Key takeaways:
Trulicity (dulaglutide) is a once-weekly injection for managing Type 2 diabetes. It’s known to cause gastrointestinal side effects, especially when you start treatment.
Common Trulicity side effects include nausea, diarrhea, and stomach pain. Indigestion and fatigue are also possible. Many of these side effects may improve as your body gets used to the medication.
Serious side effects — such as pancreatitis, gallbladder disease, and kidney damage — have been linked to medications such as Trulicity. While rare, they require medical attention.
Many Trulicity side effects can be managed at home with dietary and lifestyle adjustments. But more serious side effects may require changing your dose, stopping Trulicity, or getting emergency medical care.
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Trulicity (dulaglutide) is a once-weekly injection used to manage Type 2 diabetes. It offers benefits such as improving blood glucose (sugar) levels and lowering the risk of serious cardiovascular events. But it can also cause side effects, especially when you start treatment.
Side effects, such as nausea and diarrhea, are common complaints with Trulicity. Oftentimes, they can be managed with changes to your diet and may improve over time. But other side effects can be more serious and require immediate medical care.
When you’re starting Trulicity, your prescriber will slowly increase your dose over time. This can help your body adjust and lessen side effects. Still, you may encounter a number of side effects while taking your medication. Here’s what you should know.
Trulicity side effects at a glance
Many people who use Trulicity are able to tolerate the medication. Common side effects tend to be mild for them and either resolve on their own or can be managed at home. But rare and potentially serious side effects might need medical attention.
Mild or common Trulicity side effects in clinical trials have included:
Nausea and vomiting
Diarrhea
Stomach pain
Decreased appetite
Indigestion
Fatigue
Weight loss
Rare but potentially serious Trulicity side effects may include:
Low blood glucose
Gallbladder disease
Kidney damage
Pancreatitis
Trulicity also has a boxed warning, which is the FDA’s strongest medication warning. This is because animal studies showed an increased risk of thyroid C-cell tumors with Trulicity. And while rare, severe allergic reactions (including anaphylaxis) are also possible.
So, how long do Trulicity side effects last? For many people, gastrointestinal (GI) side effects, such as nausea and vomiting, improve over time as their bodies adjust to the medication. But adjustments such as dietary and lifestyle changes can help in the meantime.
Below, we’ll get into more detail about 11 notable Trulicity side effects, as well as some frequently asked questions.
1. Nausea and vomiting
Nausea is the most common Trulicity side effect. About 1 out of every 5 people receiving it during clinical trials reported nausea. Vomiting was slightly less common. You may be more likely to experience these side effects when starting Trulicity and as your dose is increased.
How they compare: Trulicity belongs to a medication class called glucagon-like peptide-1 (GLP-1) receptor agonists. Here’s how the various GLP-1 receptor agonists compare.
Ozempic vs. Trulicity: Compare two common GLP-1 agonists used to treat Type 2 diabetes.
Trulicity for weight loss: Learn more about how and why Trulicity causes weight loss in people using the medication.
Here are a few tips to lessen nausea and vomiting from Trulicity:
Eat smaller, more frequent meals to avoid overloading your stomach.
Stop eating when you start to feel full.
Avoid high-fat, greasy, or spicy foods, which can worsen symptoms.
Try a home remedy, such as consuming food or drinks made with ginger.
Stay upright for at least 30 minutes after eating.
Talk to your prescriber about extending the time between your dose increases, if necessary.
For many people, nausea and vomiting subside over time. But sometimes your symptoms may not go away, or they could be severe. Let your prescriber know if this is the case. They may need to lower your Trulicity dose or switch you to a different medication.
2. Diarrhea
Diarrhea is another common Trulicity side effect. While it’s less common, Trulicity can also cause constipation. And some people may even experience both. As with nausea and vomiting, diarrhea should improve over time.
Here are a few tips for managing diarrhea from Trulicity:
Stay hydrated by drinking water or electrolyte drinks to help replace the fluids you’ve lost.
Avoid or cut back on foods and drinks that can worsen diarrhea, such as sugar substitutes, dairy products, and fatty foods.
Eat smaller, more frequent meals to reduce the load on your digestive system.
Persistent or severe diarrhea can cause you to become dehydrated. And while this is uncommon, it can potentially lead to kidney issues. Tell your healthcare team right away if your diarrhea doesn’t improve or gets worse. They may lower your dose or change your medication.
3. Stomach pain
Stomach pain is another potential GI side effect of Trulicity. Stomach pain is a broad term that can mean many things, including discomfort and tenderness.
If you’re experiencing stomach pain from Trulicity, here are a few tips to help manage it:
Eat smaller meals, and stop eating when you start feeling full.
Choose foods that are lower in fat.
Avoid carbonated drinks, which can increase bloating.
