FDA-Approved MedicationUpdated November 2026

Trulicity Guide

Trulicity is the brand-name formulation of dulaglutide, a once-weekly subcutaneous GLP-1 receptor agonist FDA-approved for glycemic control in adults with type 2 diabetes and for cardiovascular risk reduction in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors. Manufactured by Eli Lilly, Trulicity was the first GLP-1 to show a CV benefit in a primary-prevention diabetes population (REWIND, 2019). It has never had an obesity indication — average weight loss in trials is modest at roughly 3–5 kg — and Wegovy and Zepbound dominate the chronic weight management category.

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed

At a Glance

Generic NameDulaglutide
Brand NamesTrulicity
FDA StatusFDA-approved for glycemic control in adults with type 2 diabetes mellitus (September 18, 2014); FDA-approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have established CVD or multiple cardiovascular risk factors (February 2020); pediatric indication for type 2 diabetes in patients aged 10 years and older added in 2022. Not approved for chronic weight management.[1]
Approval DateSeptember 18, 2014[1]

How Trulicity Works

Dulaglutide is a long-acting GLP-1 receptor agonist engineered by fusing two modified GLP-1 peptide chains to a human IgG4 Fc fragment, which extends the half-life to about five days and allows once-weekly dosing. By activating GLP-1 receptors, dulaglutide stimulates glucose-dependent insulin secretion, suppresses inappropriate glucagon release, slows gastric emptying, and modestly reduces appetite. The blood-sugar-lowering effect is the labeled indication; the weight reduction is a secondary effect that is smaller than what is seen with semaglutide or tirzepatide.[2]

Dosing Schedule

Trulicity uses a gradual dose escalation to minimize side effects. Always follow your prescriber's guidance and the current FDA label[1].

Weeks 1–40.75 mg/week (starting dose)
Week 5+1.5 mg/week (standard maintenance)
After ≥4 weeks at 1.5 mg3 mg/week (if additional glycemic control needed)
After ≥4 weeks at 3 mg4.5 mg/week (maximum recommended dose)

Side Effects

Common: nausea, diarrhea, vomiting, abdominal pain, decreased appetite, dyspepsia, fatigue. Side effects are most pronounced during dose initiation and escalation, and typically diminish over 4–8 weeks. Serious (rare): pancreatitis, gallbladder disease (cholecystitis, cholelithiasis), acute kidney injury (often secondary to dehydration from GI side effects), severe hypoglycemia when combined with insulin or sulfonylureas, hypersensitivity reactions, diabetic retinopathy complications. Boxed warning for thyroid C-cell tumors observed in rodents; contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).[1][2]

This is not a complete list. Consult your healthcare provider or prescriber for full safety information. The complete adverse reaction profile is published in the current FDA prescribing information[1].

Clinical Trial Results

The AWARD program comprised the pivotal phase 3 trials supporting Trulicity's approval and label expansions, evaluating dulaglutide as monotherapy and in combination with metformin, sulfonylureas, insulin, and SGLT2 inhibitors across more than 10 studies. AWARD-7 (Tuttle et al. Lancet Diabetes Endocrinol 2018, PMID 29910024) showed dulaglutide was noninferior to insulin glargine for HbA1c reduction in patients with type 2 diabetes and moderate-to-severe chronic kidney disease, with less weight gain and a lower hypoglycemia rate. SUSTAIN-7 (Pratley et al. Lancet Diabetes Endocrinol 2018, PMID 29397376) directly compared once-weekly semaglutide to dulaglutide; semaglutide produced greater reductions in HbA1c and body weight at matched dose levels. The landmark REWIND cardiovascular outcomes trial (Gerstein et al. Lancet 2019, PMID 31189511) randomized 9,901 adults with type 2 diabetes — most without established CVD — and showed a 12% relative reduction in major adverse cardiovascular events with dulaglutide 1.5 mg over a median follow-up of 5.4 years (HR 0.88, 95% CI 0.79–0.99). REWIND remains the largest and longest GLP-1 CVOT and the first to demonstrate CV benefit in a primary-prevention diabetes population, though the effect size was the smallest in the GLP-1 CVOT class.[2]

Source: Published clinical trial data (STEP / SURMOUNT trial series) — see the Sources panel below for full citations.

