Trulicity (dulaglutide) is a once-weekly injectable GLP-1 receptor agonist prescribed for type 2 diabetes management. As a biological medicine, it requires specific storage conditions to maintain efficacy and safety. Understanding how long Trulicity can be unrefrigerated is essential for patients who travel, experience power outages, or face situations where refrigeration is temporarily unavailable. According to UK regulatory guidance, Trulicity may be stored unrefrigerated for up to 14 days at temperatures not exceeding 30°C. This article provides comprehensive guidance on Trulicity storage requirements, temperature exposure risks, travel considerations, and when to discard compromised medication.

Trulicity Storage Requirements and Temperature Guidelines

Trulicity (dulaglutide) is a once-weekly injectable glucagon-like peptide-1 (GLP-1) receptor agonist used in the management of type 2 diabetes mellitus. As a biological medicine, Trulicity requires specific storage conditions to maintain its stability, efficacy, and safety profile. Understanding these requirements is essential for patients and healthcare professionals to ensure optimal therapeutic outcomes.

Refrigerated storage is the primary recommendation for Trulicity pens. According to the UK Summary of Product Characteristics (SmPC), the medicine should be stored in a refrigerator at temperatures between 2°C and 8°C until the expiry date printed on the label. It is important to keep Trulicity in its original carton to protect it from light exposure, which may affect the medication's stability. The pen should never be frozen; if Trulicity has been frozen, it must be discarded immediately, even if it has subsequently thawed. Freezing can denature the protein structure of dulaglutide, rendering it ineffective.

When stored correctly in the refrigerator, Trulicity maintains its potency throughout its shelf life. Patients should always check the expiry date before use and never administer medication that has passed this date. As advised in the Patient Information Leaflet (PIL), the pen should be removed from the refrigerator approximately 30 minutes before injection to allow it to reach room temperature, which can reduce injection site discomfort. Do not use artificial methods (such as microwaves or hot water) to warm the pen. This brief period at room temperature does not constitute unrefrigerated storage in the context of stability guidelines.

Trulicity should be kept out of sight and reach of children, and pens should not be used if they appear damaged. Healthcare professionals should counsel patients on proper storage during initial prescribing and at regular review appointments. Community pharmacists play a vital role in reinforcing these messages when dispensing Trulicity, ensuring patients understand the importance of maintaining the cold chain from pharmacy to home refrigerator.

How Long Can Trulicity Be Left Unrefrigerated?

According to the Summary of Product Characteristics (SmPC) approved by the Medicines and Healthcare products Regulatory Agency (MHRA), Trulicity may be stored unrefrigerated for a maximum of 14 days at temperatures not exceeding 30°C. This provision allows for flexibility in situations where refrigeration is temporarily unavailable, such as during travel, power outages, or when patients are away from home. This 14-day window provides reassurance that brief lapses in ideal storage conditions do not necessarily compromise the medication.

It is crucial to emphasise that this 14-day period is cumulative, not renewable. Once a Trulicity pen has been stored at room temperature for 14 days in total, it must be used within this period or discarded, even if it has been returned to the refrigerator during that time. Patients should not attempt to "reset" the unrefrigerated time by returning the pen to cold storage. Keeping track of unrefrigerated time is therefore essential, and patients may find it helpful to note the date when the pen was first removed from refrigeration.

The 30°C maximum temperature is particularly important in the UK context, where summer temperatures occasionally exceed this threshold, especially in vehicles, conservatories, or south-facing rooms. Patients should be advised to avoid leaving Trulicity in hot environments such as cars, near radiators, or in direct sunlight. Even within the 14-day unrefrigerated period, exposure to temperatures above 30°C may compromise the medication's integrity.

For patients who regularly travel or have lifestyle factors that make refrigeration challenging, discussing these circumstances with their GP or diabetes specialist nurse is advisable. Treatment options should be considered based on individual clinical needs and circumstances. Trulicity's 14-day unrefrigerated allowance is generally considered accommodating for most patients' needs.

What Happens If Trulicity Gets Too Warm?

When Trulicity is exposed to temperatures exceeding the recommended storage conditions, the protein structure of dulaglutide may begin to degrade. As a peptide-based biological medicine, dulaglutide is susceptible to denaturation when subjected to excessive heat. This degradation process can reduce the medication's potency, potentially leading to suboptimal glycaemic control. The primary concern with heat-exposed Trulicity is reduced efficacy, which could affect diabetes management.

Visual inspection alone is not a reliable method to determine whether Trulicity has been compromised by heat exposure. The solution should always appear clear and colourless to slightly yellow. However, even if the appearance remains normal, the medication may have lost potency if stored incorrectly. Patients should never assume that normal-looking medication is necessarily effective if it has been exposed to temperatures above 30°C or stored unrefrigerated for more than 14 days.

