Learning how to use a Trulicity pen correctly is essential for effective type 2 diabetes management. Trulicity (dulaglutide) is a once-weekly GLP-1 receptor agonist that helps regulate blood glucose levels through a convenient, pre-filled injection pen. Unlike daily insulin regimens, Trulicity requires no mixing, measuring or dose dialling, making it a straightforward option for many patients. This guide provides step-by-step instructions on preparing, injecting and storing your Trulicity pen, alongside practical advice on site rotation, common mistakes to avoid, and safe disposal practices. Proper injection technique ensures optimal medication absorption and helps you achieve better glycaemic control as part of your diabetes care plan.

What Is Trulicity and How Does It Work?

Trulicity (dulaglutide) is a once-weekly injectable medication used to manage 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 medication works through several complementary mechanisms. Trulicity stimulates insulin secretion from the pancreas when blood glucose levels are elevated, helping to lower blood sugar after meals. Simultaneously, it suppresses the release of glucagon, a hormone that raises blood glucose. Additionally, Trulicity slows gastric emptying, which means food moves more slowly from the stomach into the small intestine, resulting in a more gradual rise in blood glucose after eating. Many patients also experience reduced appetite, which may contribute to weight loss—a beneficial effect for many people with type 2 diabetes.

Trulicity may be used as monotherapy when diet and exercise alone do not provide adequate glycaemic control and when metformin is considered inappropriate due to intolerance or contraindications. It is also used in combination with other glucose-lowering medicines, including insulin. According to NICE guidance (NG28), GLP-1 receptor agonists such as Trulicity may be considered as part of triple therapy regimens, particularly for people with a body mass index (BMI) of 35 kg/m² or above (or lower BMI thresholds for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background), or when weight loss would benefit other obesity-related comorbidities, or when insulin therapy would have significant occupational implications.

The medication comes in a pre-filled, single-dose pen that requires no mixing, measuring, or dialling of a dose on the pen itself. Each pen contains one weekly dose, making it convenient for patients who prefer less frequent injections compared to daily insulin regimens. Trulicity is available in several dose strengths (0.75 mg, 1.5 mg, 3 mg, and 4.5 mg). Your healthcare provider will determine the appropriate starting dose—typically 0.75 mg or 1.5 mg once weekly—and may increase the dose in increments (to 3 mg, then 4.5 mg if needed) at intervals of at least four weeks, based on your individual response and tolerability.

Important safety information:

Trulicity is not suitable for treating type 1 diabetes or diabetic ketoacidosis. If you experience severe, persistent abdominal pain, seek urgent medical attention, as this may indicate pancreatitis. Signs of a severe allergic reaction (such as swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, severe rash or itching) require immediate emergency care. If you are also taking insulin or a sulfonylurea, your risk of hypoglycaemia (low blood sugar) may be increased; your doctor may need to adjust these doses. Maintain adequate hydration if you experience significant gastrointestinal symptoms such as nausea, vomiting or diarrhoea.

Preparing Your Trulicity Pen Before Use

Proper preparation of your Trulicity pen is essential for safe and effective administration. Before each injection, take time to inspect the pen and ensure you are ready to proceed.

Initial inspection steps:

• Remove the pen from the refrigerator approximately 30 minutes before injection to allow it to reach room temperature. This helps reduce discomfort during injection.

• Check the expiration date printed on the pen label. Never use a pen that has passed its expiry date, as the medication may have degraded and lost effectiveness.

• Examine the medication through the viewing window on the pen. The solution should be clear and colourless to slightly yellow. Do not use the pen if the liquid appears cloudy, discoloured, or contains particles or flakes.

• Inspect the pen for any visible damage. Ensure the pen has not been frozen. If you suspect the medication has been frozen at any point, discard it and use a new pen.

• Check that the lock ring is in the locked position and that the green injection button has not been pressed.

Preparing yourself and your injection area:

Wash your hands thoroughly with soap and water before handling the pen. Choose your injection site (abdomen, thigh, or upper arm) and clean the area with an alcohol wipe if recommended by your healthcare provider, allowing the skin to dry completely before injection.

