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Trulicity (Dulaglutide) - Subcutaneous

What Is Trulicity? Trulicity (dulaglutide) is a prescription drug injected subcutaneously (under the skin). Trulicity is used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes. It can also be used to

  • Posted on 03rd May, 2022 11:40 AM
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Trulicity (Dulaglutide) - Subcutaneous Image

What Is Trulicity?

Trulicity (dulaglutide) is a prescription drug injected subcutaneously (under the skin). Trulicity is used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes. It can also be used to lower the risk of major heart events, such as cardiovascular death, heart attack, or stroke, in adults with type 2 diabetes who have heart disease or risk factors for heart disease.

Trulicity is available as an injection pen. It is injected under the skin of the abdomen, thigh, or upper arm. It should never be given by an intravenous (into a vein) or intramuscular (into a muscle) injection.

Trulicity is in a drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. It works by helping the pancreas release insulin to decrease blood sugar levels. Insulin helps move sugar out of the blood into other tissues, where it can be used for energy. Trulicity also decreases sugar production and slows food movement through the stomach.

Drug Facts

Generic Name: Dulaglutide

Brand Name(s): Trulicity

Drug Availability: Prescription

Therapeutic Classification: Antidiabetic

Available Generically: No

Controlled Substance: N/A

Administration Route: Subcutaneous (under the skin) injection

Active Ingredient: Dulaglutide

Dosage Form(s): Injection pen (solution)

What Is Trulicity Used For?

The Food and Drug Administration (FDA) approved Trulicity to:

  • Improve blood sugar control (in combination with diet and exercise) in adults with type 2 diabetes.
  • Lower the risk of major heart events, such as cardiovascular death, stroke, and heart attack, in adults with type 2 diabetes who have heart disease or risk factors for heart disease.

Trulicity has not been studied in people who have a history of pancreatitis (inflammation of the pancreas) or severe gastrointestinal disease, including severe gastroparesis (a condition where the stomach does not properly empty). A different medication should be used for these conditions. Trulicity also should not be used to treat type 1 diabetes.

How to Take Trulicity

If you are prescribed Trulicity, read the prescription label and the information leaflet that comes with your prescription. A healthcare provider will train you to inject Trulicity. Use Trulicity exactly as directed by your healthcare provider, and do not skip doses.

When taking Trulicity:

  • Inject Trulicity once every week on the same day every week. For example, if you inject Trulicity on Friday, you will inject Trulicity every Friday. You can inject Trulicity at any time of day, as long as you inject it on the same day each week.
  • If needed, you can change the day of the week as long as three or more days have passed since the last injection. Do not take two doses of Trulicity within three days of each other.
  • Inject Trulicity under the skin of the stomach, thigh, or upper arm.
  • Do not use the same site to inject each dose of Trulicity. Change your site every week.
  • You can take Trulicity with or without food.
  • Do not mix Trulicity with insulin in the same injection. You can inject Trulicity and insulin (as two different injections) in the same body area, such as your thigh, but not right next to each other.
  • Discard the needle safely in a sharps container after use. Always use a new needle for each injection. Do not share the pen or any needles.

Ask your healthcare provider if you have any questions or concerns.

Storage

Store the Trulicity pen in the refrigerator, but make sure you do not freeze the medication. If the pen has been frozen, discard the pen and get a new pen. You can store the open at room temperature for up to 14 days. Keep the pen in the original carton, away from direct heat and light. The Trulicity pen has glass parts. If you drop the pen on a hard surface, do not use it. Use a new pen. Keep Trulicity out of reach and out of sight of children.

How Long Does Trulicity Take to Work?

A single dose of Trulicity reaches its maximum levels in one to three days. It may take four or five weeks until you see a change in blood sugar levels. It may take longer to see the full benefits. Your healthcare provider will likely check your hemoglobin A1C (which measures blood sugar control over three months) at the three-month and six-month mark.

What Are the Side Effects of Trulicity?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Trulicity can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

The most common side effects of Trulicity are:

  • Stomach problems: Nausea, vomiting, diarrhea, stomach pain, indigestion
  • Decreased appetite
  • Tiredness
  • Tachycardia (fast heart rate)
  • Increased amylase and lipase (digestive enzymes) levels
  • AV block (abnormally slow heart conduction)

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing. These symptoms require emergency medical attention. 
  • Pancreatitis (inflammation of the pancreas): Symptoms may include severe, persistent stomach pain, which may spread to the back, with or without vomiting.
  • Hypoglycemia (low blood sugar): Symptoms of low blood sugar can include dizziness, confusion, shaking, blurred vision, headache, irritability, hunger, and weakness. The risk of low blood sugar may be higher if you take Trulicity with other medications that can cause hypoglycemia, such as insulin or certain diabetes medications.
  • Kidney problems or kidney failure: Symptoms of kidney problems may include little or no urination, swelling of the feet or ankles, tiredness, or shortness of breath. In people who already have kidney problems, the stomach side effects of Trulicity (e.g., nausea, vomiting, and diarrhea) can cause dehydration, which can worsen kidney problems. Tell your healthcare provider if you are sick with vomiting or diarrhea so you can be monitored for dehydration.
  • Severe stomach problems
  • Changes in vision: Report any vision changes to your healthcare provider.
  • Thyroid tumor: Symptoms may include a lump or swollen area on the neck, difficulty swallowing, hoarseness, or shortness of breath.

