Trulicity side effects: What to do about them

Taking Trulicity® can be a game-changer for your health, whether you’re taking it to treat type 2 diabetes or obesity, or both. But side effects can also make it challenging.

It’s important to understand the side effects you may experience while on Trulicity and how to manage them best to ensure you stay safe and healthy. Here’s an in-depth guide to Trulicity’s side effects.

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What is Trulicity? 

Trulicity (dulaglutide) is a diabetes medication that the U.S. Food and Drug Administration (FDA) approved in 2014 to treat type 2 diabetes in adults along with diet and exercise.  Eight years later, in November 2022, the FDA extended its approval for the treatment of type 2 diabetes in children 10 and older.

Trulicity is the brand name for the medication dulaglutide, manufactured by the United States-based pharmaceutical company Eli Lilly. It’s part of the glucagon-like peptide-1 (GLP-1) receptor agonist medication class. As a once-weekly subcutaneous (under-the-skin) injection, dulaglutide helps lower blood sugar levels (A1C) by mimicking the actions of GLP-1, a hormone the body makes naturally. (After eating, GLP-1 is released, prompting the pancreas to secrete insulin.) Trulicity also slows digestion, increasing satiety, which can support weight loss. 

It’s been a game-changer in the treatment of type 2 diabetes, and it’s also shown success in treating excess weight and obesity when prescribed off-label. Even more, it’s one of a number of medications proven to lower the risk of cardiovascular events like heart attacks and stroke in patients with type 2 diabetes who have a history of cardiovascular disease (CVD) or multiple risk factors. 

What are the common side effects of Trulicity?

While Trulicity can help with chronic weight management, like other GLP-1s, there are potential side effects.

Common Trulicity side effects can include:

• Nausea
• Constipation
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Indigestion 
• Injection site reactions
• Dizziness
• Back pain
• Increased lipase or amylase 
• Altered taste
• Nasopharyngitis (common cold)
• Passing gas
• Bloating
• Belching
• Gastroenteritis
• Decreased appetite 
• Fatigue
• Gastroesophageal reflux disease
• Upset stomach

How long do Trulicity side effects last?

In clinical trials, nausea was the most common side effect, typically subsiding two weeks after starting Trulicity. Other common side effects typically lasted a couple of weeks and gradually decreased. It’s important to note that patients experienced some common side effects with each dose increase while their bodies adjusted to the higher dose. This may be the case for you as well.

If you have side effects lasting longer than a few days to a couple of weeks or are severe and unmanageable, talk to your health care provider immediately about what you can do. 

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Tips for how to deal with the Trulicity side effects

Dealing with side effects can be challenging, and it’s important to talk to your Found-affiliated provider if you have any. If you do experience side effects, here are some things you can do to help manage them as your body adjusts to the med. 

To manage side effects, Eli Lilly suggests trying these things to help:

• Eat smaller meals. Try splitting your three daily meals into four or more smaller ones.
• Stop eating when you feel full.
• Avoid fat or fatty foods.
• Eat bland foods like toast, crackers, or rice.

What happens if you miss a dose of Trulicity? 

Don’t worry; if you miss a dose of Trulicity, you can take the missed dose as soon as you remember, as long as it’s at least three days (72 hours) before your next scheduled injection. If you remember you missed your dose less than three days before your next dose, skip the missed dose and take your next dose on your regularly scheduled day. Do not take two doses of Trulicity within three days of one another. 

Take Trulicity on the same day each week. If your previous dose was more than three days prior, you can change the day of your injection. 

Are there long-term Trulicity side effects? 

Trulicity has been on the market for nearly a decade and had years of rigorous testing before the FDA approved it. Dulaglutide underwent clinical trials in which scientists evaluated its long-term side effects. For most trial participants, there were no long-term side effects. Your health care provider can determine if Trulicity is a long-term and  sustainable weight management tool for you. Prescriptions are up to a medical provider’s discretion.

Are there more serious Trulicity side effects? 

While the chances of a severe reaction to Trulicity are rare, it’s important to understand its potentially life-threatening side effects. While on Trulicity, you may be at an increased risk for the following:

• Inflamed pancreas (pancreatitis)
• Serious allergic reactions
• Acute kidney injury
• Severe stomach problems
• Changes in vision
• Gallbladder problems
• Low blood sugar (hypoglycemia) when used  with an insulin secretagogue (e.g., sulfonylurea) or insulin

Trulicity warnings

Please contact your doctor ASAP and seek in-person care immediately if a side effect becomes problematic or you experience:

• Severe nausea and/or vomiting resulting in dehydration. It’s important to stay well-hydrated and drink plenty of fluids while on this medication.
  
  
• Kidney problems or kidney failure. Vomiting, nausea, and diarrhea can cause dehydration and kidney issues and worsen kidney problems in individuals who have pre-existing kidney conditions. (It may sometimes lead to the need for hemodialysis.)
  
  
• Thyroid C-cell tumor. Symptoms may include trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath. (See black box warning below.)
  