Where to Get Trulicity

Where verified telehealth access exists, it is listed here.

None of the telehealth providers we track publishes a verified cash price for Trulicity yet, so we don't list providers here. Ask your prescriber or pharmacy, or check the manufacturer's savings program.

Cost Comparison

Trulicity cost & pricing →Storage & handling →Alternatives →

No verified cash prices for Trulicity yet

None of the providers we track publishes a cash price for Trulicity itself, so there is no price comparison to show. We never fill this table with other drugs' prices, insurance copays or membership fees.

Trulicity Head-to-Head Comparisons

Short-form verdict pages comparing Trulicity to other GLP-1 options with trial-anchored data, FDA-label dosing, and current manufacturer pricing.

Trulicity vs Ozempic
SUSTAIN-7 head-to-head: Ozempic 1 mg cut A1C 1.8% and weight 6.5 kg vs Trulicity 1.5 mg's 1.4% and 3.0 kg. Trulicity wins on pediatric label and AWARD-7 kidney data.
Last verified August 2026
Trulicity vs Mounjaro
Both made by Eli Lilly. Mounjaro 15 mg cut A1C ~2.3% and weight ~12.4% in SURPASS trials vs Trulicity 1.5 mg ~1.1% A1C and ~3 kg. Both now carry pediatric (ages 10+) T2D and cardiovascular-risk-reduction indications.
Last verified October 2026
Trulicity vs Wegovy
Wegovy delivered -14.9% body weight in STEP-1 vs Trulicity's ~3 kg in T2D trials. Trulicity wins on T2D CV outcomes (REWIND, MACE -12%) and pediatric coverage from age 10.
Last verified August 2026
Trulicity vs Rybelsus
Rybelsus is oral semaglutide (daily, 30-minute fast required); Trulicity is weekly dulaglutide injection. Both T2D-only — compare A1C, CV outcomes, pediatric label, cost.
Last verified October 2026
Trulicity vs Foundayo
Foundayo (orforglipron) is Lilly's first oral non-peptide GLP-1, obesity-labeled with -11.1% TBWL in ATTAIN-1. Trulicity (dulaglutide) is the older weekly injectable with proven CV and CKD outcomes.
Last verified October 2026
Trulicity vs Saxenda
Saxenda is Novo's daily liraglutide 3.0 mg for obesity (SCALE -7-8%). Trulicity is Lilly's weekly dulaglutide for type 2 diabetes (REWIND MACE -12%). Different labels, frequencies, molecules.
Last verified October 2026

See all drug-vs-drug verdicts, or compare every weight loss medication we cover.

Pivotal Trulicity Trial Walkthroughs

Endpoint-by-endpoint breakdowns of the trials that shaped the Trulicity label, with primary-source numbers and FAQs.

