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The most common Trulicity side effects are digestive: nausea, diarrhea, vomiting, belly pain and a smaller appetite. In the label’s pooled placebo-controlled trials, nausea affected 12% to 21% of adults on Trulicity (dulaglutide), depending on strength, versus about 5% on placebo. Most stomach symptoms were rated mild or moderate, and the label says the slowing of stomach emptying behind them is largest after the first injection. Less common but serious risks on the label include pancreatitis, gallbladder problems, kidney injury from dehydration, low blood sugar when combined with insulin or a sulfonylurea, and a boxed warning about thyroid C-cell tumors seen in rats. Trulicity is approved for type 2 diabetes, not for weight loss.
Peptide Labs does not sell Trulicity, Ozempic or any prescription drug. This article summarizes the Trulicity prescribing information on DailyMed (revised March 2026). For how it compares with semaglutide, see Trulicity vs Ozempic; for the whole drug class, see GLP-1 medicine side effects.
Key Takeaways
- Nausea: 12% to 21% on Trulicity versus 5% on placebo in pooled trials of about 24 weeks.
- Digestive side effects overall: 32% to 41% versus 21% on placebo; most were mild or moderate.
- The boxed warning covers thyroid C-cell tumors in rats and rules out use with MTC or MEN 2.
- Low blood sugar is mainly a risk when Trulicity is combined with insulin or a sulfonylurea.
- Weight change is modest: about 3 to 5 kg on average over 36 weeks in the high-strength trial.
- Severe belly pain, signs of an allergic reaction or a neck lump need prompt medical attention.
Common Trulicity side effects: label rates versus placebo
The table shows the reactions that occurred in at least 5% of adults on Trulicity and more often than on placebo. The data come from a pool of placebo-controlled trials that included 1,670 adults with type 2 diabetes, who were exposed for an average of 23.8 weeks. The two figures for Trulicity are the two original strengths studied; the higher strength generally caused more symptoms.
| Side effect | Placebo (568 adults) | Trulicity, lower strength (836) | Trulicity, higher strength (834) |
|---|---|---|---|
| Nausea | 5.3% | 12.4% | 21.1% |
| Diarrhea | 6.7% | 8.9% | 12.6% |
| Vomiting | 2.3% | 6.0% | 12.7% |
| Abdominal pain | 4.9% | 6.5% | 9.4% |
| Decreased appetite | 1.6% | 4.9% | 8.6% |
| Indigestion (dyspepsia) | 2.3% | 4.1% | 5.8% |
| Fatigue | 2.6% | 4.2% | 5.6% |
Digestive side effects of any kind were reported by 21% of people on placebo and 32% to 41% on Trulicity. Investigators rated about half of them mild, most of the rest moderate, and 7% to 11% severe. Between 1.3% and 3.5% of people stopped Trulicity because of them, compared with 0.2% on placebo. Smaller increases were seen for constipation (about 4% versus 0.7%), gas, bloating, acid reflux (about 2% versus 0.5%) and burping.
In a later 36-week trial of three higher strengths, nausea was reported by 13% to 16% of people, diarrhea by 7% to 11% and vomiting by 6% to 9%. That trial had no placebo group. Practical tips for the most frequent complaints are in our guides to nausea on GLP-1 medicines, GLP-1 diarrhea and GLP-1 constipation; the advice applies to dulaglutide too. Tiredness is covered in fatigue on GLP-1 medicines.
The Trulicity boxed warning
The Trulicity boxed warning is the same type carried by other long-acting GLP-1 medicines. It says dulaglutide causes thyroid C-cell tumors in rats, and that it is unknown whether Trulicity causes such tumors, including medullary thyroid carcinoma (MTC), in humans. Trulicity must not be used by anyone with a personal or family history of MTC or with multiple endocrine neoplasia syndrome type 2 (MEN 2).
The label asks patients to report symptoms of a thyroid tumor: a lump or swelling in the neck, trouble swallowing, shortness of breath or hoarseness that does not go away. It also notes that routine calcitonin blood tests or thyroid ultrasounds are of uncertain value for early detection.
Serious dulaglutide side effects on the label
These dulaglutide side effects are uncommon, but each has its own section in the Warnings and Precautions part of the label:
- Pancreatitis. Adjudicated cases occurred at 1.4 per 1,000 patient-years on Trulicity versus 0.88 on comparison drugs. Persistent, severe belly pain, sometimes spreading to the back, with or without vomiting, is the warning sign; the label says to stop Trulicity if pancreatitis is suspected.
- Gallbladder disease. In the REWIND heart outcomes trial, gallstones occurred at 0.62 versus 0.56 per 100 patient-years, and serious acute gallbladder inflammation in 0.5% versus 0.3%.
- Kidney injury from dehydration. Postmarketing reports describe acute kidney injury, sometimes needing dialysis, mostly in people who had nausea, vomiting or diarrhea.
