure (sympathomimetic)
- Dry mouth
- Insomnia and sleep disturbances
- Nausea
- +4 more
- Stacks With
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