  
• Pancreatitis. Severe pain in your abdomen or back that will not go away.
  
  
• Acute gallbladder disease. Symptoms can include pain in the middle or right upper stomach, fever, jaundice (white parts of the eyes or skin turn yellow), nausea or vomiting. (If gallstones or gallbladder inflammation are suspected, further examination is needed.)
  
  
• Severe stomach problems that won’t go away. These include abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting. These may be symptoms of gastroparesis (stomach paralysis).
  
  
• Hepatitis, elevated liver enzymes, or jaundice.
  
  
• Diabetic retinopathy problems. It may cause changes in vision in those with type 2 diabetes, and vision problems may worsen in those with a history of diabetic retinopathy.
  
  
• Severe gastrointestinal disease. It may cause gastrointestinal disease; do not use it if you have a history of severe gastrointestinal disease.
  
  
• Signs of low blood sugar which may include dizziness, weakness, shakiness, jitteriness, headache, anxiety/mood changes, rapid heartbeat, confusion, slurred speech, sweating, or lightheadedness. (If you have these symptoms, have something with 15-20 grams of sugar. Drinking juice or regular soda, or eating some hard candies right away, can help raise your blood sugar quickly.) While this is rare with GLP-1s, if it occurs, please seek in-person care immediately. Before taking dulaglutide with insulin or an insulin secretagogue (e.g., sulfonylurea), talk to your health care provider about possibly lowering the dose of these medications to lower the risk of hypoglycemia.
  
  
• Increasing heart rate.
  
  
• Worsening depression, behavior changes, or suicidality.

Those with type 1 diabetes shouldn’t use Trulicity.

If you are going under general anesthesia or deep sedation, GLP-1s like Trulicity may make you accidentally breathe food or liquid into your lungs (pulmonary aspiration). Tell the providers who will be performing the procedure that you’re taking a GLP-1 so they can give you instructions to avoid this.

Trulicity also comes with a Black Box Warning. (The FDA requires a drug to carry this warning when it may have serious safety risks that can be potentially fatal, life-threatening, or cause permanent harm.) The Black Box warning for Trulicity says it may cause thyroid tumors, including c-cell tumors.

If you have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), you should not use Trulicity. In animal studies, GLP-1s have caused thyroid tumors, including thyroid cancer; it is yet to be determined if dulaglutide will cause thyroid tumors or cancer in humans. Do not take this medication if you’ve ever had medullary thyroid cancer. Please notify your doctor as soon as possible if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath. 

If you experience a medical emergency, call 911 or go to the nearest emergency room.

Tell your health care provider about your medical history before taking Trulicity.

Avoid alcohol while taking this medication. If you’re taking diabetes medications, please discuss this with your prescribing doctor before starting Trulicity, as your diabetes medications may need to be adjusted as you lose weight.

Use effective contraception while taking Trulicity. Do not take this medication if you are pregnant, trying to get pregnant, or breastfeeding. If you plan to become pregnant, stop this medication at least two months before trying as it may cause fetal harm.

Notify your doctor if you have kidney, liver, or pancreas problems.

Stop using Trulicity and call your health care provider immediately if you have severe stomach or abdomen pain that will not go away, with or without vomiting.

Serious hypersensitivity reactions (e.g., anaphylaxis and angioedema) have been reported. Discontinue Trulicity if this is suspected and promptly seek medical advice if you have any symptoms of a severe allergic reaction. Symptoms may include swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat.

Are there any Trulicity drug interactions?

Trulicity may be taken with other diabetes medications like metformin. Always tell your health care professional about any other meds you currently take, whether over-the-counter supplements or prescription drugs, as there may be risk factors or possible side effects when used with Trulicity. 

Trulicity can interact with alcohol and certain prescription and non-prescription medications and herbal products. When using Trulicity, the risk of hypoglycemia increases if combined with insulin or insulin secretagogues, such as sulfonylureas. Trulicity delays gastric emptying, which can impact the absorption of oral medications. If you are on a thyroid hormone drug, please review the timing of your thyroid medication with your prescribing provider before starting Trulicity—they may need to adjust your dose. You should closely monitor drug levels of medications with narrow therapeutic windows (e.g., warfarin) while on Trulicity. 

Please consult the pharmaceutical packaging for a complete list of side effects, warnings, interactions, and additional information. 

Working with a care provider to manage Trulicity side effects  

In the end, talking to your health care team about how you’re feeling is one of the most important things on your weight care journey. They’ll have up-to-date drug information and can let you know whether what you’re experiencing is typical for those on Trulicity. Also, let them know about your medical conditions and concerns before starting Trulicity.

While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a provider’s evaluation of your medical history, MetabolicPrint™, and lab work. If a GLP-1 is not appropriate for you, a provider will work with you to determine an effective medication for your health profile.

About Found

Found is among the largest medically supported telehealth weight care clinics in the country, having served more than 250,000 members to date. To discover your MetabolicPrint and start your journey with Found, take our quiz.

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