Note: This document contains side effect information about dulaglutide. Some dosage forms listed on this page may not apply to the brand name Trulicity.
Trulicity Side Effects
Medically reviewed by Philip Thornton, DipPharm. Last updated on Dec 7, 2022.
Note: This document contains side effect information about dulaglutide. Some dosage forms listed on this page may not apply to the brand name Trulicity.
Summary
Common side effects of Trulicity include: diarrhea, frequent bowel movements, nausea, and retching. Other side effects include: abdominal distress, abdominal pain, abdominal tenderness, asthenia, dyspepsia, fatigue, gastrointestinal pain, lower abdominal pain, upper abdominal pain, decreased appetite, and malaise. Continue reading for a comprehensive list of adverse effects.
Applies to dulaglutide: subcutaneous solution.
Warning
Subcutaneous route (Solution)
In male and female rats, dulaglutide caused a dose-related and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors (adenomas and carcinomas) after lifetime exposure. It is unknown whether dulaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of dulaglutide-induced rodent thyroid C-cell tumors has not been determined. Dulaglutide is contraindicated in patients with a personal or family history of MTC and in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with use of dulaglutide and inform them of symptoms of thyroid tumors (eg, mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with dulaglutide.
Serious side effects of Trulicity
Along with its needed effects, dulaglutide (the active ingredient contained in Trulicity) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking dulaglutide:
Less common
- Gaseous stomach pain
- indigestion
- severe nausea or vomiting
- stomach pain or fullness
- yellow eyes or skin
Incidence not known
- Agitation
- change in urination
- chest tightness
- chills
- clay-colored stools
- cold sweats
- confusion
- cool, pale skin
- cough
- decreased urine output
- depression
- diarrhea
- difficulty with breathing or swallowing
- dizziness
- dry mouth
- fainting
- fast heartbeat
- fever
- headache
- hives, itching, skin rash
- hoarseness
- hostility
- increased hunger
- irritability
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
- lethargy
- lightheadedness
- loss of appetite
- lump in the neck
- muscle twitching
- pains in the stomach, side, or abdomen, possibly radiating to the back
- rapid weight gain
- reddening of the skin, especially around the ears
- seizures
- severe constipation
- shakiness
- slurred speech
- sunken eyes
- swelling of the eyes or inside of the nose
- swelling of the face, ankles, or hands
- trouble breathing
- unpleasant breath odor
- unusual tiredness or weakness
- vomiting of blood
- wrinkled skin
Other side effects of Trulicity
Some side effects of dulaglutide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
- Acid or sour stomach
- belching
- bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- decreased appetite
- general feeling of discomfort or illness
- heartburn
- lack or loss of strength
- stomach discomfort, upset, or pain
For Healthcare Professionals
Applies to dulaglutide: subcutaneous solution.
General
The most common adverse reactions included nausea, diarrhea, vomiting, abdominal pain, and decreased appetite. [Ref]
Gastrointestinal
During clinical trials, a greater number of pancreatitis related adverse reactions were reported in patients exposed to this drug versus non-incretin comparators (12 cases vs 3 cases). Analyses of adjudicated events revealed 5 cases of confirmed pancreatitis in dulaglutide-exposed patients compared with 1 case in the non-incretin comparator group.
