Trulicity, a once-weekly injectable medication produced by Eli Lilly, is used to manage blood sugar in people living with type 2 diabetes. 

It was first approved by the Food and Drug Administration in 2014 and may help with blood sugar management, improve HbA1c levels, increase insulin sensitivity, and aid in weight loss. 

This article will explore everything you need to know about taking Trulicity, its benefits, and its side effects. 

Four Trulicity pens on a white background

What is Trulicity?

Trulicity is a name-brand prescription medication for people with type 2 diabetes and is prescribed to help manage blood sugar levels, A1C, and weight loss. 

It may also help prevent stroke, heart attack, and premature death in people with type 2 diabetes and pre-existing heart disease. It is only available via injection and is taken once weekly. 

It falls under the glucagon-like peptide-1 receptor (GLP-1) agonist drug class, and its active ingredient is dulaglutide. 

It is usually used in conjunction with insulin and other diabetes medications. 

How does Trulicity work?

Trulicity attaches to specific receptors on the cells in the pancreas. This signals the pancreas to release more insulin, lowering blood sugars naturally. 

Trulicity also inhibits glucagon production in the liver, preventing blood sugar spikes after meals, which improves insulin sensitivity. 

Finally, it slows digestion, which leads to appetite suppression and weight loss. 

By lowering your blood sugar levels and A1C over time, Trulicity lowers the risk of heart attack, stroke, and premature death. 

What are the benefits of taking Trulicity?

There are many benefits to taking Trulicity. Patients who use Trulicity for diabetes management do lose weight

In randomized control trials (RCTs), Trulicity helped the average person lose around 6.6 pounds over 6 months. 

Another study showed that compared to a placebo, Trulicity helped patients achieve lower blood sugar levels, A1C, and weight loss. 

In its clinical trial, study participants with type 2 diabetes experienced a reduced risk of major cardiovascular events such as heart attack, stroke, and even death. 

Trulicity is most effective when combined with a healthy diet, increased physical activity, and as a supplement to any prescribed diabetes medications. 

Why would you be prescribed Trulicity?

You may be prescribed Trulicity if you currently live with type 2 diabetes and are experiencing insulin resistance, or are having trouble managing your blood sugar levels. 

Sometimes people without type 2 diabetes are prescribed Trulicity to help combat insulin resistance, or if they’re having trouble managing their blood sugars with other diabetes medications. 

Due to its effects on cardiovascular health, sometimes people with existing heart disease are prescribed Trulicity. 

Though it is not an FDA-approved weight loss treatment, Trulicity is sometimes prescribed off-label as a weight loss medication for those struggling to maintain or lose weight. 

Never take Trulicity if you are not prescribed Trulicity. 

What are the side effects?

Trulicity may cause adverse side effects. You may notice this especially when you first start taking the medication until your body acclimates to the drug. 

The side effects are usually mild to moderate and may include the following:

  • Nausea 
  • Diarrhea
  • Vomiting
  • Stomach aches and pains
  • Redness and swelling at the injection site
  • Suppressed appetite 
  • Weight loss 
  • Low blood sugar, especially if you’re on insulin therapy

Although rare, more serious adverse side effects may include:

  • Acute pancreatitis
  • Severe allergic reaction
  • Impaired kidney function
  • Medullary thyroid carcinoma (MTC)

Do not take Trulicity if you have a personal or family history of MTC, multiple endocrine neoplasia, or if you are allergic to its active ingredient, dulaglutide. 

Additionally, the FDA released a black box warning about the increased risk of thyroid cancer if you use Trulicity. 

If you have gastroparesis or chronic kidney disease (CKD), talk with your doctor before starting Trulicity, as the medication may make these conditions worsen. 

What are the typical Trulicity doses?

When you are first prescribed Trulicity your doctor will probably want to start you on a low dose to avoid adverse side effects. 

The starting dose for Trulicity is 0.75mg administered once weekly. 

After four weeks, if additional medication is necessary to manage blood sugar levels and you’re not experiencing too many side effects, your doctor may increase your dose to 1.5mg administered once weekly. 

The maximum dose for children is 1.5mg administered once weekly as a maintenance dose. 

Adults may take either 1.5mg, 3mg, or 4.5mg administered once weekly as a maintenance dose. 

Never increase your dose without talking with your doctor first. 

If you do decide to increase your dose, never increase your dose in increments of more than 1.5mg, and only after being at your current dose for at least four weeks. 

What is the maximum weekly dose?

The maximum dose of Trulicity for children is 1.5mg administered weekly. 

The maximum dose of Trulicity for adults is 4.5mg administered weekly. 

People will have different maintenance doses, depending on their health history, health goals, body weight, lifestyle, activity level, and amount of insulin resistance they are experiencing. 

Never take more Trulicity than you are prescribed. 

