Trulicity

How Does Trulicity Work?

Trulicity works by mimicking glucagon-like peptide-1 (GLP-1), a hormone naturally produced in the gut after eating. The active ingredient, dulaglutide, is an engineered fusion protein: a GLP-1 analog sequence attached to the Fc portion of a modified human IgG4 antibody. This structure extends dulaglutide's half-life to approximately 5 days, enabling once-weekly dosing.

Once injected, dulaglutide activates GLP-1 receptors throughout the body. This produces four key effects: (1) glucose-dependent stimulation of insulin secretion from the pancreas when blood sugar is elevated, (2) suppression of glucagon to reduce liver glucose output, (3) slowing of gastric emptying to blunt post-meal blood sugar spikes, and (4) appetite suppression via action on the brain's satiety centers. Because insulin release is glucose-dependent, Trulicity alone has a low risk of causing dangerous hypoglycemia.

GLP-1 receptors are also expressed in the heart and blood vessels, which explains Trulicity's cardiovascular protective effects demonstrated in the REWIND outcomes trial. The REWIND trial showed that dulaglutide reduced MACE by 12% versus placebo in patients with T2DM — including patients without established cardiovascular disease, making it uniquely relevant for primary and secondary CV prevention in the T2DM population.

How Hard Is It to Find Trulicity in Stock?

Trulicity (dulaglutide) is one of the most challenging GLP-1 medications to find in 2026. It has been on the FDA drug shortage database since August 2022, making it one of the longest-running active drug shortages. The shortage affects higher doses (3 mg and 4.5 mg) most severely, while lower doses (0.75 mg and 1.5 mg) have seen somewhat improved availability. The shortage is driven by a combination of demand surges, manufacturing issues at Eli Lilly, and Eli Lilly's strategic resource shift toward Mounjaro and Zepbound.

Availability varies significantly by location, pharmacy type, and week. National chains, independent pharmacies, big-box stores, and mail-order pharmacies all have different supply chains and may have different stock. Many patients report needing to call 5-10 pharmacies before locating their specific dose. The situation can change week to week.

Rather than spending hours on hold, patients can use medfinder to have pharmacies called on their behalf. Provide your medication, dose, and zip code, and medfinder will locate which pharmacies near you have Trulicity in stock and text you the results.

Who Can Prescribe Trulicity?

Trulicity (dulaglutide) is not a controlled substance, so any licensed prescriber can write a prescription without special DEA or state-level controlled substance authorization. The FDA does maintain a Risk Evaluation and Mitigation Strategy (REMS) program for Trulicity, which requires Eli Lilly to inform healthcare providers about the risks of medullary thyroid carcinoma and pancreatitis, but this does not restrict prescribing.

Healthcare providers who commonly prescribe Trulicity include:

• Endocrinologists — specialists in diabetes and hormonal conditions; typically manage complex T2DM cases

• Primary care physicians (PCPs) / Internal medicine — the most common prescribers; manage the majority of T2DM patients in the U.S.

• Pediatricians / Pediatric endocrinologists — Trulicity is approved for children ages 10+ with T2DM

• Cardiologists — may co-manage or prescribe for patients using Trulicity specifically for MACE risk reduction

• Nurse practitioners (NPs) and physician assistants (PAs) — have full or collaborative prescribing authority in most states

Telehealth prescribing is fully available for Trulicity since it is not a controlled substance. Eli Lilly operates LillyDirect, which connects patients with independent telehealth providers for Trulicity prescriptions and offers home delivery options.

Is Trulicity a Controlled Substance?

No. Trulicity (dulaglutide) is not a controlled substance and has no DEA scheduling classification. It can be prescribed by any licensed prescriber including primary care physicians, endocrinologists, nurse practitioners, and physician assistants. There are no special DEA requirements for prescribing or dispensing Trulicity, no federal limits on refills (beyond standard prescription duration), and no prescription monitoring program (PMP) reporting requirements.

Because Trulicity is not a controlled substance, it can also be prescribed via telehealth without the additional restrictions that apply to scheduled medications. Prescriptions can be transferred between pharmacies when needed. The only prescribing limitation specific to Trulicity is the FDA's REMS program requirement, which obligates Eli Lilly to inform healthcare professionals about the risk of pancreatitis and potential risk of medullary thyroid carcinoma.

Common Side Effects of Trulicity

The most frequently reported side effects of Trulicity are gastrointestinal, especially when first starting the medication or increasing the dose:

• Nausea (most common; typically improves after first 1-4 weeks)

• Diarrhea

• Vomiting

• Abdominal pain or discomfort

• Decreased appetite

• Dyspepsia (indigestion)

Serious Side Effects (Seek Medical Attention)

• Thyroid C-cell tumors (Boxed Warning): Risk seen in animal studies; human relevance unknown. Contraindicated in patients with personal/family history of medullary thyroid carcinoma or MEN 2.

• Acute pancreatitis: Severe abdominal pain radiating to back; discontinue immediately and seek emergency care.

• Hypoglycemia: Risk significantly increased when combined with insulin or sulfonylureas.

• Acute kidney injury: May occur secondary to dehydration from vomiting/diarrhea.

• Serious hypersensitivity: Including anaphylaxis and angioedema (rare); discontinue and seek emergency care.

Final Thoughts on Trulicity

Trulicity (dulaglutide) is a well-established, FDA-approved once-weekly GLP-1 receptor agonist that has been helping patients with type 2 diabetes manage their blood sugar and protect their cardiovascular health since 2014. It offers the convenience of once-weekly dosing, a proven cardiovascular benefit, and a relatively manageable side effect profile compared to some newer GLP-1 agents.

However, the ongoing shortage — active since August 2022 and with no confirmed U.S. resolution date — is a real barrier for patients who need this medication. The shortage is most severe for the 3 mg and 4.5 mg doses. Patients and providers should proactively plan for supply disruptions, have a therapeutic substitution plan in place, and use available savings programs to reduce financial barriers when Trulicity is accessible.

If you're struggling to find Trulicity at a pharmacy near you, medfinder can call pharmacies in your area to locate which ones have your specific dose in stock, and text you the results — saving you the time and frustration of calling pharmacies yourself.