In this article:
7/ Trulicity warnings and precautions
10/ The bottom line
GLP-1s may seem like novel inventions, but some of these medications aren’t all that new. Take Trulicity, which was approved to treat type 2 diabetes back in 2014. “We’ve used Trulicity for a very long time,” says Dr. Gitanjali Srivastava, M.D., medical director for obesity medicine at Vanderbilt University Medical Center. And there are good reasons for that. Learn more about what it is, how it works, dosages, side effects, and more.
What is Trulicity?
Trulicity (a brand name for the drug dulaglutide) is a once-weekly injection approved by the FDA in 2014 for people who have type 2 diabetes. It helps lower blood sugar and is meant to be paired with a healthy diet and exercise. Trulicity belongs to a class of medications called GLP-1 receptor agonists, which also includes semaglutide (Ozempic and Wegovy), liraglutide (Victoza and Saxenda), and tirzepatide (Zepbound and Mounjaro).
Trulicity generic
The active medication in Trulicity is dulaglutide and, as of today, there isn’t a generic version available. Eli Lilly, the manufacturer of Trulicity, owns a patent on the medication that is set to expire in 2027, at which point generic versions may become available.
Trulicity uses
“Dulaglutide is an older generation GLP-1 medication,” says Dr. Devika Umashanker, M.D., a bariatric medicine physician with Hartford HealthCare Medical & Surgical Weight Loss in Glastonbury, Connecticut. That doesn’t mean it’s outdated, however. “In medical practice, we don’t necessarily [always] go to the newest medication because there may be more data on older ones,” Umashanker says.
What is Trulicity used for?
Trulicity is a medication that can help lower blood sugar in adults with type 2 diabetes when paired with diet and exercise, bringing down A1c (a way to measure blood sugar over time) by an average of .78% to 1.64%. It may also result in some weight loss: One study found that people with type 2 diabetes taking 4.5 mg of Trulicity lost about 10 pounds over 36 weeks, with those who had higher starting BMIs losing the most weight.
“Some patients do fantastic on dulaglutide for both diabetes and weight loss. Some may not have a robust weight-loss response, so there is variability,” says Srivastana. Although she’s had patients who have lost 50 pounds (or more) on Trulicity, it often does not have the same weight loss effect as the newer GLP-1s semaglutide (Ozempic) or tirzepatide (Mounjaro), she says.
Research in The Lancet also shows that dulaglutide may have a cardioprotective effect, meaning it can reduce the risk of major heart-related events like stroke. That’s important, as those with diabetes are twice as likely to have heart disease or a stroke.
How does Trulicity work?
As a GLP-1 receptor agonist medication, Trulicity works by mimicking the body’s own GLP-1 hormone. This hormone is released in the gut when you eat and stimulates the secretion of insulin and decreases the hormone glucagon, thereby lowering blood sugar. Although the medication has the same impact as your body’s own GLP-1 hormone, it stays in your system much longer, resulting in a greater impact on your blood sugar. The medication also slows gastric emptying (or the speed at which food moves out of your stomach) to help you stay fuller longer and signals to the brain that you’re full. As a result of this reduced hunger, you may eat less food and lose weight.
To maximize the effectiveness of Trulicity, doctors recommend pairing it with a healthy lifestyle. “I tell patients that this medication is a tool. If you’re not eating well or exercising, this medication won’t work for you,” says Umashanker. “You really need lifestyle modifications to make sure you’re using it to its best ability to optimize your health.”
Trulicity dosage
When starting on a Trulicity dosage, your prescriber will start you out on the lowest dose and slowly increase it in order for your body to adapt to the medication and reduce the risk of side effects.
Forms and strengths
Trulicity is available in a single-dose injector pen, which you will use to inject the medicine under your skin once weekly. You can do a self-injection into your upper arm, abdomen, or thigh. The pens come in four different doses:
- 0.75 mg: This is the starting dose, which you stay on for four weeks.
- 1.5 mg: Remain on this for at least 4 weeks before increasing, if needed.
- 3 mg: Remain on this for at least 4 weeks before increasing, if needed.
- 4.5 mg: This is the maximum recommended dose.
You can stay on the lowest dose (0.75 mg) if you’re getting adequate blood glucose control and you’ve reached your A1c target. (A1c is your average blood sugar over about three months.) Otherwise your provider may talk to you about increasing the dose until you find one that helps you get to your goal.
Trulicity side effects
Like other GLP-1 receptor agonist medications, gastrointestinal problems are the most common side effects of Trulicity. Different people react differently to these medications, but talk to your prescribing provider about what side effects you might experience and what to do if they happen to you.
Common side effects
The biggest risk for side effects is when you first start the medication and when you increase your dose. “We anticipate possible nausea and vomiting,” says Srivastana. These can be managed with antacids like Tums or anti-nausea medications like ondansetron (Zofran). And take comfort: “These symptoms do get better over time,” she says.
Here are the most common side effects:
- Nausea
- Vomiting
- Abdominal pain
- Decreased appetite
- Diarrhea
Although these side effects are typically mild, they can be problematic for some people and impact how you feel day-to-day to the point where you want to stop the medication. This is why it’s important to talk openly to your provider. “If a patient says their side effects are so bad that they can’t take the medication anymore, I highly recommend they contact our office,” says Umashanker. Your provider can adjust your dose or they may recommend an alternative medication. You can find more information on possible side effects on Trulicity’s medication guide.
