Trulicity® (dulaglutide) is a medication primarily indicated for the treatment of type 2 diabetes. It belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. While it is not FDA-approved for weight loss, clinicians may prescribe Trulicity® off-label to support weight loss and metabolic health in individuals with obesity or overweight. This article explores how Trulicity® works, its effectiveness for weight loss, and other important considerations.
What is Trulicity®?
Trulicity® is the brand name for dulaglutide, a glucagon-like peptide-1 agonist (or GLP-1) medication. It is a once-weekly injectable medication and one of several GLP-1 medications prescribed by clinicians. Trulicity® is FDA-approved and indicated primarily for the management of type-2 diabetes. It helps lower blood sugar by stimulating insulin release and slowing down digestion, giving patients better control over their glucose levels.
How Trulicity® Helps with Weight Loss
Trulicity®, like other GLP-1 drugs, works by mimicking the natural incretin hormones that your body produces. Incretin hormones signal to the brain, endocrine, and gastrointestinal systems that food has been consumed. This results in a complex cascade of hormones and neurotransmitters which effectively communicate feelings of satiety (feeling full) and slow down the rate at which food leaves your stomach (making you feel fuller for longer).
In addition, GLP-1 medications can improve blood sugar levels in people living with impaired glucose tolerance or diabetes. As explained by the manufacturer, Trulicity® “helps your pancreas release insulin in response to high levels of sugar in your blood after you eat” and “can limit how much sugar gets into your blood from your liver.”
When combined with healthy lifestyle choices, like small changes to food and exercise, Trulicity® has shown promise in helping people lose weight. It is particularly effective when used in conjunction with a holistic program that helps you make steady adjustments to your lifestyle to promote metabolic health.
Read also: Choosing Between Trulicity and Victoza
Clinical Studies on Trulicity® (Dulaglutide) for Weight Loss
Several clinical studies have explored the effects of Trulicity® (dulaglutide) on weight loss. Below are some of the key findings from notable studies:
AWARD-11 Clinical Trial (2018-2020)
The AWARD-11 trial was conducted between 2018 and 2020 to evaluate the effects of different doses of Trulicity® on weight and glycemic control in patients with type 2 diabetes. The study compared 1.5 mg, 3 mg, and 4.5 mg doses of Trulicity® over 52 weeks. Results showed that patients taking the higher doses (3 mg and 4.5 mg) experienced greater weight loss compared to those on the standard 1.5 mg dose. Specifically,
- The 4.5 mg group lost an average of 4.7 kg (10.4 lbs).
- The 3 mg group lost an average of 3.7 kg (8.2 lbs).
- The 1.5 mg group lost an average of 2.7 kg (6 lbs).
AWARD-6 Trial (2012-2014)
The AWARD-6 trial took place from 2012 to 2014, comparing Trulicity® (dulaglutide) 1.5 mg with another GLP-1 medication, liraglutide (brand names Saxenda® and Victoza®) 1.8 mg over 26 weeks in patients with type-2 diabetes. While the primary goal was to assess blood sugar control, weight loss was also evaluated. Both medications resulted in modest weight loss:
- Trulicity® (dulaglutide) users lost an average of 2.9 kg (6.4 lbs).
- Liraglutide users lost an average of 3.6 kg (7.9 lbs).
REWIND Study (2011-2018)
The REWIND study, conducted from 2011 to 2018, evaluated the long-term cardiovascular outcomes of Trulicity® (dulaglutide) in people with type 2 diabetes, with weight loss as a secondary outcome. Over a median of 5.4 years, patients taking Trulicity® experienced a modest but sustained weight loss of around 1.5 kg (3.3 lbs) compared to the placebo group.
How to Use Trulicity®
How to use Trulicity® is straightforward. The medication comes in a pre-filled pen that’s administered as a once-weekly injection. If prescribed Trulicity® by your clinician, you’ll receive detailed instructions on how to use your medication. However, here’s a high-level overview on what to expect when giving a Trulicity® injection:
Read also: Using Trulicity for Weight Management
- Prepare the injection site: Choose an area such as your stomach, thigh, or upper arm. Clean the area with alcohol.
- Uncap the pen: Remove the grey base cap of the pen.
- Place the pen against the skin: Hold the pen at a 90-degree angle to your skin.
- Press the button: Once you hear a click, the injection has started. Keep the pen in place until the green bar stops moving, which takes about 5-10 seconds.
Many people begin to notice improvements in blood sugar levels within a few weeks of starting Trulicity®. However, the weight loss effects may take longer, with some individuals reporting changes after 4 to 6 weeks.
Trulicity® is typically prescribed in doses starting at 0.75 mg once a week, with adjustments made based on the individual’s response. Your clinician may recommend increasing your Trulicity® dose if the initial dose isn’t providing adequate blood sugar control or if you aren’t seeing the desired weight loss. The standard dosage increase is from 0.75 mg to 1.5 mg once weekly, but always follow your clinician’s advice on timing and dosage adjustments. Increasing the dose too quickly can increase the risk of side effects, so it’s essential to work closely with your clinical team.
Taking Trulicity® with Other Medications
Yes, Trulicity® and metformin are often used together, especially in managing type 2 diabetes. Metformin works by improving the body’s response to insulin and reducing glucose production in the liver, while Trulicity® helps lower blood sugar by stimulating insulin secretion and slowing digestion. Combining these medications can be an effective approach for managing blood sugar levels and potentially aiding weight loss. However, some people may experience side effects like gastrointestinal discomfort when starting this combination. Always consult your clinician to understand the best approach for your health needs.