REWIND
REWIND is the largest and longest GLP-1 cardiovascular outcomes trial ever conducted — 9,901 adults with type 2 diabetes followed a median 5.4 years, with the unique distinction that 69% had no established cardiovascular disease at baseline. Weekly dulaglutide 1.5 mg reduced the primary three-point MACE composite by 12% versus placebo (HR 0.88, 95% CI 0.79-0.99, P=0.026). Unlike LEADER and SUSTAIN-6, which enrolled mostly secondary-prevention populations, REWIND tested whether GLP-1 agonism could prevent first cardiovascular events in lower-risk T2D patients — and the answer was yes, with effect sizes that held up in both primary- and secondary-prevention subgroups.
Phase 3 · N=9,901 · Last verified August 2026
AWARD-7
AWARD-7 is the first phase-3 GLP-1 receptor agonist trial designed specifically for adults with type 2 diabetes and moderate-to-severe chronic kidney disease (eGFR 15 to <60 mL/min/1.73 m²). Eli Lilly randomized 577 participants to once-weekly dulaglutide 1.5 mg, dulaglutide 0.75 mg, or daily insulin glargine titrated to fasting plasma glucose, all layered on prandial insulin lispro, for 52 weeks. Both dulaglutide doses met non-inferiority versus glargine on the HbA1c primary endpoint at 26 weeks and produced less eGFR decline, lower urinary albumin-to-creatinine ratio, weight loss (rather than weight gain), and roughly two-thirds fewer hypoglycemic events at week 52. The trial supplied the kidney-specific evidence base behind dulaglutide's label use in advanced CKD and seeded later kidney-outcome programs.
Phase 3 · N=577 · Last verified August 2026
SUSTAIN-7
SUSTAIN-7 (Pratley 2018 Lancet Diabetes Endocrinol, PMID 29397376) is the first registrational head-to-head trial of two once-weekly GLP-1 receptor agonists. Novo Nordisk randomized 1,201 adults with type 2 diabetes inadequately controlled on metformin 1:1:1:1 to once-weekly subcutaneous semaglutide 0.5 mg, dulaglutide 0.75 mg, semaglutide 1.0 mg, or dulaglutide 1.5 mg for 40 weeks in an open-label design. At both the low-dose and high-dose comparisons, semaglutide cut HbA1c roughly 0.4 percentage points more than dulaglutide and reduced body weight by an additional 2.3 to 3.5 kg, with broadly similar gastrointestinal tolerability. The trial provided the regulatory and clinical basis for positioning semaglutide as the strongest A1C-reducing GLP-1 in the class.
Phase 3b · N=1,201 · Last verified August 2026

Ranked PubMed Studies on Trulicity

Curated lists of the highest-impact peer-reviewed studies on Trulicity and related GLP-1 drugs. Every PMID live-verified via PubMed esummary.

Top 10 PubMed Studies on GLP-1 Cardiovascular Outcomes (2026)
Ten landmark cardiovascular outcomes trials that established GLP-1 receptor agonists as cardioprotective drugs beyond glycemic control. Covers MACE reduction in type 2 diabetes (LEADER, SUSTAIN-6, REWIND, HARMONY OUTCOMES, AMPLITUDE-O, PIONEER 6), the SELECT paradigm-shift in obesity without diabetes, kidney outcomes in FLOW, heart failure in STEP-HFpEF, and the foundational neutral ELIXA post-ACS trial. Each entry includes the PMID, NCT, primary endpoint, and editorial summary.
10 ranked papers · Last verified August 2026

Related Research on Trulicity

Deep-dive articles from our research desk with primary-source trial data, FDA label verification, and editorial analysis.

