What are the side effects of Trulicity (dulaglutide) injections?

Side Effects of Trulicity (Dulaglutide) Injections

Trulicity (dulaglutide) commonly causes gastrointestinal side effects including nausea, vomiting, diarrhea, and abdominal pain, with more serious potential complications including pancreatitis, gallbladder disease, and kidney problems. 1

Common Side Effects

• Gastrointestinal effects - The most frequently reported side effects of Trulicity include:

  • Nausea 1
  • Vomiting 1
  • Diarrhea 1
  • Abdominal pain 1
  • Decreased appetite 1
  • Constipation 2
  • Dyspepsia (indigestion) 2

• Injection site reactions - May occur at the location where the medication is administered 2

• Cardiovascular effects - Elevated heart rate (typically increases by approximately 5 beats per minute) 2

Serious Side Effects

• Pancreatitis - Inflammation of the pancreas is a potentially serious complication:

  • Stop using Trulicity and seek immediate medical attention if experiencing severe abdominal pain that may radiate to the back, with or without vomiting 1, 3
  • Causality has not been definitively established, but cases have been reported in clinical trials 2

• Hypoglycemia (low blood sugar):

  • Risk is higher when used with other medications that can lower blood sugar, such as sulfonylureas or insulin 1
  • Signs include dizziness, sweating, confusion, headache, blurred vision, fast heartbeat, anxiety, and hunger 1

• Serious allergic reactions:

  • Can include swelling of face, lips, tongue or throat 1
  • Breathing or swallowing problems 1
  • Severe rash or itching 1
  • Fainting, dizziness, or rapid heartbeat 1

• Kidney problems:

  • Dehydration from gastrointestinal side effects may worsen existing kidney problems 1
  • Use with caution in patients with kidney disease 2

• Gallbladder disease:

  • May cause cholelithiasis (gallstones) and gallbladder-related complications 2
  • Symptoms include pain in upper abdomen, fever, jaundice, and clay-colored stools 1

• Severe gastrointestinal disorders:

  • Severe constipation and small bowel obstruction/ileus progression have been reported 2

• Vision changes:

  • Report any changes in vision during treatment 1

Black Box Warning

• Risk of thyroid C-cell tumors:
  • Has been observed in rodents, though human relevance has not been determined 2
  • Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) 1

Monitoring and Management

• Assess efficacy and safety at least monthly for the first 3 months and quarterly thereafter 2

• Monitor for signs of pancreatitis, especially severe abdominal pain that may radiate to the back 1

• For patients with kidney disease, monitor kidney function as GLP-1 receptor agonists like dulaglutide can affect kidney outcomes 2, 4

• If taking medications that can cause hypoglycemia (insulin or sulfonylureas), doses of these drugs may need to be reduced to avoid low blood sugar 2

• Consider discontinuation if:

  • Pancreatitis is suspected 1
  • Severe allergic reactions occur 1
  • Insufficient weight loss (typically <5% after 3 months of use) 2

Special Considerations

• Pregnancy: Contraindicated in women who are or may become pregnant 2

• Drug interactions: Monitor effects of oral medications with narrow therapeutic index (like warfarin) as Trulicity may delay absorption 2

• Oral contraceptives: Women using oral hormonal contraception should use or add a non-oral contraception method for 4 weeks after initiation and dose escalations 2

• Kidney disease: Dulaglutide has been studied in patients with moderate-to-severe chronic kidney disease and may be safer than some alternatives in this population 4

By understanding these potential side effects and following proper monitoring guidelines, patients can work with their healthcare providers to manage risks while benefiting from Trulicity's effectiveness in treating type 2 diabetes and reducing cardiovascular events.