Yes, Trulicity® can be taken with insulin, but it’s important to follow your clinician's guidance. Trulicity® helps manage blood sugar differently by stimulating insulin release and reducing appetite. Combining it with insulin can improve blood sugar control, but it may also increase the risk of low blood sugar (hypoglycemia). Your clinician may adjust your insulin dosage to avoid this. Always monitor your blood sugar closely when using both medications.
Trulicity® Side Effects
The most common side effects of Trulicity® (dulaglutide) are:
Read also: The Truth About Trulicity for Weight Loss
- Nausea
- Constipation
- Diarrhea
- Stomach discomfort
- Vomiting
- Decreased appetite
- Indigestion
- Fatigue
The good news is that, in most cases, these side effects will go away between 3-4 weeks after starting the medication. According to the manufacturer, Eli Lilly, “8% to 29% using Trulicity® experienced some nausea, which typically occurred during the first 2 to 3 days after they took their first dose.”
“Nausea generally subsided after the first 2 weeks, but some people experienced nausea with Trulicity® beyond their second week of treatment. Less than 2% needed to stop taking Trulicity® because of nausea.”
Here are some tips for reducing nausea and stomach discomfort with Trulicity®:
- Eat blander foods
- Refrain from eating fatty, processed, or greasy foods
- Eat smaller meals or stick to smaller portion sizes
- Do your best to stay active
Talk to your health care provider about any side effects of Trulicity® that become bothersome or that don’t go away. If you experience any allergic reaction such as anaphylaxis or shortness of breath, please seek immediate medical care.
Risks and Warnings Associated with Trulicity® (Dulaglutide)
In rare cases, Trulicity® has been associated with an increased risk of thyroid cancer. People with a family history of thyroid cancer or certain other risk factors should consult their clinician before starting the medication. Always discuss the potential risks and benefits with your healthcare provider.
If you’re worried about hypoglycemia (low blood sugar), rest assured that GLP-1 medications pose a relatively small risk. Hypoglycemia is typically only a concern when GLP-1s are used in conjunction with other diabetes medications such as insulin. As one 2015 study evaluating Trulicity® concluded, “The long-acting GLP-1 receptor agonists improve glycemic control and help to promote weight loss. Furthermore, based on their glucose-dependent mechanism of action, the GLP-1 receptor agonists have a low risk for hypoglycemia.”
Possible serious side effects of Trulicity include:
- Possible thyroid tumors, including cancer.
- Inflammation of your pancreas (pancreatitis). Stop using Trulicity and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting.
- Low blood sugar (hypoglycemia). Your risk of getting low blood sugar may be higher if you use Trulicity with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin.
- Serious allergic reactions.
- Kidney problems (kidney failure).
- Severe stomach problems.
- Vision changes.
- Gallbladder problems.
- Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation).
These are not all the possible side effects of Trulicity. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects.
You should not use Trulicity if you are allergic to dulaglutide, Trulicity, or any of the inactive ingredients in the Trulicity pen. Trulicity is not approved for use by anyone younger than 10 years old with type 2 diabetes. It is not known if Trulicity will harm an unborn baby. It is not known if Trulicity passes into your breast milk.
Never share an injection pen or prefilled syringe with another person, even if the needle has been changed. Other drugs may interact with Trulicity, including prescription and over-the-counter medicines, vitamins, and herbal products. Know the medicines you take.
Trulicity® for Weight Loss: Key Takeaways
- Trulicity (dulaglutide) is not a weight loss drug, but people receiving it may lose weight.
- Higher doses of Trulicity typically result in more weight loss.
- Trulicity is a prescription drug approved by the Food and Drug Administration (FDA) for the following uses:
- To lower blood sugar levels in adults and some children with type 2 diabetes, along with changes in diet and exercise
- To reduce the risk of serious cardiovascular (heart and blood vessel) problems, such as heart attack and stroke in adults with type 2 diabetes who have, or are at risk of having heart disease
The FDA has not approved Trulicity as a weight loss medication, but some doctors may prescribe it off-label for this purpose. With off-label use, a drug is prescribed for a condition it isn’t approved to treat.
Trulicity® vs. Other GLP-1 Receptor Agonists
While Trulicity is a GLP-1 receptor agonist, other medications in this class, such as Ozempic (semaglutide) and Wegovy (semaglutide), are approved for weight loss. Zepbound (tirzepatide), a combination GLP-1 with a glucose-dependent insulinotropic peptide (GIP), has also demonstrated superior weight loss results in clinical trials.
Trulicity vs. Ozempic
Trulicity and Ozempic are both injectable medications used to treat type 2 diabetes. The active ingredient in Trulicity is dulaglutide, and for Ozempic, it is semaglutide. While Trulicity and Ozempic belong to the same drug class called GLP-1 receptor agonists and have the same mechanism of action, they differ in their structure, the way they are processed by the body and their clinical effects. Studies show that Ozempic may work better for blood sugar control and weight loss than Trulicity.
Trulicity vs. Mounjaro
Trulicity (dulaglutide) and Mounjaro (tirzepatide) are injectable medicines approved to help manage blood sugar levels in people with type 2 diabetes. Zepbound shows superior blood glucose control and weight loss compared to Trulicity.