Texas Medicaid GLP-1 Coverage (2026): STAR+PLUS PA Pathway and How to Appeal a Denial
Texas Medicaid covers Ozempic, Trulicity, Victoza, and Byetta as Preferred for type 2 diabetes per the Acentra "PDL Criteria, January 30, 2026" guide — the operational implementation of the Texas Vendor Drug Program (VDP) Preferred Drug List. Texas does NOT cover Wegovy or Saxenda for chronic weight management — both are explicitly labeled "Non-Covered Benefit" in the Superior HealthPlan Texas Medicaid + CHIP coverage table (June 6, 2023 provider notice, verified July 2026). The legal rationale is the federal optional weight-loss-drug exclusion at 42 U.S.C. § 1396r-8(d)(2)(A), which permits states to decline coverage of "agents when used for anorexia, weight loss, or weight gain." Texas has elected to use this exclusion. Mounjaro and Rybelsus are Non-Preferred (T2D context). Texas Prior Authorization Program clinical criteria (Acentra Health) cover Wegovy for cardiovascular disease or MASH and Zepbound for obstructive sleep apnea, each with prior authorization. HB 2412 (89th Texas Legislature, 2025) would have mandated obesity-indication GLP-1 coverage but did NOT pass — historical context only. Per the KFF January 2026 survey, Texas is not among the 13 states covering GLP-1s for obesity. The verbatim PA criteria for the preferred T2D incretins is a 14-day failed trial of a preferred agent OR documented allergy/contraindication OR stage-4 metastatic cancer indication, with 365-day approval. Managed-care plans (STAR, STAR+PLUS, STAR Kids, STAR Health, CHIP — Aetna Better Health of Texas, Wellpoint/Amerigroup, Molina, Superior HealthPlan, UnitedHealthcare Community Plan) operationally defer to the state VDP PDL.
14 min read8 citations
Does UnitedHealthcare Cover Weight Loss Drugs? OptumRx Coverage Review
UnitedHealthcare covers type 2 diabetes GLP-1s (Ozempic, Mounjaro, Trulicity, Rybelsus) with prior authorization, but excludes weight-loss drugs under most plans unless the employer opts in. Medicare members may qualify for the $50 Medicare GLP-1 Bridge.
12 min read18 citations
Hawaii Medicaid GLP-1 Coverage 2026: PA Pathway, Eligibility & Appeals
Hawaii Med-QUEST does not cover GLP-1 drugs for chronic weight management in 2026; plan formularies exclude drugs for weight loss. GLP-1s for type 2 diabetes stay covered. The PA steps, the five QUEST plans, the stalled SB 3195 and the two-step appeal process.
22 min read31 citations
Mounjaro and Heart Rate: Why Tirzepatide Raises Your Pulse (and What It Means) (2026)
A small rise in resting heart rate (roughly 2-5 bpm) is a labeled effect of tirzepatide (Mounjaro). Why it happens, the key evidence nuance vs semaglutide — tirzepatide's cardiovascular outcomes trial (SURPASS-CVOT) compared it with dulaglutide, not placebo, and showed noninferiority — how to tell a modest pulse rise from palpitations, and the red flags.
8 min read3 citations
GLP-1 with Kidney Disease (CKD): The Patient Action Plan
If you have CKD and your clinician is considering a GLP-1, here is what changed: FLOW trial Perkovic 2024 NEJM 24% kidney + CV event reduction, AWARD-7 dulaglutide in moderate-severe CKD, no renal dose adjustment for most GLP-1s, sick-day rules with SGLT2 + ACE-I.
14 min read10 citations
Mounjaro vs Trulicity: Glycemic Control and Switching Evidence
Tirzepatide vs dulaglutide: indirect comparison through SURPASS-2 and AWARD-11 shows ~0.5 pp larger A1C drop and 6 to 7 kg more weight loss on Mounjaro. Trulicity has REWIND MACE indication.
9 min read10 citations

Frequently Asked Questions

FDA-approved for glycemic control in adults with type 2 diabetes mellitus (September 18, 2014); FDA-approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have established CVD or multiple cardiovascular risk factors (February 2020); pediatric indication for type 2 diabetes in patients aged 10 years and older added in 2022. Not approved for chronic weight management.
None of the providers we track publishes a verified cash price for Trulicity, so we don't quote one. Your cost depends on your insurance coverage, the manufacturer's savings program and your pharmacy.
Common: nausea, diarrhea, vomiting, abdominal pain, decreased appetite, dyspepsia, fatigue. Side effects are most pronounced during dose initiation and escalation, and typically diminish over 4–8 weeks. Serious (rare): pancreatitis, gallbladder disease (cholecystitis, cholelithiasis), acute kidney injury (often secondary to dehydration from GI side effects), severe hypoglycemia when combined with insulin or sulfonylureas, hypersensitivity reactions, diabetic retinopathy complications. Boxed warning for thyroid C-cell tumors observed in rodents; contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Trulicity requires a prescription from a licensed healthcare provider. You can get it through your primary care doctor, endocrinologist, or a telehealth platform.
Sources & methodology (as of November 2026)
  1. 1.FDA — Wegovy (semaglutide) Approval History via Drugs@FDA— U.S. Food & Drug Administration.
  2. 2.STEP 1 Trial — Once-Weekly Semaglutide in Adults with Overweight or Obesity (Wilding JPH et al.)— New England Journal of Medicine.PMID: 33567185.
  3. 3.FDA — Compounding and the 503A Pharmacy Framework— U.S. Food & Drug Administration.
  4. 4.FDA — Drug Shortages Database (current shortage listings)— U.S. Food & Drug Administration.
  5. 5.IRS Publication 502 — Medical and Dental Expenses (HSA/FSA eligibility)— Internal Revenue Service.