Gastrointestinal events occurred more frequently with the higher dose. Cases were graded as mild, moderate, or severe in 58% and 48%, 35% and 43%, and 7% and 11%, of patients receiving the 0.75 mg dose and the 1.5 mg dose, respectively. The severity of events was graded by clinical trial investigators. [Ref]
Very common (10% or more): Nausea (up to 21.1%), diarrhea (up to 13.7%), vomiting (up to 11.5%)
Common (1% to 10%): Abdominal pain, dyspepsia, constipation, flatulence, abdominal distention, gastroesophageal reflux disease, eructation, lipase and/or pancreatic amylase increases from baseline (up to 20%)
Frequency not reported: Pancreatitis [Ref]
Hypersensitivity
Uncommon (0.1% to 1%): Systemic hypersensitivity including severe urticaria, systemic rash, facial edema, lip swelling
Postmarketing reports: Anaphylactic reactions, angioedema [Ref]
Oncologic
Very rare (less than 0.01%): Medullary Thyroid Carcinoma [Ref]
One case of Medullary Thyroid Carcinoma (MTC) has been reported in a patient treated with this drug. Prior to receiving treatment, this patient had calcitonin levels approximately 8 times the upper limit of normal. [Ref]
Metabolic
Hypoglycemia occurred more frequently when this drug was used in combination with a sulfonylurea or insulin. In combination with prandial insulin, hypoglycemia occurred in 85% and 80% of patients receiving 0.75 mg and 1.5 mg; severe hypoglycemia in 2.4% and 3.4% of patients, respectively. In combination with a sulfonylurea, symptomatic hypoglycemia occurred in 39% and 40%. As add-on therapy to metformin or metformin plus pioglitazone, symptomatic hypoglycemia occurred in up to 5.6% of patients, with no reports of severe hypoglycemia. [Ref]
Very common (10% or more): Hypoglycemia (up to 85% when combined with prandial insulin)
Common (1% to 10%): Decreased appetite [Ref]
Cardiovascular
During clinical trials, a mean increase in heart rate of 2 to 4 beats per minute was observed. Sinus tachycardia was reported in 2.8% and 5.6% of patients receiving 0.75 mg and 1.5 mg of dulaglutide (the active ingredient contained in Trulicity) compared with 3% in placebo. Persistent sinus tachycardia defined as occurring at more than 2 visits was reported in 0.4%, 1.6%, and 0.2% of patients receiving dulaglutide 0.75 mg, 1.5 mg, or placebo. Episodes of sinus tachycardia associated with an increase of 15 or more beats per minute from baseline occurred in 1.3%, 2.2%, and 0.7% of patients, respectively.
During clinical trials, a 2 to 3 millisecond mean increase from baseline in PR interval was observed in dulaglutide-treated patients compared to a mean decrease of 0.9 milliseconds in placebo-treated patients. AV block occurred more frequently compared with placebo (0.9%, 1.7% and 2.3% for placebo, 0.75 mg and 1.5 mg, respectively). On electrocardiograms, a PR interval increase to at least 220 milliseconds was observed in 0.7%, 2.5% and 3.2% of patients treated with placebo, 0.75 mg, 1.5 mg, respectively. [Ref]
Common (1% to 10%): First degree AV block, sinus tachycardia, PR prolongation on ECG
Frequency not reported: Increased heart rate [Ref]
Renal
Postmarketing reports: Increased serum creatinine, acute renal failure or worsening of chronic renal failure (sometimes requiring hemodialysis)
Immunologic
In clinical studies 1.6% (n=64) of patients developed anti-drug antibodies (ADAs). Half of the patients had dulaglutide-neutralizing antibodies and half developed antibodies against native GLP-1. [Ref]
Common (1% to 10%): Anti-drug antibodies [Ref]
Local
Common (1% to 10%): Injection site reactions [Ref]
Other
Frequently asked questions
- Does Trulicity cause weight loss?
- Does Trulicity need to be refrigerated?
- How do you use/inject Trulicity?
- Can Trulicity be used with insulin?
- Can Trulicity be injected cold?
- How does Trulicity work?
- Is Trulicity a form of insulin?
- Does dulaglutide cause weight loss?
- What is dulaglutide used for and how does it work?
Trulicity
Medically reviewed by Sanjai Sinha, MD. Last updated on Oct 24, 2022.
What is Trulicity?
Trulicity is an injectable diabetes medicine that helps control blood sugar levels.
Trulicity is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.
Trulicity is also used to help reduce the risk of serious heart problems such as heart attack or stroke in adults who have type 2 diabetes and heart disease.
Trulicity is not for treating type 1 diabetes.
Warnings
You should not use Trulicity if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer). Do not use this medicine if you are in a state of diabetic ketoacidosis (call your doctor for treatment).
In animal studies, Trulicity caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.
Call your doctor at once if you have signs of a thyroid tumor, such as swelling or a lump in your neck, trouble swallowing, a hoarse voice, or shortness of breath.
Related/similar drugs
Before taking this medicine
You should not use Trulicity if you are allergic to dulaglutide, or if you have:
- multiple endocrine neoplasia type 2 (tumors in your glands);
- a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or
- diabetic ketoacidosis (call your doctor for treatment).
Tell your doctor if you have ever had:
- pancreatitis;
- a stomach or intestinal disorder;
- gastroesophageal reflux disease (GERD) or slow digestion;
- eye problems caused by diabetes (retinopathy);
- liver or kidney disease;
- if you also use insulin or oral diabetes medicine; or
- if you have been sick with vomiting or diarrhea.
In animal studies, Trulicity caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.
