Trulicity (dulaglutide) is dispensed as a convenient, single-use pre-filled pen for once-weekly subcutaneous injection in adults with type 2 diabetes mellitus. This glucagon-like peptide-1 (GLP-1) receptor agonist comes ready to use with a hidden needle and fixed dose, eliminating the need for manual preparation. Available on NHS prescription when clinical criteria are met, or privately, Trulicity pens require refrigerated storage between 2°C and 8°C until use. Understanding proper dispensing, storage, and administration is essential for safe and effective diabetes management. This guide explains how Trulicity is supplied, stored, prescribed, and administered in UK clinical practice.

What Is Trulicity and How Does It Work?

Trulicity (dulaglutide) is a once-weekly injectable medication used primarily for the management of type 2 diabetes mellitus in adults. It belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone that helps regulate blood glucose levels.

The mechanism of action involves several complementary pathways. Trulicity stimulates insulin secretion from pancreatic beta cells in a glucose-dependent manner, meaning it only promotes insulin release when blood sugar levels are elevated. This reduces the risk of hypoglycaemia compared to some other diabetes medications, though this risk increases if used with sulfonylureas or insulin. Additionally, it suppresses the release of glucagon (a hormone that raises blood sugar) and slows gastric emptying, which helps moderate the post-meal rise in blood glucose. Many patients also experience modest weight loss, which can be beneficial in type 2 diabetes management, though Trulicity is not licensed for weight management.

Trulicity is typically prescribed when diet and exercise alone, or in combination with other oral antidiabetic agents such as metformin, have not achieved adequate glycaemic control. According to NICE guidance (NG28), GLP-1 receptor agonists like Trulicity may be considered as part of dual or triple therapy regimens for patients with a BMI ≥35 kg/m² (or lower in certain ethnic groups or if weight loss would benefit obesity-related comorbidities) and specific psychological or medical problems associated with obesity, or for whom insulin therapy would not be appropriate. Treatment should only be continued if there is a reduction in HbA1c of at least 11 mmol/mol (1.0%) and a weight loss of at least 3% of initial body weight after 6 months. GLP-1 receptor agonists should not be used in combination with DPP-4 inhibitors.

The medication is administered subcutaneously (under the skin) once weekly, on the same day each week, regardless of meals. The starting dose is typically 0.75 mg, which can be increased to 1.5 mg after at least 4 weeks if needed. Further dose increases to 3 mg and then 4.5 mg can be made at intervals of at least 4 weeks, based on glycaemic response and tolerability. If a dose is missed, it should be administered as soon as possible if there are at least 3 days (72 hours) until the next scheduled dose.

Understanding the Trulicity Pre-Filled Pen

Trulicity is dispensed as a single-use, pre-filled pen designed for ease of use and patient convenience. Unlike some injectable diabetes medications that require manual needle attachment or dose dialling, the Trulicity pen comes ready to use with a hidden needle and a fixed dose already loaded. The pen is designed to simplify the administration process, particularly for patients who may be apprehensive about self-injection.

Each pen contains one weekly dose and is intended for single use only. Before injection, it's important to inspect the solution visually through the inspection window—the medication should appear clear and colourless to slightly yellow. Do not use if the liquid appears cloudy, discoloured, or contains particles. The pen should never be shared with another person, even if the needle has been changed, due to infection risk.

Key features of the Trulicity pen include:

• A protective cap that must be removed before use

• An automatic needle insertion and retraction mechanism

• An audible click when the injection starts and a second click when completed

• A lock mechanism that prevents reuse after administration

The injection can be administered into the abdomen, thigh, or upper arm. Upper arm injections should generally be administered by another person. It's advisable to rotate injection sites each week to reduce the risk of injection site reactions. The entire injection process typically takes about 5-10 seconds, during which you should keep the pen pressed firmly against your skin until you hear the second click and see the green indicator showing the injection is complete.

Patients receive comprehensive instructions with their first prescription, and healthcare professionals—including practice nurses and diabetes specialist nurses—can provide practical demonstrations. Always read the Patient Information Leaflet and Instructions for Use provided with each new prescription, as these contain detailed guidance on proper administration.

