Nausea is one of the most frequently reported side effects of Trulicity (dulaglutide), a glucagon-like peptide-1 (GLP-1) receptor agonist used to manage type 2 diabetes mellitus. This gastrointestinal symptom occurs because Trulicity slows gastric emptying and acts on brain centres regulating appetite and nausea. Whilst nausea affects more than 1 in 10 people taking Trulicity, it typically appears during the first few weeks of treatment and often improves as the body adjusts. Understanding why nausea occurs, how common it is, and practical strategies to manage symptoms can help patients continue treatment safely and effectively whilst maintaining good diabetes control.
Summary: Yes, Trulicity (dulaglutide) commonly causes nausea in more than 1 in 10 people, particularly during the first few weeks of treatment.
- Trulicity is a GLP-1 receptor agonist that slows gastric emptying, which directly contributes to nausea and gastrointestinal symptoms.
- Nausea is classified as very common (>10% of patients) and is dose-dependent, with higher rates at 1.5 mg, 3 mg, and 4.5 mg weekly doses.
- Symptoms typically peak during the initial 2–4 weeks or after dose escalation and usually improve as tolerance develops.
- Practical management includes eating smaller meals, avoiding high-fat foods, staying hydrated, and ensuring gradual dose titration at four-week intervals.
- Contact your GP if nausea persists beyond four weeks, causes repeated vomiting, or is accompanied by severe abdominal pain suggesting pancreatitis.
- Trulicity is licensed in the UK at 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg doses, with regulatory approval from the MHRA and EMA.
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Can Trulicity Cause Nausea?
Yes, Trulicity (dulaglutide) can cause nausea, and this is one of the most frequently reported side effects associated with this medication. Trulicity belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists, which are used primarily to manage type 2 diabetes mellitus. These medications work by mimicking the action of the naturally occurring hormone GLP-1, which helps regulate blood glucose levels by stimulating insulin secretion, suppressing glucagon release, and slowing gastric emptying.
The mechanism by which Trulicity causes nausea is directly related to its effect on the gastrointestinal system. By slowing the rate at which food leaves the stomach (delayed gastric emptying), the medication can create sensations of fullness, bloating, and nausea, particularly when treatment is first initiated or when the dose is increased. Additionally, GLP-1 receptor agonists act on areas of the brain involved in appetite regulation and the sensation of nausea, which may contribute to these gastrointestinal symptoms.
It is important to understand that whilst nausea is a recognised and common adverse effect of Trulicity, it does not affect everyone who takes the medication. The severity and duration of nausea can vary considerably between individuals. For most patients who do experience nausea, symptoms tend to be most pronounced during the first few weeks of treatment and often improve as the body adjusts to the medication. According to the UK Summary of Product Characteristics (SmPC) available via the electronic Medicines Compendium (emc), nausea is listed as a very common side effect of Trulicity, confirming its well-established association with this treatment. The Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA) regulatory documentation support this safety profile.
Trulicity is available in the UK in four licensed doses: 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg, administered once weekly by subcutaneous injection. Gastrointestinal side effects, including nausea, tend to be more frequent at higher doses. The SmPC advises caution in patients with severe gastrointestinal disease, including gastroparesis, as GLP-1 receptor agonists may worsen symptoms in these conditions.
How Common Is Nausea with Trulicity?
Nausea is classified as a very common side effect of Trulicity, meaning it affects more than 1 in 10 people (>10%) who take this medication. Clinical trial data submitted to the European Medicines Agency (EMA) and detailed in the UK emc SmPC consistently demonstrate that gastrointestinal side effects—particularly nausea—are among the most frequently reported adverse reactions during Trulicity treatment.
In pivotal clinical studies, nausea occurred in approximately 12–21% of patients taking Trulicity, depending on the dose and the specific trial population. The incidence is dose-dependent, with higher rates of nausea observed at the 1.5 mg, 3 mg, and 4.5 mg weekly doses compared to the 0.75 mg dose. It is worth noting that nausea rates are typically highest during the initial 2–4 weeks of treatment or following dose escalation, and tend to decrease substantially over time as tolerance develops.
Other gastrointestinal symptoms frequently accompany nausea in patients taking Trulicity. According to the UK SmPC, these include:
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Diarrhoea (very common: >1 in 10 people)
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Vomiting (common: up to 1 in 10 people)
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Abdominal pain or discomfort (common: up to 1 in 10 people)
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Dyspepsia or indigestion (common: up to 1 in 10 people)
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Decreased appetite (common: up to 1 in 10 people)
Whilst these statistics indicate that nausea is a frequent occurrence, it is equally important to recognise that many patients tolerate Trulicity well without experiencing significant gastrointestinal symptoms. Individual susceptibility varies, and factors such as dose titration strategy, timing of administration, and dietary habits may influence the likelihood and severity of nausea. The majority of patients who do experience nausea find that symptoms are mild to moderate in intensity and resolve within the first month of treatment. Higher doses (3 mg and 4.5 mg) are associated with increased rates of gastrointestinal adverse events, and careful dose escalation at intervals of at least four weeks is recommended to improve tolerability.
Managing Nausea When Taking Trulicity
If you experience nausea whilst taking Trulicity, there are several practical strategies that may help reduce symptoms and improve tolerability. These approaches are consistent with guidance provided by diabetes specialist nurses and align with patient information resources from the NHS medicines pages.