Talk to your doctor if you’re interested in increasing your dose. 

What happens if you take too much Trulicity?

The maximum dose that you can take of Trulicity per week is 4.5mg. 

Never take two doses within 72 hours of each other, or you may experience severe adverse side effects, including nausea, vomiting, and low blood sugar, which can be fatal if left untreated. 

Symptoms of extremely low blood sugar include: 

  • Dizziness
  • Shakiness 
  • Confusion
  • Rapid heartbeat 
  • Shallow breathing
  • Nervousness
  • Lethargy 
  • Fatigue
  • In extreme cases, unconsciousness and diabetic coma 

Call your doctor or emergency services immediately if you suspect that you’ve overdosed on Trulicity.

Can I miss a dose?

Don’t worry if you miss a dose of Trulicity.  You won’t experience increased insulin resistance, higher blood sugars, or weight gain if you miss a week of the medication. 

However, always try to remember to take your medications on time as they are most effective when taken consistently. 

Schedule an alarm or reminder on your phone so you can ensure that you always take your dose on the same day and at the same time. 

If you’re still within a 3-day window of your missed dose, you can take it. 

However, if you’re 5 or more days from your missed dose, go ahead and skip a week and take your next dose as regularly scheduled. 

How do I inject Trulicity?

Trulicity comes in pen form and is injected subcutaneously (which means under the skin).

 You will inject Trulicity perpendicular to an area of your body that has fatty tissue. Typically good areas include the upper thighs, upper arms, and stomach.

You will clean the area with an alcohol swab beforehand, and always twist a new pen cap on for each dose. 

You’ll dial your weekly dose to your prescribed milligram (mg), pinch an inch of skin, push the needle into your skin, and press the top of the pen to release the medication. 

Keep the pen needle in your skin for about 10 seconds to make sure all of the medication was released. 

Twist the needle off and discard it, throwing it into a sharps container. Wipe any excess medication and/or blood away with another alcohol wipe, and you are done. 

Who shouldn’t take Trulicity?

You should only take Trulicity if you are prescribed Trulicity. Trulicity is not intended for people who are pregnant, planning on becoming pregnant, or breastfeeding. 

It is not recommended for people without diabetes, or those with prediabetes or type 1 diabetes, without the guidance of a physician. 

Do not use Trulicity if you or any of your family members have ever had medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). 

Do not use Trulicity if you are allergic to dulaglutide. If you’re interested in trying a GLP-1 agonist but you’re allergic to dulaglutide, you may opt for Ozempic whose active ingredient is semaglutide. 

If you have chronic kidney disease (CKD) or gastroparesis, talk with your doctor before starting Trulicity, as the medication can make these conditions worse. 

Talk with your doctor if you have questions or concerns about starting Trulicity or if you’ve recently been prescribed the medication. 

How do I stop taking Trulicity?

Never stop taking Trulicity or any of your prescribed medications without talking with your doctor first. 

Your doctor will probably want to wean you off of any medication slowly instead of abruptly stopping your therapy, so you do not experience adverse side effects. 

These side effects may include weight gain, a sharp rise in blood sugar levels, increased A1C, or worsening insulin resistance. 

If you’d like to stop taking Trulicity, call your doctor who can recommend the appropriate next steps. 

Can Trulicity replace insulin?

No. Trulicity and other GLP-1 agonist medications do not take the place of insulin. 

They may, however, reduce your insulin needs over time, but if you are prescribed insulin, Trulicity acts as a supplement to insulin therapy. 

Never stop taking your insulin unless with the close guidance and recommendation of your doctor. 

Can I take Trulicity with other diabetes medications?

This will depend on the medication. Trulicity can be taken with medications such as insulin and/or metformin

However, you should never mix two GLP-1 agonists, or you’ll experience adverse side effects, like serious low blood sugar, nausea, vomiting, and diarrhea. These include medications like Ozempic, Victoza, and Mounjaro

Talk with your doctor if you’re concerned about any contraindications your current diabetes medications may have with your Trulicity; there may be alternatives that they can suggest if there is an issue. 

Does Trulicity need to be refrigerated?

Yes. Trulicity should be stored in the refrigerator between 36°F to 46°F. It can be used for up to 56 days after opening. Never freeze Trulicity or expose it to extreme heat. 

How do I get a prescription for Trulicity?

Talk with your doctor if you want a prescription for Trulicity. You may qualify if you’re struggling with healthy weight maintenance, insulin resistance, and have type 2 diabetes. 

If you have prediabetes or type 1 diabetes and are struggling with insulin resistance, Trulicity may help increase insulin sensitivity. 

If you do not have any form of diabetes and are looking to lose weight, talk with your doctor about FDA-approved weight loss prescription medications that may be safer and more appropriate for you, without the side effects that Trulicity often causes.