Long-Term Side Effects

While many people tolerate Trulicity well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Appetite loss
  • Reflux (indigestion) 

Moderate long-term side effects can include: 

Severe long-term side effects may include:

  • Pancreatitis
  • Kidney failure
  • New malignancy (cancer)

Report Side Effects

Trulicity may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Trulicity Should I Take?

Drug Content Provided and Reviewed byIBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For diabetes mellitus:
      • Adults—At first, 0.75 milligram (mg) injected under the skin once a week. Your doctor may increase your dose as needed and until your blood sugar is controlled. However, dose is usually not more than 4.5 mg once a week.
      • Children—Use is not recommended.

Modifications

Treatment with this medication may need to be used with caution or modified in some cases, such as:

  • Kidney problems: People with kidney issues taking Trulicity may need close monitoring.
  • Liver problems: There is limited data on Trulicity's use in people with liver problems.
  • Gastroparesis (delayed gastric emptying): Trulicity delays gastric emptying and has not been studied in people with this condition.
  • Pregnancy: Trulicity may harm the fetus. People who are pregnant or planning to become pregnant should consult their healthcare provider.
  • Breastfeeding: There is no data on using Trulicity while nursing. Consult with your healthcare provider.

Missed Dose

If you miss a dose of Trulicity, inject it as soon as possible if there are at least three days until the next dose. If there are less than three days until the next dose, skip the missed dose and inject the next dose on the regular day. Consult your healthcare provider if you have questions or are unsure about resuming your Trulicity dose.

Overdose: What Happens If I Take Too Much Trulicity?

Taking too much Trulicity can cause nausea, vomiting, and low blood sugar.

What Happens If I Overdose on Trulicity?

If you think you or someone else may have overdosed on Trulicity, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Trulicity, call 911 immediately.

911
Drug Content Provided and Reviewed byIBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

It is very important to carefully follow any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are using dulaglutide unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, diabetic patients may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur during pregnancy in patients with diabetes.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
  • In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

Check with your doctor right away if you have a mass in the neck, difficulty with swallowing, hoarseness, or trouble breathing. These may be symptoms of a serious thyroid problem.

Pancreatitis may occur while you are using this medicine. Tell your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips or tongue, skin rash, trouble breathing, unusual tiredness or weakness, or large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs.

This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use dulaglutide with other medicines that can lower blood sugar, including insulin, metformin, or a sulfonylurea. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.

  • Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
  • If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms, including seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

  • Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, stomachache, nausea, or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, or unusual thirst.
  • If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

Check with your doctor right away if you have any changes to your eyes, such as blurred vision or vision changes while you are using this medicine. Your doctor may want you to have your eyes checked by an eye doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Trulicity?

Trulicity is not appropriate for everyone. You should not take this medication if you are allergic to dulaglutide or any of the inactive ingredients in Trulicity. Other reasons you should not take Trulicity include:

Trulicity may be prescribed with caution in some people, only if the healthcare provider determines it is safe. This includes people with:

  • Risk of pancreatitis
  • Severe gastrointestinal disease
  • Gastroparesis
  • Kidney or liver problems
  • History of diabetic retinopathy (a complication of diabetes that affects the eyes)

Also, people who are taking medication that can harm the kidneys must use Trulicity with caution.

What Other Medications Interact With Trulicity?

Tell your healthcare provider about your medicines, including prescription and over-the-counter (OTC) medicines and vitamins or supplements.

Taking Trulicity and insulin or certain oral diabetes medications can increase the risk of low blood sugar. A dosage adjustment may be required. Examples of oral diabetes medications that may be affected include:

  • Amaryl (glimepiride)
  • Glucotrol (glipizide)
  • Micronase (glyburide)
  • Prandin (repaglinide)
  • Starlix (nateglinide)

Trulicity causes delayed gastric emptying and may potentially affect the absorption of any medications taken by mouth at the same time, especially drugs with a narrow therapeutic index. A narrow therapeutic index means a slight difference between a drug being effective and potentially toxic. Examples of narrow therapeutic index drugs include Lanoxin (digoxin) and Dilantin (phenytoin). Ask your healthcare provider how you should time your medications to avoid absorption issues. 

