What you’ll learn:
- Trulicity® is a once-weekly injectable medication that is FDA-approved for type 2 diabetes and can be prescribed off-label for weight loss.
- Trulicity® has similar side effects to other GLP-1 medications, with nausea, diarrhea, and fatigue being the most common.
- Side effects are most common when starting or increasing the dose, but are generally manageable with slow dose escalation and diet changes.
While you may be familiar with Ozempic®, you might not be as familiar with Trulicity®. Like Ozempic®, Trulicity® is a once-weekly injectable medication that helps regulate blood sugar in people with type 2 diabetes. It can also support weight loss off-label, though this is a less common use.
Trulicity® (dulaglutide) was approved by the FDA in 2014, but Ozempic® (semaglutide) has generally been shown to be more effective for both blood sugar control and weight loss. It has largely taken Trulicity®’s place since its approval in 2017.
Some people may still prefer Trulicity®, especially for type 2 diabetes management. It tends to have a slightly lower rate of gastrointestinal side effects and may be a better fit for those who don’t tolerate semaglutide well. Trulicity® may also be covered more often by certain insurance plans (for diabetes) or preferred by providers based on a person’s medical history.
While the side effects of Trulicity® can be less than with Ozempic®, people still tend to experience nausea, diarrhea, and fatigue when starting the medication or during dose increases. Many of these effects are manageable and tend to improve over time. A key strategy to manage this is following the medication’s step-up dosing schedule, where the dose is gradually increased over time to help minimize side effects.
While rare, more serious side effects like pancreatitis or severe allergic reactions can occur, so it’s important to know what signs to watch for and when to contact your doctor.
We’ll break down the most common and less common Trulicity® side effects, how they compare to other GLP-1s, and what you can do to manage them.
How Trulicity® affects your body
Trulicity® works by mimicking a hormone called GLP-1, which helps regulate appetite and blood sugar after you eat. Here’s what it does—and why those actions can sometimes cause side effects:
- Lowers appetite – By signaling your brain that you’re full, Trulicity® reduces how much you want to eat. But this sudden drop in appetite can make you feel nauseous, especially during the first few weeks. You may also get tired since you’re eating less food.
- Slows digestion – Trulicity® helps food stay in your stomach longer to prevent blood sugar spikes and help you feel full. That delayed emptying, though, can lead to bloating or even vomiting in some cases.
These symptoms are usually temporary and tend to ease as your body adapts to the medication. They can also be managed by changing how you eat. Keep in mind, though, that these may come back when your dose increases since your body has to adjust again.
When are side effects most likely with Trulicity®?
Side effects with Trulicity® are most likely when you’re just starting the medication or when your dose is increased. The medication is started at the lowest dose— 0.75 mg once a week—to ease your body into treatment and help reduce side effects. If the initial dose is well tolerated, your healthcare provider may increase it to 1.5 mg, 3 mg, and 4.5 mg, the maximum approved dose.
Trulicity® side effects: Most common symptoms
Trulicity® tends to come with mild to moderate side effects. Most people experience varying levels of digestive issues when starting Trulicity® or upping their dose. Since the medication works by slowing how quickly food leaves your stomach, it can take your digestive system a little while to adjust. The most common side effect reported with Trulicity® across all doses is nausea.
Here’s what you can expect at each dose based on clinical trials and some ways to manage them:
| Symptom | Dulaglutide 1.5mg | Dulaglutide 3mg | Dulaglutide 4.5mg | What can help |
|---|---|---|---|---|
| Nausea | 13% | 16% | 16% | Eat smaller, lighter meals throughout the day instead of large portions, and avoid greasy or fatty foods. |
| Diarrhea | 7% | 11% | 11% | Drink plenty of fluids to prevent dehydration and avoid foods that are high in fat or fiber. Choose gentle, easy-to-digest foods like oatmeal or soup until symptoms improve. |
| Vomiting | 6% | 8% | 9% | Stay well hydrated by taking small sips of water or clear liquids. Stick to bland, easy-to-digest foods like bananas, rice, or toast until your stomach settles. |
| Dyspepsia (indigestion) | 3% | 5% | 3% | Try avoiding acidic or spicy foods, and eat smaller meals more frequently. Not lying down immediately after eating may also help ease symptoms. |
Injection site reactions with Trulicity®
Trulicity® injections are generally quick and relatively painless, but some people report mild reactions at the injection site. These are typically not serious and tend to improve over time.
Common injection site reactions include:
- Pain or tenderness shortly after injecting
- Redness or a warm sensation around the injection area
- Mild swelling at the site that usually resolves on its own
Some people may also experience a rash or slight irritation at or near the injection site, itchy patches of skin, or small lumps under the skin that are temporary.
To reduce the chances of irritation:
- Rotate your injection sites each week. Trulicity® can be injected into the abdomen, thigh, or upper arm, and switching between these areas helps prevent repeated stress on the same patch of skin.
- Avoid areas that are irritated. Always avoid injecting into areas that are already bruised, scarred, or irritated.
- Let the medication warm up. Allow refrigerated medication to warm up slightly before injecting, which may help.
Are there side effects of stopping Trulicity®?