Slowly add more fiber into your diet, especially if your stomach pain is from constipation.
Try an over-the-counter (OTC) anti-gas remedy or an enzyme such as alpha galactosidase (Beano) if your stomach pain is associated with bloating.
Severe or persistent stomach pain could indicate a more serious issue, such as pancreatitis (inflamed pancreas) or gallbladder problems. Seek immediate medical attention if your pain is intense or accompanied by fever or jaundice (yellowing of the skin or eyes).
4. Decreased appetite
You may notice a decrease in your appetite after starting Trulicity. This may be due to its effects on your digestive tract and the areas of your brain that regulate appetite. As a result, some people lose weight during treatment. In fact, weight loss from Trulicity may be one of the reasons your healthcare team prescribed it for you.
Here are a few tips for managing appetite changes from Trulicity:
Adjust your portion sizes to match your reduced appetite, which can lessen nausea and stomach upset.
Ensure you’re still meeting your nutritional needs with balanced meals.
Check your blood glucose regularly to ensure it’s not dropping too low from eating less.
Talk to your prescriber if you’re concerned about appetite changes from Trulicity. If nausea and vomiting are affecting your appetite, keep in mind that this should improve over time. But if not, your healthcare team can determine the best next steps.
5. Indigestion
People taking Trulicity have also reported indigestion. If this happens for you, you may experience a burning sensation or pain in your upper abdomen. And you may get full too fast when eating and also feel uncomfortable afterward.
The same tips for managing nausea, such as eating smaller meals and stopping when you’re starting to get full, can apply to indigestion. It’s also a good idea to avoid or limit alcohol and caffeine. Talk to your prescriber if your symptoms aren’t improving.
6. Fatigue
Fatigue is also possible while using Trulicity. You may have low energy and feel tired. This may be related to eating fewer calories, as well as Trulicity’s impact on your blood glucose levels.
If you’re feeling fatigued from Trulicity, here are a few tips to boost your energy levels:
Ensure you’re eating nutrient-dense, energy-boosting foods.
Stay hydrated by drinking enough fluids throughout the day.
Prioritize getting enough sleep every night.
Incorporate more movement into your routine.
Avoid energy drinks, since the temporary energy boost can be followed by a crash.
Check your blood glucose levels to ensure they’re not dropping too low.
Talk to your prescriber if your fatigue is persistent or severe.
7. Low blood glucose
Trulicity doesn’t usually cause low blood glucose (hypoglycemia) on its own. This is because it stimulates insulin release primarily when you eat.
But if you combine Trulicity with other diabetes medications, your risk of hypoglycemia goes up. This is more likely if you use insulin or insulin-releasing medications, such as sulfonylureas or glinides. To manage this risk, your prescriber may lower your insulin, sulfonylurea, or glinide dose when you start Trulicity.
To manage the risk of hypoglycemia from Trulicity, here are a few tips:
Regularly monitor your blood glucose levels.
Always carry a fast-acting sugar source, such as glucose tablets, to treat hypoglycemia quickly.
Fuel up properly before and after working out.
Limit your alcohol intake.
If your blood glucose drops too low, you may notice symptoms such as shakiness, sweating, and a fast heartbeat. Tell your healthcare team if you have frequent or severe episodes of low blood glucose. Further adjustments may be needed.
8. Gallbladder disease
While uncommon, Trulicity has been linked to gallbladder disease in some people. This can include gallstones and gallbladder inflammation (cholecystitis). Watch for the following symptoms, which may indicate a gallbladder problem:
Severe abdominal pain (especially in the upper-right side)
Nausea and vomiting
Fever
Jaundice
If left untreated, cholecystitis can be life-threatening. So, be sure to tell your healthcare team right away if these symptoms develop. They’ll want to do some tests to determine the cause.
9. Kidney damage
Research suggests that Trulicity may have some kidney benefits. But some cases of acute (sudden) kidney damage have also been reported.
Most commonly, kidney damage appears to happen in people experiencing severe nausea, vomiting, and diarrhea from Trulicity. These side effects can result in dehydration, which can lead to kidney damage or worsen existing kidney problems.
To avoid dehydration from Trulicity, drink enough water throughout the day. This is especially necessary if you’re losing fluids from diarrhea or vomiting. Tell your healthcare team right away if these side effects are persistent or severe. And if you already have kidney problems, they may want to monitor you more closely during treatment.
10. Pancreatitis
While rare, pancreatitis has been reported in some people using Trulicity. If you develop pancreatitis, you’ll likely need to be treated in a hospital. Symptoms to watch for include:
Severe abdominal pain that won’t go away
Nausea and vomiting
Jaundice
If these symptoms develop, get immediate medical attention. Tell your healthcare team if you have a history of pancreatitis before starting Trulicity. They may recommend a different treatment.