Other drug interactions may occur with Trulicity. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Trulicity is in a class of medications called GLP-1 receptor agonists. Trulicity contains the ingredient dulaglutide. Other injectable drugs in the GLP-1 receptor agonist class of drugs include:

  • Adlyxin (lixisenatide)
  • Bydureon (exenatide)
  • Byetta (exenatide)
  • Ozempic (semaglutide)
  • Saxenda (liraglutide): Indicated for weight loss
  • Victoza (liraglutide)
  • Wegovy (semaglutide): Indicated for weight loss

Rybelsus is an oral GLP-1 receptor agonist. Rybelsus contains the ingredient semaglutide. It is used to improve blood sugar control in adults with type 2 diabetes.  

Other oral medicines are available to help with blood sugar control in adults with type 2 diabetes, including:

  • DPP-4 inhibitors (e.g., Januvia (sitagliptin), Onglyza (saxagliptin), Tradjenta (linagliptin))
  • Glinides (e.g., Prandin (repaglinide), Starlix (nateglinide))
  • Glucophage (metformin)
  • SGLT2 inhibitors (e.g., Invokana (canagliflozin), Farxiga (dapagliflozin), Jardiance (empagliflozin))
  • Sulfonylureas (e.g., Glucotrol (glipizide), Glynase (glyburide), Amaryl (glimepiride))
  • Thiazolidinedione (e.g., Actos (pioglitazone))

Some people who have type 2 diabetes may need injectable insulin to help with blood sugar control. There are several types of long-acting insulin and short-acting insulin.

This list is a list of drugs also prescribed for type 2 diabetes. It is NOT a list of drugs recommended to take with Trulicity. Ask your pharmacist or a healthcare practitioner if you have questions.

Frequently Asked Questions

  • What is Trulicity used for?

    Trulicity is used in combination with diet and exercise to improve blood sugar control in adults with type 2 diabetes. It can also be used to lower the risk of cardiovascular death, stroke, and heart attack, in adults with type 2 diabetes who also have heart disease or risk factors for heart disease.

  • How does Trulicity work?

    Trulicity helps the pancreas release insulin, which lowers blood sugar. Trulicity also decreases sugar production and slows the movement of food through the stomach.

  • What drugs should not be taken with Trulicity?

    Trulicity may interact with insulin or certain other drugs that lower blood sugar. This does not mean that these medications must be avoided, but a dose adjustment may be required. Some drugs may require specific timing in dosing, especially drugs with a narrow therapeutic index, such as Dilantin (phenytoin) or Lanoxin (digoxin). Before taking Trulicity, tell your healthcare provider about all of the medications you take, including prescription and OTC drugs, vitamins, and supplements.

  • How long does it take for Trulicity to work?

    It may take four or five weeks until you see an improvement in blood sugar levels, and may take longer to see the full benefits of Trulicity. Your healthcare provider can check your hemoglobin A1C level, which measures blood sugar control over three months, at the three-month and six-month mark (and regularly after that).

  • What are the side effects of Trulicity?

    Common side effects include stomach problems, such as stomach pain, nausea, vomiting, diarrhea, and indigestion. Other common side effects include appetite loss, fatigue, fast heart rate, and increased levels of digestive enzymes.

  • How do I stop taking Trulicity?

    Your healthcare provider will advise you on how long to take Trulicity. Do not stop taking Trulicity without guidance from your healthcare provider.

How Can I Stay Healthy While Taking Trulicity?

Before you take Trulicity, read the patient information that comes with your prescription. Consult your healthcare provider if you have any questions or concerns.

If you have never given yourself an injection, it can seem scary at first. Your healthcare provider will teach you how to administer Trulicity. If possible, bring along a family member or a close friend for support and a second set of eyes and ears. 

When it is time for a dose, especially at first, give yourself ample time to prepare and administer the injection so you don't feel rushed. Once you get past the first injection, it becomes easier, and after you do it a few times, it will become routine. 

Prepare a kit with supplies that you take with you everywhere you go. Include:

  • Blood glucose meter and extra testing supplies (strips, lancing device, lancets, alcohol wipes, extra batteries for the meter)
  • Emergency contact information
  • Glucagon (an injection or nasal Baqsimi)
  • Low blood sugar treatments, such as glucose tablets, Smarties, and juice boxes 

Wear a medical alert, such as a bracelet or necklace that will communicate to responders that you have type 2 diabetes in an emergency.

Trulicity should be used in combination with diet and exercise. Ask your healthcare provider what kind of diet and exercise plan you should follow and if you should consult a registered dietician. You may want to inquire if your healthcare provider’s office has a certified diabetes care and education specialist (CDCES) who can train you on how to use your meter and answer questions and concerns about condition.

Ask your healthcare provider how often to monitor your blood sugar and treat it when it gets too low. A prescription for glucagon, which can be used in emergency low blood sugar situations, may be suitable. Glucagon is available in injection form as well as a nasal spray. Show your loved ones how to use it in case of emergency.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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