Dietary modifications can be particularly effective:
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Eat smaller, more frequent meals rather than large portions, as this reduces the burden on your stomach whilst it empties more slowly
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Avoid high-fat, greasy, or spicy foods, which can exacerbate nausea and delayed gastric emptying
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Stay well hydrated by sipping water throughout the day, but avoid drinking large volumes with meals
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Choose bland, easily digestible foods such as toast, crackers, rice, or bananas when nausea is present
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Avoid lying down immediately after eating; remain upright for at least 30–60 minutes after meals
Timing and administration considerations may also help:
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Trulicity can be administered at any time of day, with or without food. Some patients report that injecting at bedtime may reduce daytime nausea, though this is not evidence-based and individual responses vary
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Ensure you are using the correct injection technique and rotating injection sites (abdomen, thigh, or upper arm) as instructed
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If you are starting Trulicity or increasing your dose, be particularly mindful of portion sizes during the adjustment period
Dose titration and medical support: The UK SmPC recommends dose escalation at intervals of at least four weeks to allow the body to adjust and minimise gastrointestinal side effects. If nausea persists beyond the first few weeks, is severe, or is accompanied by persistent vomiting that prevents adequate fluid or food intake, contact your GP or diabetes care team. In some cases, temporary anti-emetic medication may be prescribed to help manage symptoms during the initial treatment phase. Your healthcare provider may also consider adjusting your dose or slowing the rate of dose escalation.
Important safety advice: If you develop severe or persistent abdominal pain, particularly if it radiates to your back, stop taking Trulicity immediately and seek urgent medical assessment, as this may indicate acute pancreatitis—a rare but serious side effect. Do not restart Trulicity unless pancreatitis has been excluded by your doctor. Similarly, if you experience symptoms of a severe allergic reaction (difficulty breathing, swelling of the face, lips, tongue, or throat), stop the medication and seek emergency help. For all other situations, do not stop Trulicity without consulting your healthcare provider, as this may affect your diabetes control.
When to Contact Your GP About Trulicity Side Effects
Whilst nausea is an expected and usually self-limiting side effect of Trulicity, there are specific circumstances when you should contact your GP or diabetes care team promptly for assessment and advice.
Contact your GP or diabetes team if you experience:
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Persistent or severe nausea that does not improve after the first 2–4 weeks of treatment
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Repeated vomiting that prevents you from keeping down food, fluids, or other medications
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Signs of dehydration, including dark urine, dizziness, dry mouth, reduced urination, or feeling faint
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Unexplained weight loss beyond what would be expected from improved diabetes control
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Symptoms of hypoglycaemia (low blood sugar), especially if you are also taking insulin or sulfonylureas—symptoms include trembling, sweating, confusion, rapid heartbeat, or feeling very hungry
Stop Trulicity and seek urgent medical attention (call 999, go to A&E, or contact NHS 111 for urgent advice) if you develop:
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Severe, persistent abdominal pain (especially radiating to your back) with or without vomiting, which may indicate acute pancreatitis—a rare but serious side effect. Do not restart Trulicity unless pancreatitis has been excluded by your doctor
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Signs of a severe allergic reaction, such as difficulty breathing, swelling of the face, lips, tongue, or throat, or a widespread rash
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Symptoms suggesting diabetic ketoacidosis (DKA), including excessive thirst, frequent urination, confusion, fruity-smelling breath, or rapid breathing. Whilst DKA is uncommon with GLP-1 receptor agonists alone, risk may be higher if you reduce or omit insulin doses, become dehydrated, have an intercurrent illness, or take an SGLT2 inhibitor alongside Trulicity. Follow sick-day rules and seek urgent advice if unwell
Your GP may wish to review your treatment plan if nausea significantly affects your quality of life or adherence to therapy. Alternative GLP-1 receptor agonists, different dosing strategies, or adjunctive treatments may be considered. You can report any suspected side effects directly via the MHRA Yellow Card scheme at https://yellowcard.mhra.gov.uk/. Open communication with your diabetes care team ensures that your treatment remains both effective and tolerable.
References and further information:
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emc (electronic Medicines Compendium): Trulicity (dulaglutide) Summary of Product Characteristics
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European Medicines Agency (EMA): Trulicity European Public Assessment Report (EPAR)
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NHS medicines: Dulaglutide – patient information and side-effect guidance
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NICE guideline NG28: Type 2 diabetes in adults: management
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MHRA Yellow Card scheme: https://yellowcard.mhra.gov.uk/
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NHS or Diabetes UK: Sick-day rules for people with diabetes
Frequently Asked Questions
How long does nausea from Trulicity typically last?
Nausea from Trulicity is usually most pronounced during the first 2–4 weeks of treatment or after a dose increase. For most patients, symptoms improve significantly as the body adjusts to the medication, though individual experiences vary.
What should I do if Trulicity nausea becomes severe?
If nausea is severe, persistent beyond four weeks, or accompanied by repeated vomiting that prevents adequate fluid intake, contact your GP or diabetes care team. They may prescribe temporary anti-emetic medication, adjust your dose, or review your treatment plan.
Can I prevent nausea when starting Trulicity?
Whilst nausea cannot always be prevented, eating smaller frequent meals, avoiding high-fat or spicy foods, staying well hydrated, and following gradual dose escalation at four-week intervals can significantly reduce the likelihood and severity of symptoms.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
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