- Severe digestive reactions. A section added in March 2026 reports severe digestive reactions in 2.2% to 4.3% on Trulicity versus 1.4% on placebo, and says Trulicity is not recommended for people with severe gastroparesis.
- Low blood sugar with other diabetes medicines, described in the next section.
- Allergic reactions. Serious reactions, including anaphylaxis and swelling of the face or throat (angioedema), have been reported after approval.
- Diabetic eye disease. In REWIND, retinopathy complications occurred in 1.9% versus 1.5%, and in 8.5% versus 6.2% among people with existing retinopathy. Rapid glucose improvement can temporarily worsen retinopathy.
- Anesthesia. Because Trulicity slows stomach emptying, rare cases of inhaling stomach contents during anesthesia or deep sedation have been reported. Tell your care team before any planned procedure.
Reports collected after approval also list bowel obstruction (ileus), severe constipation, liver enzyme changes, changes in taste and hair loss. Such reports cannot show how often a reaction happens or prove that the drug caused it. Hair loss across the class is discussed in our GLP-1 hair loss guide.
Low blood sugar, heart rate and injection-site reactions
Added to metformin, Trulicity rarely caused low blood sugar in trials: below 1% of people had a reading under the label’s threshold for clinically important hypoglycemia. The picture changed with other medicines. In a 78-week trial with a sulfonylurea, about 20% had low readings, and in a 52-week trial with mealtime insulin, 69% to 77% did, with severe episodes in about 3%. The label says the prescriber may need to lower the insulin or sulfonylurea when Trulicity is started.
Trulicity raised average heart rate by 2 to 4 beats per minute, and a fast heart rhythm (sinus tachycardia) was reported in up to 5.6% versus 3.0% on placebo. Injection-site reactions such as rash or redness occurred in 0.5% of adults versus none on placebo, and in about 4% of children versus 2%.
Trulicity weight loss: what the label shows
Trulicity weight loss is real but usually modest, and it is not an approved use. Trulicity is approved to improve blood sugar in adults and children 10 and older with type 2 diabetes, and to lower the risk of major heart events in adults with type 2 diabetes and heart disease or several heart risk factors. In the label’s 36-week trial of 1,842 adults comparing three strengths, average weight change was minus 3.0, 3.8 and 4.6 kg (roughly 7 to 10 pounds). Lower appetite, one of the listed side effects, is part of the reason.
The heart indication rests on REWIND, which followed 9,901 adults (average age 66) for a median of 5.4 years. Heart attack, stroke or cardiovascular death occurred in 12.0% on Trulicity versus 13.4% on placebo, a 12% relative reduction. For background on how these medicines work, see what GLP-1 is; for semaglutide’s side-effect profile, see semaglutide side effects.
Who should not use Trulicity, and when to get help
- Do not use it with a personal or family history of MTC, with MEN 2, or after a serious allergic reaction to dulaglutide.
- Pregnancy data are limited; the label says to use it only if the benefit justifies the risk to the fetus. There are no data on breast milk.
- Trulicity slows stomach emptying, so tell your prescriber about oral medicines with narrow safety margins, such as warfarin.
- Get urgent care for severe belly pain that will not go away, swelling of the face or throat, trouble breathing, or vomiting that stops you keeping fluids down.
- Report side effects to your prescriber, and to the FDA MedWatch program if you wish.
Frequently Asked Questions
What are the most common Trulicity side effects?
Nausea, diarrhea, vomiting, abdominal pain and decreased appetite. In pooled trials, nausea affected 12% to 21% of adults versus about 5% on placebo.
How long do dulaglutide side effects last?
The label says the delay in stomach emptying is largest after the first injection and lessens over time. Tell your prescriber if digestive symptoms persist or keep you from eating and drinking.
What is the Trulicity boxed warning?
It warns that dulaglutide caused thyroid C-cell tumors in rats, that the human risk is unknown, and that people with a personal or family history of MTC or with MEN 2 must not use it.
Does Trulicity cause weight loss?
Many people lose some weight. In a 36-week label trial, average loss was about 3 to 5 kg, but Trulicity is not FDA-approved for weight loss.
Can Trulicity cause low blood sugar?
Rarely on its own. The risk rises with insulin or a sulfonylurea; in one trial with mealtime insulin, 69% to 77% had low readings.
Does Trulicity cause hair loss?
Hair loss (alopecia) is listed among reports received after approval, which cannot show how often it happens or prove the drug caused it.
Peptide Labs does not sell GLP-1 medicines or any prescription drug. This article is general information, not medical advice. Read the Medication Guide that comes with a prescription, and ask a pharmacist or prescriber how this information applies to you.
Last reviewed October 2026.
Related guides: Trulicity vs Ozempic: Dulaglutide and Semaglutide Compared, GLP-1 Side Effects: What Every GLP-1 Drug Label Warns About, Ozempic Nausea: How Long It Lasts and What Helps.