Trulicity, a once-weekly injectable medication made by Eli Lilly, is used to control blood sugar levels in people with type 2 diabetes.
It was first approved by the Food and Drug Administration in 2014 and may help manage blood sugar levels, improve HbA1c levels, increase insulin sensitivity, and help with weight loss.
In this article you will find everything you need to know about taking Trulicity, its benefits and side effects.
What is Trulicity?
Trulicity is a branded prescription drug for people with type 2 diabetes, prescribed for blood sugar control, HbA1C and weight loss.
It may also help prevent stroke, heart attack and premature death in people with type 2 diabetes and pre-existing heart disease. It is only available by injection and is taken once a week.
It belongs to the class of drugs that are glucagon-like peptide-1 (GLP-1) receptor agonists and its active ingredient is dulaglutide.
It is usually used in combination with insulin and other diabetes medications.
How does Trulicity work?
Trulicity attaches to specific receptors on pancreatic cells. This signals the pancreas to release more insulin, naturally lowering blood sugar.
Trulicity also inhibits glucagon production in the liver, preventing blood sugar spikes after meals, which improves insulin sensitivity.
Finally, it slows down digestion, which leads to appetite suppression and weight loss.
By lowering blood sugar and HbA1C levels over time, Trulicity reduces the risk of heart attack, stroke and premature death.
What are the benefits of taking Trulicity?
There are many advantages to using Trulicity. Patients using Trulicity to treat diabetes lose weight.
In randomized controlled trials (RCTs), Trulicity helped the average person lose about 6.6 pounds in 6 months.
Another study showed that, compared to a placebo, Trulicity helped patients achieve lower blood sugar, HbA1c, and weight loss.
In a clinical trial, study participants with type 2 diabetes experienced a reduced risk of major cardiovascular events such as heart attack, stroke, and even death.
Trulicity is most effective when combined with a healthy diet, increased physical activity, and in addition to any prescribed diabetes medication.
Why would you prescribe Trulicity?
You can prescribe Trulicity if you currently have type 2 diabetes and experience insulin resistance or have problems controlling your blood sugar.
Sometimes people without type 2 diabetes are prescribed Trulicity to help fight insulin resistance or if they are having trouble controlling their blood sugar with other diabetes medications.
Due to its effects on cardiovascular health, Trulicity is sometimes prescribed to people with existing heart conditions.
While not an FDA-approved weight loss treatment, Trulicity is sometimes prescribed off-label as a weight loss drug for those struggling to maintain or lose weight.
Never take Trulicity unless you have been prescribed Trulicity.
What are the side effects?
Trulicity may cause side effects. You may notice this especially when you start taking the drug until your body acclimatizes to the drug.
Side effects are usually mild to moderate and may include:
- Stomach pains
- Redness and swelling at the injection site
- Suppressed appetite
- Weight loss
- Low blood sugar, especially if you are on insulin therapy
Although rare, more serious side effects may include:
- Acute pancreatitis
- A severe allergic reaction
- Impaired kidney function
- Medullary thyroid cancer (MTC)
You should not take Trulicity if you or a family member have a history of MTC, multiple endocrine neoplasia, or if you are allergic to the active ingredient dulaglutide.
Additionally, the FDA has issued a black box warning regarding the increased risk of thyroid cancer with Trulicity.
If you have gastroparesis or chronic kidney disease (CKD), talk to your doctor before starting Trulicity, as the drug may make these conditions worse.
What are typical doses of Trulicity?
When you are first prescribed Trulicity, your doctor will probably want to start you on a low dose to avoid side effects.
The starting dose of Trulicity is 0.75 mg once a week.
After four weeks, if additional medication is needed to control blood sugar levels and there are not too many side effects, the doctor may increase the dose to 1.5 mg once a week.
The maximum dose for children is 1.5 mg once a week as a maintenance dose.
Adults can take 1.5 mg, 3 mg or 4.5 mg once a week as a maintenance dose.
Never increase the dose without consulting your doctor first.
If you decide to increase your dose, never increase your dose by more than 1.5mg and only after you have been on your current dose for at least four weeks.
What is the maximum weekly dose?
The maximum dose of Trulicity for children is 1.5 mg once a week.
The maximum dose of Trulicity for adults is 4.5 mg once a week.
People will receive different maintenance doses depending on their health history, health goals, weight, lifestyle, activity level, and the degree of insulin resistance they experience.
Never take more Trulicity than prescribed.
Talk to your doctor if you are interested in increasing your dose.