If you’ve been on Trulicity® for a few months, quitting suddenly can make hunger return or blood sugar rise if you’ve been treating diabetes. Your body has gotten used to how Trulicity® helps regulate your blood sugar and appetite. It’s so important to work with your healthcare provider—they’ll help you figure out the best way to come off the medication, which may or may not involve a gradual transition depending on your needs.
Here’s what you might notice when you stop taking Trulicity®:
- Rising blood sugar levels: Without Trulicity®, your glucose may rise, especially if you have been taking it for diabetes.
- Increased appetite: You will feel hungrier than before since Trulicity® helps suppress appetite and promote fullness.
- Weight regain: If weight loss was one of your treatment goals, you might notice that it is harder to lose weight without the same appetite control and metabolic support.
Maintaining healthier habits like eating balanced meals, staying active, getting good sleep, and managing stress can help you maintain the progress you’ve made after stopping Trulicity®. If you get your prescription through Noom Med, your clinician will help design a plan that helps you lose weight sustainably. If you get your medication through a private doctor, you can add the GLP-1 Companion to your Noom app. The free add-on will give you a protein target and exercise recommendations to help maintain muscle and manage side effects while losing weight.
Trulicity®: Safety and warnings
Trulicity® is a powerful tool for managing blood sugar and, for some, supporting weight loss—but it does have the potential for more serious side effects. While these events are rare, knowing what to look out for can help you act quickly if something doesn’t feel right. Here are some symptoms of conditions that require immediate medical attention:
- Pancreatitis – Symptoms include severe abdominal pain that may spread to your back, with or without vomiting.
- Vision changes – Any sudden vision loss or changes require immediate medical attention.
- Low blood sugar (hypoglycemia) – Symptoms include dizziness, shakiness, blurred vision, rapid heartbeat, and feeling jittery. This is more common in people taking additional diabetes medications.
- Kidney problems – Dehydration from diarrhea, nausea, or vomiting can worsen kidney function. Watch for reduced urination, swelling in the ankles or legs, fatigue, or shortness of breath.
- Gallbladder issues – Signs include upper abdominal pain, fever, jaundice, or pale-colored stools, which may indicate gallbladder problems.
- Allergic reactions – Swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, or a rapid heartbeat could indicate a severe allergic reaction. Seek emergency care immediately.
- Thyroid tumors – Trulicity® has an FDA-boxed warning about a potential risk of thyroid C-cell tumors. This risk has only been observed in animal studies, and it is unclear if it applies to humans.
For a full breakdown of potential risks, see the Trulicity® safety information.
Who shouldn’t take Trulicity®?
Trulicity® isn’t safe for everyone. Talking with your provider about your medical history will help you both decide if this is the best medication for you.
You can’t take Trulicity® if:
- You or a family member has a history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- You’re currently pregnant, planning to become pregnant, or breastfeeding
- You have a known allergy to any of the ingredients
Ask your doctor about whether they are right for you if you have a history of:
- Pancreatitis
- Severe gastrointestinal issues
Comparing Trulicity® side effects to other GLP-1 drugs
While GLP-1 medications all work in similar ways, they don’t always affect people the same way. Some people may experience more nausea with one medication than another, or find that certain side effects ease up faster with another.
To help you get a clearer picture, here’s a side-by-side look at how Trulicity®’s side effects compare with those of other commonly prescribed GLP-1 medications for diabetes management and off-label weight loss.
| Medication | Nausea | Vomiting | Diarrhea | Key differences |
|---|---|---|---|---|
| Trulicity® (4.5 mg – dulaglutide) | 16% | 9% | 10% | Lower rates of nausea and similar rates for diarrhea and vomiting compared to other GLP-1s. |
| Ozempic® (1 mg – semaglutide) | 20% | 9% | 9% | Similar vomiting and diarrhea rates with Trulicity®, but more reports of nausea. |
| Rybelsus® (14 mg – semaglutide) | 20% | 8% | 10% | Similar vomiting and diarrhea rates with Trulicity®, but more reports of nausea |
| Mounjaro® (15 mg) | 18% | 9% | 17% | More reports of nausea and diarrhea than Trulicity®. |
| Victoza® (1.8 mg) | 20% | 9% | 12% | Higher rates of nausea and diarrhea than Trulicity®. |
Managing Trulicity® side effects with Noom
Trulicity® can be a good option for managing blood sugar and, in some cases, supporting weight loss, but it comes with potential side effects. For most people, symptoms like nausea and digestive changes are temporary and manageable. They are most likely to occur when first starting the medication or when there are dose changes. Serious side effects are rare, but it’s important to know what to look for and when to reach out to your healthcare provider.
Everyone’s body responds differently, so finding the right dose—or even the right medication—can take time. Staying informed, tracking how you feel, and making small adjustments to your habits can go a long way in minimizing side effects and staying on track. Whether you’re just starting Trulicity® or reassessing your treatment plan, having a conversation with your provider is key to making it work safely for you.
If you qualify for Noom Med, you’ll be connected with a clinician who can assess your goals, find the right medication for you, and prescribe it if needed. They’ll help design a weight loss plan to follow while taking a GLP-1 medication. Plus, you’ll get access to all of Noom’s behavior tools and trackers to help you develop a healthy lifestyle you can stick with.
Note: Trulicity®, Ozempic®, Rybelsus®, Victoza®, and Mounjaro® are not FDA-approved for treating obesity or weight loss.
