Dulaglutide

About Dulaglutide

Dulaglutide acts like GLP-1, a gut hormone: it raises insulin release when blood sugar is high, lowers glucagon and slows stomach emptying. Trulicity is labeled, with diet and exercise, for blood sugar control in adults and children 10 and older with type 2 diabetes, and to lower the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors. Weight loss is not one of its labeled uses, and safety and effectiveness under age 10 have not been established. Adults start at 0.75 mg once a week; after four weeks the dose can rise to 1.5 mg, then by 1.5 mg steps at least four weeks apart, to a maximum of 4.5 mg. Children start at 0.75 mg and can go to 1.5 mg after at least four weeks, which is their maximum.

The boxed warning: dulaglutide caused thyroid C-cell tumors in rats, it is not known whether it does in people, and it must not be used with a personal or family history of medullary thyroid carcinoma or with multiple endocrine neoplasia type 2 (MEN 2); a lump in the neck or other thyroid symptoms should be reported. It is also not used after a serious allergic reaction to it. The label warns of pancreatitis, low blood sugar with insulin or a sulfonylurea, allergic reactions, kidney injury from dehydration, severe stomach and bowel reactions, worsening eye disease in people with a history of diabetic retinopathy, gallbladder disease, and inhaling stomach contents under anesthesia or deep sedation. Nausea, diarrhea, vomiting, stomach pain and decreased appetite are the most common side effects.

Trulicity is licensed as a biologic, and the FDA’s list of approved biosimilars (current as of October 2026) includes none for it, so there is nothing to substitute at the counter. It is a different medicine from semaglutide, liraglutide and tirzepatide and cannot be swapped for them. Each pen holds one weekly dose and is used once. The label’s warning on severe stomach and bowel reactions was updated in March 2026. As of October 2026 the FDA drug shortage database lists dulaglutide as a resolved shortage. In pregnancy, the label says to use it only if the potential benefit justifies the potential risk to the fetus.

Taking Dulaglutide

How to take it

Once a week on the same day, at any time, with or without food, under the skin of the abdomen, thigh or upper arm, rotating sites each week. Do not mix it with insulin in the same injection. The day can be changed if the last dose was at least 3 days earlier.

If you miss a dose

If at least 3 days remain before the next scheduled dose, take it as soon as possible; if fewer than 3 days remain, skip it and take the next dose on the usual day.

Storage

In the refrigerator in the original carton, protected from light and never frozen. If needed, a pen may be kept at room temperature for up to 14 days.

Interactions to know about

Insulin or a sulfonylurea raises the risk of low blood sugar, so those doses may be lowered. Slower stomach emptying can change how other oral medicines are absorbed, and the care team should know about it before surgery or sedation.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dulaglutide differs from pharmacy to pharmacy

Trulicity has no generic or biosimilar, so every fill is priced as a brand, and a quote helps only if the pharmacy can supply your strength. Each pen holds one weekly dose, so the number of pens in a fill follows the number of weeks prescribed.

The four strengths are separate products, and while the dose is being raised a different strength may be needed every month or so, so early fills can be small and each carries its own dispensing fee.

Ways to pay less for Dulaglutide without insurance

• Ask the maker whether a savings or patient assistance program applies to someone paying cash; many copay cards require commercial insurance.
• Once your dose is stable, ask whether the prescription can cover more than one month.
• Confirm the pharmacy has your strength before the prescription is sent, and compare more than one pharmacy.
• If the price is a barrier, ask the prescriber whether a medicine with a generic, such as liraglutide or metformin, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dulaglutide

1. 1.Is this the strength on my prescription, and how many weekly pens are in my fill?
2. 2.How long can my pens stay out of the refrigerator?
3. 3.Should my insulin or sulfonylurea dose change?
4. 4.Can I change my injection day, and how?

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