How to Store and Handle Your Trulicity Prescription

Proper storage of Trulicity is essential to maintain its effectiveness and safety. Unopened Trulicity pens must be stored in a refrigerator at temperatures between 2°C and 8°C. They should be kept in the original carton to protect from light and must never be frozen. If a pen has been accidentally frozen, it must be discarded and should not be used, even if it has subsequently thawed.

For practical convenience, particularly when travelling, an unopened pen may be kept at room temperature (not exceeding 30°C) for up to 14 days. This flexibility allows patients to carry their medication during short trips without requiring refrigerated storage. However, once removed from refrigeration, the pen should not be returned to the fridge. Always check the expiry date printed on the pen and carton—expired medication should never be used.

Before administering your injection, it's recommended to allow the pen to reach room temperature naturally for about 30 minutes to make the injection more comfortable. Do not warm the pen using hot water, a microwave, or other heating methods.

Important storage and handling guidelines:

• Keep pens in the outer carton until ready to use

• Store away from direct heat and sunlight

• Keep out of reach and sight of children

• Do not store with the cap removed

• Transport carefully to avoid damage to the pen mechanism

When collecting your prescription from the pharmacy, Trulicity will typically be dispensed in a cool bag or with cold packs if ambient temperatures are high. Once home, transfer the pens to your refrigerator promptly. If you're collecting multiple pens (e.g., a month's supply), ensure adequate refrigerator space is available.

Disposal of used pens should follow local guidelines for sharps waste. Your GP surgery or pharmacy can provide a sharps bin for safe disposal. Once full, return the sharps bin to your local council collection point, pharmacy, or GP surgery according to local arrangements. Never dispose of pens in household waste or recycling bins. Unused or expired pens should be returned to your pharmacy for appropriate disposal.

Getting Your Trulicity Prescription: NHS and Private Options

In the UK, Trulicity is a prescription-only medicine (POM) and must be prescribed by an appropriate healthcare professional. The pathway to obtaining Trulicity typically begins with your GP or diabetes specialist, who will assess whether this medication is suitable based on your individual circumstances, current glycaemic control, other medications, and overall health status.

NHS Prescription Route:

For NHS patients in England, Trulicity prescriptions are subject to NICE guidance and local formulary decisions. Your GP or diabetes consultant will initiate treatment if you meet the clinical criteria outlined in NICE guideline NG28, including BMI thresholds and other specific considerations. Once prescribed, you can collect your medication from any NHS community pharmacy. The standard NHS prescription charge applies in England (see the NHS website for current charges), though many people with diabetes qualify for a Medical Exemption Certificate (MedEx), which provides free prescriptions for all conditions. Patients in Scotland, Wales, and Northern Ireland receive free NHS prescriptions.

Your prescription will typically be issued monthly or for longer periods (up to three months) depending on local practice and your treatment stability. Some areas offer electronic repeat dispensing (eRD), allowing your pharmacy to dispense regular supplies without requiring a new prescription each time, though your GP will still review your treatment periodically.

Private Prescription Options:

Trulicity can also be obtained through private prescriptions from private GPs, endocrinologists, or online doctor services. Private prescriptions offer faster access and may be an option if NHS prescribing restrictions apply in your area. However, the medication cost is significantly higher when obtained privately, making this a substantial financial commitment. Costs vary considerably between pharmacies and by dose strength, so it's advisable to check prices with the dispensing pharmacy.

Important considerations:

• Regular monitoring of HbA1c, weight, renal function and side effects is essential regardless of prescription route

• Ensure continuity of supply by ordering repeat prescriptions in good time

• If experiencing supply issues, contact your pharmacist or GP surgery promptly

• When travelling abroad, carry a letter from your doctor explaining your medication needs

• Common side effects include nausea, vomiting, diarrhoea and constipation, particularly when starting treatment

• Seek immediate medical advice if you experience severe abdominal pain, as this could indicate pancreatitis

• Report any suspected side effects via the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk)

If you have difficulty affording your medication or experience access problems, discuss this openly with your diabetes care team, who may be able to suggest alternative solutions or support options.

Frequently Asked Questions