Gather everything you will need: the Trulicity pen, an alcohol wipe (if using), and a sharps disposal container for safe disposal after use. Unlike some other injectable medications, Trulicity pens do not require you to attach a needle or prime the pen—the pen is pre-assembled with a hidden needle and ready to use straight from the packaging. This design significantly reduces the complexity of administration and minimises the risk of dosing errors.

For detailed device-specific instructions, always refer to the official Trulicity Patient Information Leaflet and Instructions for Use provided with your medication.

Step-by-Step Guide to Injecting Trulicity

Administering Trulicity is straightforward thanks to its user-friendly pen design. Follow these steps carefully to ensure proper injection technique, as described in the official Instructions for Use:

Step 1: Remove the base cap

Twist and pull off the clear base cap from the pen. The needle remains hidden inside the pen—do not attempt to touch it. Once removed, do not replace the base cap, as this could damage the needle. You must use the pen immediately after removing the cap.

Step 2: Unlock the pen

Turn the lock ring on the pen from the locked to the unlocked position. This step is essential—the pen will not inject if it remains locked.

Step 3: Position the pen

Place the clear base of the pen flat and firmly against your chosen injection site. The pen must be positioned at a 90-degree angle (perpendicular) to your skin. Ensure the entire clear base is in contact with your skin.

Step 4: Press and hold

Press the green injection button firmly. You will hear a loud click, which indicates the injection has started. Continue holding the pen firmly against your skin—this is crucial. You will hear a second click after several seconds, which signals the injection is nearing completion.

Step 5: Complete the injection

After the second click, continue to hold the pen in place as instructed in the device Instructions for Use (typically for a few additional seconds). The visual indicator in the viewing window will confirm when the injection is complete—check your Instructions for Use for the specific completion signal for your pen.

Step 6: Remove and dispose

Carefully lift the pen away from your skin. The needle will automatically retract into the pen for safety. Place the used pen immediately into a sharps disposal container—never attempt to reuse a Trulicity pen.

If you experience resistance, the injection does not feel complete, or the visual indicator does not confirm successful delivery, the full dose may not have been administered. Contact your healthcare provider or pharmacist for guidance before attempting another injection.

Where to Inject Trulicity and Rotating Injection Sites

Trulicity is administered as a subcutaneous injection, meaning it is injected into the fatty tissue just beneath the skin rather than into muscle. Choosing the correct injection site and rotating between sites is important for optimal medication absorption and to prevent skin complications.

Approved injection sites:

Trulicity can be injected into three areas of the body:

• Abdomen (stomach area): Inject at least 5 cm (2 inches) away from your navel (belly button). This is often the most convenient site for self-injection and typically provides consistent absorption.

• Thigh: Use the front and outer areas of your thigh, in the middle section between your hip and knee. Avoid the inner thigh, which has less subcutaneous fat and more blood vessels.

• Upper arm: The back of the upper arm, in the fatty area between the shoulder and elbow, can be used. This site may require assistance from another person, as it can be difficult to reach and position the pen correctly yourself.

Inject into subcutaneous fat and avoid intramuscular injection. A skin pinch technique may be used if advised by your diabetes care team, depending on your body habitus.

The importance of site rotation:

Rotating your injection sites is essential to prevent lipohypertrophy (lumpy, thickened skin) or lipoatrophy (loss of fatty tissue), both of which can affect medication absorption and cause discomfort. These conditions develop when the same site is used repeatedly, causing local tissue damage.

Develop a systematic rotation pattern. For example, if you inject in your abdomen one week, use your right thigh the following week, then your left thigh, before returning to your abdomen. Keep each new injection at least 2.5 cm (1 inch) away from the previous injection site. Some patients find it helpful to keep a simple diary or use a body diagram to track injection locations.

Avoid injecting into areas where the skin is tender, bruised, red, hard, scarred, or damaged. If you notice persistent lumps, changes in skin texture, or reduced effectiveness of your medication, consult your diabetes care team, as these may indicate injection site problems requiring assessment.

Common Mistakes to Avoid When Using Your Trulicity Pen

Understanding common errors in Trulicity administration can help you avoid problems and ensure you receive the full therapeutic benefit of your medication.

