Trulicity, made simple.
Trulicity is a once a week shot for type 2 diabetes. The needle is hidden, the pen does the work for you, and you only use it one day a week. This guide explains what Trulicity does, how to use the pen, what to expect in the first few weeks, and what to watch for. A Mississippi pharmacist who fills Trulicity every day wrote it for you.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Trulicity is and why your doctor gave it to you
Trulicity is a medicine for type 2 diabetes. Its other name is dulaglutide. It is the same medicine. It is given as a shot you take once a week.
Doctors give it for two main reasons.
- To lower blood sugar. Trulicity helps your body manage blood sugar after meals. It is used along with healthy eating and activity, not instead of them.
- To protect the heart. For people with type 2 diabetes who have heart disease or risk factors for it, Trulicity also lowers the risk of a heart attack or stroke.
The simple version: Trulicity is a once a week shot that helps your body keep blood sugar in a better range, and for many people it also protects the heart. Most people also feel less hungry on it, which is part of how it works.
How Trulicity works
After you eat, your gut releases a natural hormone that tells your body what to do with the food. It tells the pancreas to release insulin, tells the liver to slow down, and tells the brain you are full.
Trulicity copies that natural hormone.
Because of that, your body handles blood sugar better after meals, and you tend to feel full sooner and eat a little less. Here is a reassuring part: Trulicity mostly works when your blood sugar is high. When your sugar is normal, it backs off. That is why Trulicity by itself rarely causes dangerously low blood sugar.
Your dose, and using the pen
Trulicity comes in a pen that you use once a week. Your doctor picks your dose and your pharmacist checks it. Most people start at a lower dose and may move up later, because going slow helps your stomach adjust.
The pen is designed to be easy. The needle is hidden, so you do not have to see it. You press the pen against your skin and it does the injection for you. You can inject into the belly, the thigh, or the upper arm. Pick a different spot each week so the skin has time to recover. Do not inject into skin that is bruised, sore, hard, or red.
This is important: before your very first shot, have someone show you how to use the pen. Ask your pharmacist. At Fairview we will walk you through it in person, step by step, until you feel sure. It only takes a few minutes and it makes the whole thing easier. Your doctor and your pharmacist decide your dose. This page will not tell you what dose to take.
Timing, and what to do if you miss a dose
Trulicity is taken once a week, on the same day each week. Pick a day that is easy to remember. You can take it any time of day, with or without food.
Some people pick a day and time when a little stomach upset would be easiest to handle, since that is most common early on.
If you miss a dose:
- If your next scheduled dose is still at least 3 days away, take the missed dose as soon as you remember.
- If your next dose is less than 3 days away, skip the missed dose and take the next one on your regular day.
- Never take two doses within 3 days of each other.
- If you are not sure, call your pharmacist. We will help you sort out the timing.
Side effects, what is normal and what is not
Normal, especially in the first few weeks.
- Feeling a little sick to your stomach, called nausea. This is the most common side effect.
- Loose stools, or some stomach upset.
- Less appetite. You feel full sooner. This is part of how the medicine works.
- These usually settle down after the first few weeks, as your body adjusts.
Call your doctor if you see:
- Bad stomach pain that will not go away, especially pain that spreads to your back. This needs to be checked.
- Vomiting or loose stools so bad that you cannot keep fluids down, or you stop urinating much. That can dehydrate you.
- A lump in your neck, trouble swallowing, or a hoarse voice that does not go away.
- Changes in your eyesight.
- Shakiness, sweating, or confusion, which can be low blood sugar, more likely if you also take insulin or another diabetes pill.
Go to the emergency room right away if:
- You have swelling of the face, lips, tongue, or throat, or trouble breathing. This can be a serious allergic reaction.
- You have severe low blood sugar that you cannot treat yourself, or that makes you pass out.
What to be careful with
Trulicity slows down how fast your stomach empties. That is part of how it helps you. But it also means some other medicines you swallow can be absorbed a little differently while you are on it.