If a patient suspects their Trulicity has been exposed to excessive heat, they should contact their community pharmacist, GP practice, or the manufacturer's medical information service for advice. In most cases, the recommendation will be to discard the affected pen and obtain a replacement. Patients should not use medication they believe may have been compromised, as this could result in inadequate diabetes management and potential hyperglycaemia.

Patient safety considerations include monitoring blood glucose levels more frequently if there is any concern about medication integrity. If a patient has used Trulicity that may have been heat-damaged and subsequently experiences unexplained elevated blood glucose readings, they should contact their healthcare provider promptly. Seek urgent medical advice (via GP, NHS 111, or A&E) if experiencing symptoms of marked hyperglycaemia such as excessive thirst, frequent urination, drowsiness, or vomiting. The diabetes specialist team can provide guidance on temporary adjustments to diabetes management whilst replacement medication is obtained. Patients should never attempt to compensate for potentially ineffective medication by doubling doses or altering their prescribed regimen without medical supervision.

Travelling with Trulicity: Practical Storage Tips

Travelling with Trulicity requires advance planning to maintain appropriate storage conditions whilst away from home. For short trips within the UK lasting less than 14 days, patients can transport Trulicity at room temperature (below 30°C) without refrigeration, provided they track the cumulative unrefrigerated time. For longer journeys or international travel, particularly to warmer climates, additional measures are necessary to preserve the medication's integrity.

Insulated medication travel cases or cool bags with ice packs are practical solutions for maintaining appropriate temperatures during transit. However, patients must ensure that Trulicity pens do not come into direct contact with ice packs, as this could cause freezing. Placing a barrier, such as a cloth or the medication's original packaging, between the ice pack and the pen prevents this risk. When flying, Trulicity should be carried in hand luggage rather than checked baggage, as cargo holds may experience temperature extremes. Airlines and airport security are accustomed to passengers carrying injectable medications, and patients should carry a letter from their GP or a copy of their prescription to facilitate security screening.

Before travelling, patients should consult the NHS 'Taking medicines abroad' guidance and check both airline regulations and destination country import rules for medications. Diabetes UK also offers specific travel advice for people with diabetes.

Hotel accommodation typically provides refrigerators in rooms or can store medication in a secure refrigerated area upon request. Patients should contact their accommodation in advance to confirm refrigeration availability. When staying with friends or family, informing hosts about medication storage needs ensures appropriate arrangements can be made. For camping or situations where refrigeration is unavailable, the 14-day unrefrigerated allowance provides flexibility, though patients should still protect Trulicity from excessive heat.

Time zone changes and altered routines during travel may affect injection timing. Trulicity's once-weekly dosing schedule offers flexibility, and patients can adjust their injection day if necessary, provided doses are at least three days (72 hours) apart. Consulting with a healthcare professional before extended travel is advisable to discuss any necessary adjustments to diabetes management, including blood glucose monitoring frequency and management of potential travel-related factors affecting glycaemic control, such as changes in diet, activity levels, and stress.

When to Discard Trulicity After Temperature Exposure

Clear criteria for discarding Trulicity help patients make informed decisions about medication safety and efficacy. Any Trulicity pen that has been frozen must be discarded immediately, regardless of whether it has thawed or appears normal. Freezing irreversibly damages the protein structure of dulaglutide, rendering it ineffective. Similarly, any pen that has been stored unrefrigerated for more than 14 days cumulative time should be discarded, even if it has been returned to the refrigerator during that period.

If Trulicity has been exposed to temperatures exceeding 30°C, patients should not use the medication and should seek advice from their pharmacist or the manufacturer's medical information service. While the SmPC specifies storage at temperatures up to 30°C for a maximum of 14 days, exposure to higher temperatures—such as being left in a hot car or direct sunlight—may compromise the medication more rapidly. If such exposure has occurred or if there is uncertainty about storage conditions, patients should err on the side of caution and obtain replacement medication. Additionally, any Trulicity pen showing visible changes such as cloudiness, discolouration, or particulate matter should not be used and should be discarded, as these signs indicate potential degradation or contamination.

Proper disposal of Trulicity pens is important for both safety and environmental reasons. Used or expired pens should be placed in a sharps container, which can be obtained from community pharmacies or GP practices. When the sharps container is full, patients should follow local NHS or council arrangements for disposal, which vary across the UK. In many areas, this involves returning the container to a pharmacy or arranging council collection. Patients should check with their local healthcare provider or council for specific guidance. Trulicity pens should never be disposed of in household waste or recycling bins due to the needle component and residual medication.

If patients are uncertain about their medication's storage history, they should contact their community pharmacist or GP practice for guidance rather than using potentially compromised medication. Emergency supplies may be possible under UK regulations—patients should ask their community pharmacist about this option whilst replacement prescriptions are arranged. Patients should maintain open communication with their healthcare team about any storage concerns, as effective diabetes management depends on using medication that has been stored correctly and maintains full potency. Patients are encouraged to report any suspected side effects to the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Frequently Asked Questions