What happens if you take too much Trulicity?
The maximum dose of Trulicity that can be taken in a week is 4.5 mg.
Two doses should never be taken within 72 hours of each other as serious side effects can occur including nausea, vomiting and low blood sugar which can be fatal if left untreated.
Symptoms of extremely low blood sugar include:
- Fast heartbeat
- Shallow breathing
- In extreme cases, loss of consciousness and diabetic coma
If you suspect you have overdosed on Trulicity, contact your doctor or emergency room immediately.
Can I skip a dose?
Don’t worry if you miss a dose of Trulicity. You won’t experience increased insulin resistance, higher blood sugar, or weight gain if you miss a week of medication.
However, always try to remember to take your medications on time as they are most effective when taken consistently.
Schedule an alarm or reminder on your phone to make sure you always take your dose on the same day and at the same time.
If you are still within the 3-day window from the missed dose, you can take it.
However, if it has been 5 or more days since the missed dose, skip the week and take your next dose as scheduled.
How to inject Trulicity?
Trulicity comes as a pen and is injected subcutaneously (meaning subcutaneously).
Trulicity should be injected perpendicular to the area of the body where there is fatty tissue. Typically, good areas include the thighs, arms, and abdomen.
Beforehand, clean the area with an alcohol swab and always put a new pen cap on before each dose.
You’ll set your weekly dose to the prescribed milligram (mg), pinch an inch of skin, push the needle into the skin, and press the top of the pen to release the medication.
Keep the pen needle under your skin for about 10 seconds to make sure all of the medicine is released.
Unscrew the needle and dispose of it in a sharps container. Wipe off excess medication and/or blood with another alcohol swab and you’re done.
Who shouldn’t take Trulicity?
You should only take Trulicity if you have been prescribed Trulicity. Trulicity is not intended for use by women who are pregnant, planning to become pregnant or are breastfeeding.
Not recommended for people without diabetes or with pre-diabetes or type 1 diabetes without medical advice.
Do not use Trulicity if you or any member of your family have ever had medullary thyroid cancer (MTC) or if you have multiple endocrine adenomatosis type 2 (MEN 2).
Do not use Trulicity if you are allergic to dulaglutide. If you are interested in trying a GLP-1 agonist but are allergic to dulaglutide, you can choose Ozempic, which has semaglutide as its active ingredient.
If you have chronic kidney disease (CKD) or gastroparesis, talk to your doctor before starting Trulicity, as the drug may make these conditions worse.
Talk to your doctor if you have questions or concerns about starting Trulicity or if you have recently been prescribed medication.
How to stop using Trulicity?
Never stop taking Trulicity or any of your prescribed medications without consulting your doctor first.
Your doctor will probably want to wean you off any medications slowly, rather than stopping treatment suddenly, so you won’t experience unwanted side effects.
These side effects may include weight gain, a sharp rise in blood sugar, an increase in HbA1C or worsening of insulin resistance.
If you want to stop taking Trulicity, contact your doctor who can recommend appropriate next steps.
Can Trulicity replace insulin?
NO. Trulicity and other GLP-1 agonists are not a substitute for insulin.
However, they may reduce the need for insulin over time, but if you are prescribed insulin, Trulicity works in addition to your insulin therapy.
Never stop taking your insulin unless under close supervision and on the advice of your doctor.
Can I take Trulicity with other diabetes medications?
This will depend on the drug. Trulicity can be taken with medicines such as insulin and/or metformin.
However, two GLP-1 agonists should never be mixed as there will be undesirable side effects such as severe low blood sugar, nausea, vomiting and diarrhea. These include drugs such as Ozempic, Victoza, and Mounjaro.
Talk to your doctor if you are concerned about any contraindications your current diabetes medications may have with Trulicity; there may be alternatives that can suggest if there is a problem.
Should Trulicity be refrigerated?
Yes. Trulicity should be stored in a refrigerator between 36°F and 46°F. It can be used up to 56 days after opening. Never freeze Trulicity or expose it to extreme temperatures.
How do I get a prescription for Trulicity?
Talk to your doctor if you want a prescription for Trulicity. You may qualify if you struggle with maintaining a healthy weight, are insulin resistant, and have type 2 diabetes.
If you have prediabetes or type 1 diabetes and struggle with insulin resistance, Trulicity can help increase your insulin sensitivity.
If you don’t have any form of diabetes and want to lose weight, talk to your doctor about FDA-approved weight loss prescription medications that may be safer and more appropriate for you without the side effects that Trulicity often causes.