It is not known whether dulaglutide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Trulicity is not approved for use by anyone younger than 18 years old.
How should I use Trulicity?
Use Trulicity exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Trulicity is injected under the skin once per week. Use this medicine on the same day each week at the same time of day. If you change your dosing day, allow at least 3 days to pass between doses.
You may use this medicine with or without food.
Read and carefully follow any Instructions for Use provided with your medicine. Do not use Trulicity if you don’t understand all instructions for proper use. Ask your doctor or pharmacist if you do not understand these instructions.
Your healthcare provider will show you where on your body to inject Trulicity. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).
Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.
Each injection pen or prefilled syringe is for one use only. Throw away after one use, even if there is still medicine left inside. Use a puncture-proof “sharps” container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.
Store Trulicity Pens in the refrigerator, protected from light. Do not use past the expiration date on the medicine label. Do not freeze this medicine, and throw away the medicine if it has become frozen.
You may also store Trulicity Pens at room temperature for up to 14 days before use.
Dosing information
Usual Adult Dose for Diabetes Type 2:
Initial dose: 0.75 mg subcutaneously once a week
-Dose may be increased in 1.5 mg increments for additional glycemic control; patients should remain on 3 mg once a week dose for at least 4 weeks prior to increasing dose to 4.5 mg once a week
Maintenance dose: 0.75 to 4.5 mg subcutaneously once a week
Maximum dose: 4.5 mg weekly
Uses:
-As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
-To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.
Usual Adult Dose for Cardiovascular Risk Reduction:
Initial dose: 0.75 mg subcutaneously once a week
-Dose may be increased in 1.5 mg increments for additional glycemic control; patients should remain on 3 mg once a week dose for at least 4 weeks prior to increasing dose to 4.5 mg once a week
Maintenance dose: 0.75 to 4.5 mg subcutaneously once a week
Maximum dose: 4.5 mg weekly
Uses:
-As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
-To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.
What happens if I miss a dose?
Use the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 3 days. Do not use two doses at one time.
Do not use Trulicity twice within a 72-hour period.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using Trulicity?
Never share an injection pen or prefilled syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.
Trulicity side effects
Stop using Trulicity and get emergency medical help if you have signs of an allergic reaction to Trulicity: hives; difficult breathing; feeling light-headed; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- pancreatitis – severe pain in your upper stomach spreading to your back, nausea and vomiting;
- signs of a thyroid tumor – swelling or a lump in your neck, trouble swallowing, a hoarse voice, or if you feel short of breath;
- low blood sugar – headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or
- kidney problems – little or no urination, swelling in your feet or ankles, feeling tired or short of breath.
Tell your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while using this medicine and this can lead to kidney failure.
Common Trulicity side effects may include:
- nausea, vomiting, stomach pain;
- diarrhea; or
- loss of appetite.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Trulicity?
Trulicity can slow your digestion, and it may take longer for your body to absorb any medicines you take by mouth.
Other drugs may interact with dulaglutide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
Popular FAQ
Trulicity is not a weight loss drug, but some people may lose weight. People lost, on average, two to six pounds while taking Trulicity. However, 15 to 30% gained weight. Continue reading
Trulicity should be stored in a refrigerator until you need to use it.
You can leave Trulicity out of a refrigerator for up to 14 days and still use it. Continue reading
To use the Trulicity Pen remove the cap of the pen and hold the pen straight up and down on the skin before pushing the green injection button. You should hear a click, followed by a second click, 10 to 15 seconds later once the injection has finished.
Trulicity is injected under the skin once a week into the thigh, stomach area, or upper arm. Continue reading
Trulicity can be used with insulin, but because the combination of Trulicity and insulin increases the risk of low blood sugar levels (hypoglycemia), the dosage of insulin may need to be reduced.
Continue reading
Trulicity may be injected straight out of the fridge (while it is still cold) but it is more likely to sting. Allow Trulicity at least 30 minutes to warm up to room temperature first so that it is less likely to sting. Continue reading
Trulicity mimics the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. It binds to GLP-1 receptors, stimulating insulin secretion and lowering glucagon secretion from the liver. It also slows stomach emptying.
Continue reading
Trulicity is not a form of insulin, it mimics the effects of GLP-1 a naturally occurring hormone that stimulates insulin secretion. Trulicity is only suitable for people with type 2 diabetes who still have functioning insulin-producing cells in their pancreas.
Continue reading
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Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Trulicity only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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