Mistake 1: Forgetting to unlock the pen

One of the most common errors is attempting to press the green injection button without first turning the lock ring to the unlocked position. The pen will not inject if it remains locked. Always unlock the pen after removing the base cap and before pressing the injection button.

Mistake 2: Not holding the pen in place long enough

Removing the pen too quickly after the second click is a frequent error. The injection mechanism requires several seconds to deliver the full dose. Always follow the timing instructions in your device Instructions for Use and wait for the visual indicator that confirms the injection is complete before lifting the pen away. Rushing this step may result in incomplete dosing, potentially affecting your blood glucose control.

Mistake 3: Injecting through clothing

Always inject directly onto bare skin. Injecting through clothing can result in incomplete needle penetration, inaccurate dosing, and increased risk of needle damage. Take time to properly expose the injection site.

Mistake 4: Using the same injection site repeatedly

As discussed previously, failing to rotate injection sites can lead to lipohypertrophy or lipoatrophy, which impairs medication absorption. Establish a rotation schedule and adhere to it consistently.

Mistake 5: Storing the pen incorrectly

Trulicity must be refrigerated (2°C to 8°C) until use and protected from light. Storing pens at room temperature for extended periods or exposing them to heat or direct sunlight can degrade the medication. Never freeze Trulicity, as this permanently damages the medication.

Mistake 6: Attempting to reuse a pen

Each Trulicity pen is designed for single use only. Never attempt to reuse a pen or share pens with others, even if the needle is changed. This poses serious infection risks and violates safe injection practices.

Mistake 7: Incorrect management of missed doses

If you miss your scheduled weekly dose, take it as soon as you remember only if your next scheduled dose is at least 3 days (72 hours) away. If fewer than 3 days remain until your next dose, skip the missed dose and take your next dose on the usual day. Never double up doses to compensate for a missed injection. You may change your weekly injection day if needed, provided there are at least 3 days between doses. If you are frequently forgetting doses, speak with your healthcare provider about strategies to improve adherence, such as setting phone reminders or linking injections to a specific weekly activity.

Storing Your Trulicity Pen and Disposing of Used Pens Safely

Proper storage and disposal of Trulicity pens are essential for medication safety and environmental protection.

Storage guidelines:

Unopened pens should be stored in the refrigerator at 2°C to 8°C until the expiration date. Keep pens in their original carton to protect them from light. Store them away from the freezer compartment—if a pen has been frozen, it must be discarded, as freezing destroys the medication's effectiveness.

Once removed from the refrigerator for use, a pen can be kept at room temperature (up to 30°C) for up to 14 days if needed, though it is generally best to use it immediately after allowing it to warm to room temperature. Never store Trulicity in direct sunlight, near heat sources, or in hot environments such as car glove compartments.

Keep all pens out of reach of children and pets. The medication should remain in its protective carton until you are ready to use it.

Safe disposal practices:

Used Trulicity pens must be disposed of in an appropriate sharps container. These puncture-resistant containers are specifically designed for safe disposal of needles and injection devices. You can obtain sharps containers from:

• Your GP surgery or practice nurse

• Local pharmacies (many provide them free of charge)

• Diabetes specialist nurses

• Local council waste services

Never dispose of used pens in household rubbish or recycling bins, as the needle poses an injury risk to waste handlers. Do not attempt to remove the needle from the pen before disposal.

When your sharps container is three-quarters full, seal it according to the manufacturer's instructions. Return it to your pharmacy, GP surgery, or local authority collection point. Disposal pathways differ across the UK—confirm arrangements with your local council, GP surgery or pharmacy regarding bin provision and collection services. Many areas offer home collection services for sharps containers.

If you are travelling, carry a portable sharps container and research disposal options at your destination. The MHRA and NHS provide guidance on safe disposal of medical sharps, and your healthcare team can offer specific advice tailored to your circumstances.

Reporting side effects:

If you experience any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the Patient Information Leaflet. You can also report side effects directly via the MHRA Yellow Card scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

Frequently Asked Questions