Trulicity (dulaglutide): what it is for, dosage and what to eat

How does Trulicity work?

Dulaglutide mimics the action of GLP-1 (glucagon-like peptide-1), a gut hormone. When blood glucose rises, it helps the pancreas release insulin. It also reduces the release of glucagon, another hormone that raises blood glucose, and slows stomach emptying [1].

The aim is to improve blood glucose control in type 2 diabetes. The injection is given once a week [1]. The same action may reduce hunger, so some people feel full sooner and eat less.

In diabetes trials, average weight fell by between 0.35 and 2.9 kg with 1.5 mg [1]. This is a modest change and does not make Trulicity a weight-loss medicine. If weight management is your main concern, talk to your doctor about authorised options [2].

The guide to GLP-1 medicines explains what these medicines have in common and why their indications vary by product.

The aim of taking Trulicity is to manage diabetes while still eating what you need each day.

Who is Trulicity authorised for in Spain?

Trulicity is authorised for people aged 10 and over with inadequately controlled type 2 diabetes. It is used alongside diet and exercise. It can be added to other diabetes medicines or used alone when metformin is not appropriate [1]. For children and teenagers, the medical team makes the decision and provides follow-up.

The question of “using it like Ozempic” often comes up in consultations. Ozempic is also authorised only for diabetes, while Wegovy is indicated for weight management. Mounjaro has both indications under specific conditions [2]. Each product is assessed according to its own product information. The comparison of Ozempic, Wegovy and Mounjaro explains these differences.

What dose of Trulicity is used?

The weekly dose depends on whether Trulicity is used alone or with other medicines. Your doctor prescribes the dose and decides whether to increase it.

• For adults, the dose when used alone is 0.75 mg once a week [1].
• For adults, the dose when used in combination is 1.5 mg once a week [1].
• If needed, your doctor may increase the dose from 1.5 to 3 mg after at least four weeks [1].
• A further increase to 4.5 mg requires at least another four weeks [1].

The 3 mg and 4.5 mg presentations are authorised but are not marketed in Spain as at 26/09/2026.

For people aged 10 to 17, treatment starts at 0.75 mg weekly. The doctor may increase it to 1.5 mg after at least four weeks; this is the maximum dose at that age [1].

It is injected under the skin of the abdomen, thigh or upper arm. It can be taken with or without food, at any time, on the same day each week [1]. Each pen contains one dose. Follow the demonstration from the team prescribing it and the instructions in the pack.

If you miss a dose and your next one is due in 3 days or more, take it as soon as you remember. If fewer than 3 days remain, skip it and take the next dose on your usual day [1]. To change your injection day, leave at least 3 days after the previous dose [1].

Combining it with insulin or a sulfonylurea increases the risk of hypoglycaemia, and your doctor may reduce the dose of that medicine when you start [1]. Do not change any dose yourself. Agree with your team how to monitor blood glucose and what to do if it falls.

How much does Trulicity cost, and who reimburses it?

The reference price of Trulicity is €128.15, and varies by presentation. With a prescription from Spain’s National Health System and, where required, prior authorisation, the medicine has reduced patient co-payment; what you pay depends on your circumstances—some people are exempt—and is shown when the prescription is dispensed.

Public reimbursement is restricted and requires prior authorisation. The Spanish Ministry of Health limits it to type 2 diabetes with a body mass index of 30 kg/m² or more, in combination with other glucose-lowering medicines, including insulin, when the previous options are insufficient [3]. It is not reimbursed when used alone [3].

Indication and reimbursement are separate questions. Before starting, ask your doctor whether your prescription meets the criteria. To compare coverage, see the GLP-1 pricing guide.

What side effects does Trulicity have?

Nausea, diarrhoea and vomiting are the most common symptoms. In trials lasting up to 104 weeks, they occurred more often with 1.5 mg than with 0.75 mg [1]. These are group figures and do not predict what will happen to you.

Nausea, diarrhoea and vomiting are more common in the first two weeks, decrease over the next four weeks and then remain fairly stable [1]. They were slightly more common at 3 mg and 4.5 mg than at 1.5 mg [1]. “Common” means affecting 1 to fewer than 10 in every 100 people [1].

If nausea means you eat very little, you may miss whole meals for several days in a row. Ask for help adapting your eating plan. If you can barely drink, tell the person who prescribes it, because dehydration can harm your kidneys [1].

What to eat while taking Trulicity

Eating well remains part of diabetes care. If your appetite drops, look at what is left on your plate before cutting back further. Spreading food across the day can help you eat enough [4].

For a meal you tolerate well, combine a source of protein with vegetables and a carbohydrate-rich food. For example, fish with potatoes and cooked vegetables. Another option is a bowl of pulses with vegetables and fruit. The amount of carbohydrate should be adjusted to your treatment, blood glucose levels and schedule.

If you feel nauseous, try smaller portions. Eat slowly and stop when you feel full. A very rich or large meal may be harder to tolerate [4].

If you have diarrhoea, keep drinking fluids throughout the day. If you become constipated, review your fluid intake, fibre and movement. Avoid cutting out whole food groups because of a short-lived symptom.

Protein and strength training deserve attention if you are losing weight or eating less. They help preserve muscle [4]. A dietitian can help you adjust meals and manage symptoms without changing your medicines.

What do we see in consultations?

A common question is whether it is enough to eat less because you feel less hungry. We review the quality and regularity of your meals with you, and adapt your eating plan to your schedule and blood glucose control. We also ask about low blood glucose if you take insulin or other medicines that can cause it, and share this information with the person prescribing Trulicity.

Your first step this week: for three days, note which meals you tolerate and when symptoms occur, then take this information to your next review.

If you need to adapt your eating to your symptoms, find out about GLP-1 nutrition support.

What happens if you stop taking Trulicity?

Blood glucose control needs a plan whenever any diabetes medicine changes. If you are considering stopping dulaglutide, ask your doctor to review your monitoring and other medicines with you. Do not replace or stop insulin on your own.

During the change, keep the meals that work for you, note any symptoms and bring your blood glucose readings. If your appetite returns, adjust portions with your dietitian and keep up strength training and protein to preserve muscle.

When is it not indicated, or when is extra medical assessment needed?

The formal contraindication in the product information is an allergy to dulaglutide or any of the ingredients in the medicine [1]. Other situations need medical assessment.

• Type 1 diabetes or diabetic ketoacidosis: Trulicity is not used to treat these conditions [1].
• Severe digestive disease, including severe gastroparesis (very slow stomach emptying): it is not recommended [1].
• Pregnancy: it is not recommended. Breastfeeding: it must not be used [1].
• Previous pancreatitis: mention it before starting, as cases have been reported with dulaglutide [1].

If you are planning a pregnancy or breastfeeding, speak to your doctor before changing your treatment. Diabetes needs specific monitoring at these times.

If you have or have had an eating disorder, speak to your doctor and a mental health professional before starting. Reduced appetite may make an existing relationship with food that needs care more difficult [4]. At Alimmenta, we assess this together with the Psychology team.

Trulicity outside Spain

The information about reimbursement in this guide applies to Spain. If you live in another country, check the authorisation, available presentation and coverage with its health authority and a local healthcare professional. Do not apply the conditions of Spain’s National Health System in another jurisdiction.

Nutrition support can be provided online. To tailor your eating plan, we need to know what your doctor has prescribed, your mealtimes and any symptoms you are experiencing. Prescribing the medicine and changing its dose remain the responsibility of the medical professional treating you in your country.