For most medicines this does not cause a problem. It matters more for a few medicines that need to stay in a tight range, like the blood thinner warfarin, thyroid medicine, and a few others. If you take one of those, your doctor may want to check your levels a little more closely.
The simple rule: before you start or stop any medicine, a prescription, an over the counter pill, or a supplement, tell your pharmacist you take Trulicity. Every single time.
One more thing to know. Trulicity carries a warning about a rare type of thyroid tumor that was seen in animal studies. Because of that, Trulicity should not be used by people who have had a certain thyroid cancer called medullary thyroid carcinoma, or a rare condition called MEN 2. Tell your doctor about any family history of thyroid cancer before you start. This is a question worth asking, not a reason to be afraid of the medicine.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Trulicity does not need a special blood test of its own, but good diabetes care means a few things get checked along the way.
Your doctor should check, now and then:
- Your blood sugar and your A1C, which shows your average sugar over time.
- How well your kidneys work, especially if you have had a lot of vomiting or loose stools.
- Your eyes, if you already have diabetic eye disease.
- Any signs of stomach problems that do not settle.
Your pharmacist should, now and then:
- Make sure you are using the pen correctly.
- Check your other medicines for anything affected by slower stomach emptying.
- Remind you about low blood sugar risk if you also take insulin or a sulfonylurea.
- Ask how the early stomach side effects are going.
At Fairview, we keep an eye on our Trulicity patients. If a refill is late, we call you. If the early side effects are rough, we can talk you through them so you do not give up on a medicine that is helping you.
Special situations
Storing your pens.
Keep Trulicity in the refrigerator. Do not freeze it. If a pen freezes, do not use it. If you need to, a pen can stay at room temperature for up to 14 days total, but no longer. Keep pens in the original box, away from light, until you use them.
Before surgery.
There is no fixed rule that you must stop Trulicity before surgery, but because it slows the stomach, the anesthesia team should know you take it. Tell your surgeon and the anesthesia team that you are on Trulicity, also called dulaglutide, well before any procedure that uses anesthesia.
Travel.
Trulicity needs to stay cool, so use a small insulated bag with a cold pack when you travel, and keep it in your carry on, never a checked bag. Bring extra pens in case of delays. Carry a list of your medicines and Fairview's phone number.
Pregnancy and breastfeeding.
Trulicity is generally not the choice during pregnancy, and blood sugar in pregnancy is usually managed a different way. If you are pregnant, planning to become pregnant, or breastfeeding, tell your doctor so your diabetes care can be planned safely.
Older adults.
Trulicity can be used by older adults with no change in dose. The main thing to watch is that stomach side effects, if they are strong, can lead to dehydration, and that is harder on older bodies. Staying ahead of fluids and checking in with the pharmacy helps.
How Fairview helps Trulicity patients
When you fill Trulicity at Fairview, here is what you get. This is normal care for us, not something extra.
At your first fill:
- We show you how to use the pen, in person, until you feel sure.
- We tell you what to expect in the first few weeks.
- We check all your other medicines against Trulicity.
- We make sure you know how to store your pens.
At every refill:
- We ask how you are feeling on it.
- We check your file for any new medicines.
- We check that you are refilling on time.
On our own, without being asked:
- If a refill is late, we call you.
- If we see a problem, we call your doctor.
- If there is important news about Trulicity, we tell you.
- We check your cost at every fill to make sure you are paying the best price for your plan.
Questions people ask about Trulicity
No. Trulicity is a once a week shot. You take it on the same day each week. You can take it any time of day, with or without food.
Related guides
Have a question about your Trulicity? Ask a pharmacist who knows it well.
A once a week shot can feel strange at first, and the early stomach upset makes some people want to quit. You do not have to figure it out alone. If something made you wonder, ask us. And if you want a pharmacy that shows every Trulicity patient how to use the pen and checks in on how it is going, Fairview is here. Moving your prescription to us takes one phone call.