11. Thyroid tumors
As mentioned above, Trulicity has a boxed warning for its potential for thyroid C-cell tumors. This is due to studies showing an increased risk of these tumors in animals exposed to Trulicity. However, it’s not clear if the same risk applies to people.
But because of this risk, certain people shouldn’t use Trulicity. These include people with a personal or family history of medullary thyroid carcinoma and those with multiple endocrine neoplasia Type 2.
Tell your healthcare team if you notice a lump in your neck or other symptoms of thyroid cancer. These can include trouble swallowing, shortness of breath, or a persistent hoarse voice.
Frequently asked questions
You don’t need to avoid specific foods entirely when taking Trulicity. But you may find that certain foods and drinks worsen its side effects and impact your blood glucose levels. Foods that may have this potential include:
Spicy foods, such as jalapeños, hot sauce, and certain salsas
High-fat foods, such as fried foods and full-fat dairy products
Processed meats, such as bacon, sausage, and deli meat
Refined carbohydrates, such as white bread and sweetened cereals
Sugary foods and drinks, such as baked goods and regular soda
Alcoholic beverages
No. Trulicity isn’t known to cause dumping syndrome, which occurs when food empties too quickly from the stomach into the intestines, often following certain surgeries. Dumping syndrome can cause symptoms that are similar to Trulicity side effects, such as nausea and vomiting, diarrhea, and belching.
As mentioned above, weight loss is a possible “side effect” of Trulicity. The amount of weight loss isn’t the same for everyone — it depends on several factors. Your starting body mass index (BMI), dose of Trulicity, and how long you take it can make a difference.
In one of the key clinical trials of Trulicity, people taking the 4.5 mg dose lost about 10 lbs, on average, over 9 months. Those taking the 3 mg dose lost about 9 lbs, and those taking the 1.5 mg dose lost about 7 lbs. Typically, the higher your dose of Trulicity and the longer you take it, the more weight you may lose.
Possibly. While uncommon, Trulicity has been linked to certain long-term side effects, such as pancreatitis and gallbladder disease. And animal studies have shown an increased risk of thyroid C-cell tumors. But it’s not clear if Trulicity actually causes these side effects. Researchers are still learning about how Trulicity may affect the GI tract, thyroid, and organs.
You don’t need to avoid specific foods entirely when taking Trulicity. But you may find that certain foods and drinks worsen its side effects and impact your blood glucose levels. Foods that may have this potential include:
Spicy foods, such as jalapeños, hot sauce, and certain salsas
High-fat foods, such as fried foods and full-fat dairy products
Processed meats, such as bacon, sausage, and deli meat
Refined carbohydrates, such as white bread and sweetened cereals
Sugary foods and drinks, such as baked goods and regular soda
Alcoholic beverages
No. Trulicity isn’t known to cause dumping syndrome, which occurs when food empties too quickly from the stomach into the intestines, often following certain surgeries. Dumping syndrome can cause symptoms that are similar to Trulicity side effects, such as nausea and vomiting, diarrhea, and belching.
As mentioned above, weight loss is a possible “side effect” of Trulicity. The amount of weight loss isn’t the same for everyone — it depends on several factors. Your starting body mass index (BMI), dose of Trulicity, and how long you take it can make a difference.
In one of the key clinical trials of Trulicity, people taking the 4.5 mg dose lost about 10 lbs, on average, over 9 months. Those taking the 3 mg dose lost about 9 lbs, and those taking the 1.5 mg dose lost about 7 lbs. Typically, the higher your dose of Trulicity and the longer you take it, the more weight you may lose.
Possibly. While uncommon, Trulicity has been linked to certain long-term side effects, such as pancreatitis and gallbladder disease. And animal studies have shown an increased risk of thyroid C-cell tumors. But it’s not clear if Trulicity actually causes these side effects. Researchers are still learning about how Trulicity may affect the GI tract, thyroid, and organs.
The bottom line
Common Trulicity (dulaglutide) side effects include nausea, diarrhea, and stomach pain. Fatigue, decreased appetite, and indigestion have also been reported. Severe side effects, such as pancreatitis or gallbladder disease, are rare — but possible.
If you’re concerned about Trulicity side effects, make sure to check with your healthcare team. They can help you prevent or manage these side effects.
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References
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Frias, J. P., et al. (2021). Efficacy and safety of dulaglutide 3.0 mg and 4.5 mg versus dulaglutide 1.5 mg in metformin-treated patients with Type 2 diabetes in a randomized controlled trial (AWARD-11). Diabetes Care.
Hui, C., et al. (2023). Dumping syndrome. StatPearls.
Kawanami, D., et al. (2020). GLP-1 receptor agonists in diabetic kidney disease: From clinical outcomes to mechanisms. Frontiers in Pharmacology.
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Indigestion (dyspepsia).
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