Serious side effects
In rare cases, Trulicity can also cause serious side effects. If you experience any of the below side effects, you should call your provider immediately:
- Allergic reactions: If you have signs of a serious allergic reaction like swelling of your face, lips, tongue, or throat or problems breathing, you should stop taking Trulicity.
- Changes in vision: If you notice blurriness, loss of vision, cloudiness in your vision or any other new problems, talk to your eye care provider. If you have a history of diabetic retinopathy, you may need closer monitoring by your ophthalmologist.
- Gallbladder problems: Signs of cholelithiasis (gallstones) or cholecystitis (gallbladder inflammation) include abdominal pain, fever, jaundice, and clay-colored stools.
- Hypoglycemia: Low blood sugar is more likely to occur if you’re taking Trulicity alongside another glucose-lowering medication, like sulfonylurea or insulin. You should know the signs of hypoglycemia — dizziness, headache, shakiness, blurred vision — and check your blood sugar accordingly. You can bring blood sugar up with 15 grams of fast-acting carbohydrates in the form of glucose tablets or gel, juice, or regular soda.
- Kidney problems: Common side effects like diarrhea or vomiting can cause dehydration, exacerbating pre-existing kidney problems.
- Pancreatitis: Inflammation in your pancreas can cause symptoms like severe abdominal pain that may radiate into your back. This pain may or may not be accompanied by vomiting.
- Severe stomach problems: Abdominal pain or other GI symptoms are common, but they shouldn’t be severe. If you have a history of severe GI disease like gastroparesis (a disorder that affects the movement of food out of your stomach), Trulicity isn’t recommended.
Alternatives to Trulicity
There are multiple medications that can be used to manage blood sugar, and Trulicity may or may not be the best one for you. Alternatives can be prescribed if you aren’t tolerating Trulicity well or if it isn’t getting your A1c levels down to where your provider wants them to be. Other options include:
- Ozempic (semaglutide): A different weekly injectable GLP-1 medication used to treat type 2 diabetes
- Mounjaro (tirzepatide): A weekly injectable medication that mimics two hormones, GLP-1 and GIP, to improve blood sugar levels
- Victoza (liraglutide): A GLP-1 medication given by daily injection instead of weekly
- Rybelsus (semaglutide): An oral semaglutide taken as a daily pill
- Metformin: A medication that decreases your body’s absorption of glucose and improves insulin sensitivity
Trulicity warnings and precautions
Trulicity has what’s known as a “boxed warning” (the strongest kind of warning) that it can potentially cause thyroid c-cell tumors. This is based on studies done on rats that have found dulaglutide causes this specific type of thyroid tumor that leads to medullary thyroid cancer. However, these tumors have not been found in studies on humans. That said, if you have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN 2), you should not take Trulicity.
Something else to note is that if you’re going to have surgery, anesthesia, or deep sedation, Trulicity can increase the risk of food getting into your lungs, a potentially dangerous complication called aspiration. This is because GLP-1 medications delay stomach emptying. Let your surgeon know if you’re on Trulicity prior to your surgery for appropriate planning, which may include skipping a dose of the medication.
Trulicity interactions
Make sure to talk about any medications or supplements you’re taking before starting Trulicity to avoid possibly dangerous interactions. For example, if you’re taking other blood sugar lowering medications alongside Trulicity, it can lead to hypoglycemia. And because dulaglutide slows stomach emptying, it may impact the absorption of some medications, affecting how well they work in the body.
Trulicity cost and coupons
Currently, the list price of Trulicity is $977.42 per month, according to the manufacturer Eli Lilly. That doesn’t mean that you’ll pay that much, though. Your actual cost of Trulicity depends on if you have insurance and what kind it is (through an employer, Medicare, or Medicaid, for example) as well as any co-pay or co-insurance. Contact your insurance provider to learn if Trulicity is covered under your plan and what you can expect to pay.
To get the price down on the medication, look at cost-savings programs like the Trulicity Savings Card (which may reduce the amount you owe to $25 per month) or pharmacy savings cards. Check the eligibility requirements and how they apply to you. You need to have commercial drug insurance that covers Trulicity, as well as a prescription for it. And people who have Medicaid, Medicare, or state prescription drug assistance programs are ineligible.
The bottom line
Trulicity (dulaglutide) is a GLP-1 receptor agonist medication that can help people with type 2 diabetes manage their blood sugar. Some people find that they also lose weight on Trulicity. It comes in four doses, and people start out on the lowest dose and gradually work their way up until they land on a dose that controls their blood sugar. Like other GLP-1s, Trulicity can cause gastrointestinal side effects like nausea and diarrhea. It also has a risk for more serious side effects, so make sure to talk about what to expect with your provider before beginning to take Trulicity.
FAQs
Although Ozempic and Trulicity belong to the same class of medication, GLP-1 receptor agonists, they are not the same medication. Ozempic contains the active ingredient semaglutide and Trulicity contains the active ingredient dulaglutide. These work in similar ways and are both approved for treating type 2 diabetes, but are different compounds.
Trulicity is not a weight-loss medication. It is indicated for the management of type 2 diabetes. However, some people will lose weight when taking Trulicity.
One way Trulicity works is by slowing digestion, which can cause GI-related side effects like decreased appetite and nausea. Avoiding high-fat foods and large meals can help you feel well when taking Trulicity.
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.