Thinking about Trulicity to manage your blood sugar? You’re probably wondering how it’ll make you feel — especially since GLP-1 medications like Trulicity are linked to side effects such as nausea and digestive discomfort. Are they really something you need to worry about? Read on for everything you need to know about Trulicity side effects and if this medication may be right for you.
What is Trulicity?
Trulicity is a brand name of the drug dulaglutide. It is a once-weekly injection that helps manage blood sugar in adults and children 10 and older with type 2 diabetes. It can also lower the risk of serious heart problems, like heart attacks and strokes, and may support weight loss. It’s part of the same family of medications as Ozempic (semaglutide) and Victoza (liraglutide): glucagon-like peptide-1 receptor agonists, or GLP-1 drugs. These medications work by mimicking a natural hormone in the body that helps the pancreas release insulin when you eat, keeping your blood sugar in check. They also slow down digestion, making you feel fuller for longer.
Common side effects of Trulicity
In clinical studies, nausea ranked as the top side effect after a starting dose of 0.75 mg weekly. Here are some of the other most common side effects and how often they occurred (find a full list of Trulicity side effects in the medication’s prescribing information):
- Nausea (Occurs in 12.4% of patients, compared to 5.3% placebo)
- Diarrhea (Occurs in 8.9% of patients, compared to 6.7% placebo)
- Abdominal pain (Occurs in 6.5% of patients, compared to 4.9% placebo)
- Vomiting (Occurs in 6% of patients, compared to 2.3% placebo)
- Fatigue (Occurs in 4.2% of patients, compared to 2.6% placebo)
- Indigestion (Occurs in 4.1% of patients, compared to 2.3% placebo)
The reason most of these are gastrointestinal in nature is due to how GLP-1 drugs work. “[Trulicity’s] mechanism involves slowing down gastric emptying, which can lead to abdominal fullness and discomfort, manifesting as nausea and vomiting,” explains Dr. Olubunmi Oladunjoye, M.D., diplomat of the American Board of Obesity Medicine and Assistant Professor at Baylor College of Medicine in Texas.
Certain people may be more prone to these side effects than others. “Studies suggest that individuals with a history of gastrointestinal diseases, such as gastroparesis [an abnormal slowdown of stomach emptying], are more likely to experience these side effects,” says Oladunjoye. “Additionally, higher doses of dulaglutide are linked to an increased incidence of gastrointestinal symptoms.” It’s something to keep in mind when discussing Trulicity dosage levels with your doctor.
Mild side effects of Trulicity
While Trulicity is generally well tolerated, you might experience a few mild side effects along the way. If any of the following pop up, always keep your doctor in the loop, especially if they stick around or worsen. Your doctor may be able to help mitigate these side effects or maybe find a better treatment option.
- Acid reflux
- Belching
- Constipation or diarrhea
- Decreased appetite
- Fatigue
- Gas
- Nausea or vomiting
Serious side effects of Trulicity
Although serious side effects are rare, it’s important to know about them, especially if you have a medical history that might put you at higher risk for them. Here’s what to watch out for:
- Pancreatitis (inflammation of the pancreas)
- Hypoglycemia (low blood sugar)
- Kidney problems
- Increased risk of thyroid cancer
- Acute gallbladder disease (conditions affecting the gallbladder, which aids in digestion)
Explanation of Trulicity side effects
Here’s a deeper dive into some of Trulicity’s side effects — get familiar with them so you know what to watch for.
Thyroid cancer risk
Like other GLP-1s, Trulicity has a black box warning — a serious warning issued by the FDA on prescription drug labels — for thyroid cancer. This is because early clinical studies in rodents showed that dulaglutide caused an increase in the incidence of thyroid C-Cell tumors known as medullary thyroid cancer, explains Oladunjoye. Higher doses and longer durations of treatment led to a greater incidence of tumors in rodents. While there is no confirmed link between the dulaglutide and thyroid cancer in humans, Trulicity should not be used by patients who have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN 2). Be sure to inform your doctor if this applies to you.
Tips for managing or identifying thyroid cancer
In addition to knowing your family medical history, it’s important to stay alert to any symptoms that could point to thyroid issues. Be aware of signs like a lump in your neck, difficulty swallowing, shortness of breath, or persistent hoarseness. If you notice any of these, consult with your doctor right away.
Pancreatitis
Although rare, pancreatitis is a serious potential side effect of Trulicity. This condition occurs when the pancreas — an organ responsible for producing digestive enzymes and regulating blood sugar — becomes inflamed. Common causes include severe alcohol abuse and gallstones in the gallbladder, but pancreatitis has also been reported in clinical trials with Trulicity.
GLP-1 agonists, like Trulicity, influence pancreatic function by stimulating insulin production when blood sugar is high, which helps lower blood sugar. “Because GLP-1 is [naturally] present in the pancreas, its activation may increase pancreatic enzyme activity, potentially leading to pancreatitis,” Oladunjoye says.
If you have a history of pancreatitis, let your doctor know before starting Trulicity. Also, be aware of warning signs, such as severe, persistent abdominal pain that may radiate to your back, with or without nausea or vomiting. “If pancreatitis is suspected, it is crucial to discontinue Trulicity immediately and seek medical attention,” Oladunjoye advises.
Tips for managing pancreatitis
Treatment options can vary depending on the severity of your condition, like whether you’re experiencing acute (sudden) or chronic (long-term) pancreatitis. If you have a mild case, management can include IV fluids, pain relief, and a clear liquid or low-fat diet. For those experiencing more severe cases, treatment may require hospitalization, fasting, a feeding tube, or surgery. To reduce the risk, it's important to avoid triggers like heavy alcohol use and smoking. Always consult your doctor to determine the best approach for your specific condition.
Gallbladder disease
A systematic review found that GLP-1s are associated with an increased risk of gallbladder issues, especially when taken at higher doses or for longer periods, explains Oladunjoye. Gallbladder diseases, such as gallstones (hardened deposits of bile) and cholecystitis (inflammation of the gallbladder), have been reported in some patients taking Trulicity. (This may be related to the weight loss associated with medication.) If you experience symptoms like pain in your upper right abdomen, nausea, vomiting, fever, yellowing of the skin or eyes (jaundice), or clay-colored stools, be sure to contact your doctor right away.
Tips for managing gallbladder disease
If you notice any of the above symptoms, it's important to reach out to your doctor right away. Managing gallbladder disease depends on factors like your age, overall health, and the severity of the condition. Treatment for mild cases may involve monitoring symptoms and making dietary adjustments. In more severe cases, your doctor might recommend gallbladder removal (cholecystectomy) to prevent further complications.
Hypoglycemia
Trulicity can raise the risk of low blood sugar, also called hypoglycemia. "They don't do it very commonly, but when combined with insulin or sulfonylureas, a type 2 diabetes medication, the indicence of low blood sugar is higher," says Dr. Lydia Alexander, M.D., president of the Obesity Medicine Association. Hypoglycemia happens when your blood sugar drops too low (below 70 mg/dL). Watch for signs like dizziness, confusion, sweating, a fast heartbeat, or shakiness.
Tips for managing low blood sugar
Experiencing low blood sugar? Follow the “15-15 rule,” according to the American Diabetes Association. That means eat 15 grams of fast-acting carbohydrates (like glucose tablets or juice), then wait 15 minutes and check your blood sugar again. If your levels are still low, repeat the process again until your numbers are back to over 70 mg/dL. Talk to your doctor about ways to keep your blood sugar levels in check and, if necessary, adjust your medication dosage to help stay on track.
The bottom line
Before taking Trulicity, make sure to go over your medical history and any medications you’re currently taking to help your doctor determine if Trulicity is the right fit for you. Like many GLP-1 receptor agonists, Trulicity can cause mild side effects such as nausea, vomiting, and diarrhea. This is because the medication slows down gastric emptying, meaning food stays in the stomach longer. Though uncommon, be mindful of any serious side effects such as pancreatitis, thyroid issues, or gallbladder problems, and alert your provider should any symptoms arise. "It's important to contact your primary care physician as soon as you're having side effects so you can get ahead of it," says Alexander.
FAQs
Nausea is the most common side effect of Trulicity. During clinical studies, 8% to 29% of patients experienced this just days after their first dose. This was especially prevalent after increasing dosage. You can help manage the nausea by sticking to smaller, frequent meals, avoiding high-fat foods that take longer to digest, and opting for bland foods (toast, rice, crackers) that are gentler on your stomach.
In clinical studies, nausea usually kicked in within two to three days of the first dose and often improved within two weeks. Some people continued to experience it beyond that, especially with dosage increases, but less than 2% of users stopped taking Trulicity because of their side effects.
"Consuming sugary foods and drinks while taking Trulicity would be counterproductive as this can lead to blood sugar spikes, countering the medication's intended effects,” says Oladunjoye. “It can also potentiate gastrointestinal side effects such as nausea and vomiting.”
This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.