Trulicity (dulaglutide) is a once-weekly injectable medicine for managing type 2 diabetes mellitus. Knowing where to inject Trulicity correctly is essential for safe, effective treatment and minimising discomfort. This glucagon-like peptide-1 (GLP-1) receptor agonist is administered subcutaneously using a pre-filled pen into three approved sites: the abdomen, thigh, or upper arm. Proper site selection, rotation, and injection technique help ensure optimal medication absorption whilst reducing the risk of local reactions. This guide provides practical, evidence-based advice on injection sites, technique, rotation strategies, and managing common injection site reactions in line with UK clinical guidance.
Summary: Trulicity should be injected subcutaneously into the abdomen (avoiding 5 cm around the navel), thigh (front or outer upper leg), or upper arm (back of upper arm).
- Trulicity (dulaglutide) is a once-weekly GLP-1 receptor agonist for type 2 diabetes administered subcutaneously via pre-filled pen.
- All three approved injection sites (abdomen, thigh, upper arm) provide similar medication absorption with no clinically relevant differences.
- Systematic site rotation (keeping 1–2 cm from previous injection points) reduces local reactions and prevents lipohypertrophy.
- Avoid injecting into areas with scarring, bruising, redness, or active skin conditions; never inject intramuscularly or intravenously.
- Mild injection site reactions (redness, swelling, bruising) are common and typically resolve within hours to days without intervention.
- Seek urgent medical attention for signs of severe allergic reaction including difficulty breathing, facial swelling, or widespread rash.
Table of Contents
Am I eligible for weight loss injections?
Find out whether you might be eligible!
Answer a few quick questions to see whether you may be suitable for prescription weight loss injections (like Wegovy® or Mounjaro®).
- No commitment — just a quick suitability check
- Takes about 1 minute to complete
Recommended Injection Sites for Trulicity
Trulicity (dulaglutide) is a once-weekly injectable medicine used to manage type 2 diabetes mellitus. It belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class and is administered subcutaneously using a pre-filled, single-dose pen. Understanding the correct injection sites is essential for safe and effective treatment.
The three approved injection sites for Trulicity are:
-
Abdomen – avoiding a 5 cm radius around the navel
-
Thigh – the front or outer area of the upper leg
-
Upper arm – the back of the upper arm, which typically requires assistance from another person or carer
These sites are chosen because they contain adequate subcutaneous tissue for proper absorption of the medication. According to the Summary of Product Characteristics (SmPC), there are no clinically relevant differences in dulaglutide exposure between the abdomen, thigh, or upper arm. You may choose whichever site you can access correctly and rotate regularly. When injecting into the thigh, select the upper, outer portion where there is sufficient fatty tissue beneath the skin.
Trulicity must be injected subcutaneously (under the skin) and not intramuscularly or intravenously. Never inject into areas with visible scarring, bruising, redness, or active skin conditions such as psoriasis or eczema. Avoid injecting into areas where clothing may rub against the injection site immediately after administration, as this could cause irritation. If you are uncertain about the appropriate injection technique or site selection, ask your GP, practice nurse, or diabetes specialist nurse for a practical demonstration.
How to Inject Trulicity Safely
Proper injection technique is crucial for ensuring medication efficacy and minimising discomfort or complications. Trulicity is supplied in a single-use pen device designed to simplify the injection process, but following the correct procedure remains essential.
Step-by-step injection guidance:
Before you start: Check the label on the pen to confirm the medicine name, strength, and expiry date. Do not use the pen if it has been dropped, damaged, or if the expiry date has passed. Store Trulicity in the refrigerator at 2–8°C. Do not freeze. Protect from light. If needed, you may keep a pen at room temperature (up to 30°C) for up to 14 days—discard it if this period is exceeded. Remove the pen from the refrigerator approximately 30 minutes before injection to allow it to reach room temperature, which can reduce injection discomfort.
Preparation: Wash your hands thoroughly with soap and water. Check the medication through the viewing window—it should be clear and colourless to slightly yellow. Do not use if the solution appears cloudy, discoloured, or contains particles. Never share your pen with another person, even if the needle is changed, as this can transmit infection.
Site selection and cleaning: Choose your injection site and clean the area with an alcohol wipe, allowing it to dry completely before proceeding. Do not fan or blow on the area, as this may reintroduce bacteria.
Injection technique: Follow the Instructions for Use supplied with your pen, as device-specific steps (such as unlocking the pen or checking the injection progress indicator) may vary slightly by pen version. Generally, remove the base cap from the pen. Place the clear base flat against your cleaned skin at a 90-degree angle. Press and hold the green injection button—you will hear a click. Continue holding the pen firmly against your skin until you hear a second click, which typically occurs after approximately 5 to 10 seconds. This second click confirms the full dose has been delivered. Remove the pen and dispose of it safely in a sharps container.
Post-injection care: Avoid rubbing the injection site, as this can increase irritation or bruising. A small amount of bleeding or clear fluid at the injection site is normal—simply apply gentle pressure with a clean tissue or cotton wool if needed. Record the date, time, and location of your injection to help with site rotation.
Sharps disposal: Use an NHS-provided sharps bin, which you can obtain from your GP surgery or local pharmacy. Return the filled container according to your local NHS arrangements. Never dispose of pens in household waste. If you experience significant pain during injection or notice any unusual symptoms afterwards, contact your healthcare provider for advice.
Rotating Injection Sites: Why It Matters
Systematic rotation of injection sites is a fundamental aspect of long-term injectable medication management and is particularly important for patients using Trulicity weekly over extended periods. Rotating sites helps to reduce local reactions such as redness, itching, and bruising, and helps to avoid the development of lumps under the skin.
Whilst lipohypertrophy (abnormal accumulation of fatty tissue creating lumps or thickened areas) is mainly reported with insulin therapy and is uncommon with GLP-1 receptor agonists like dulaglutide, it can still occur with repeated injections into the same location. These areas may impair medication absorption and can take months or even years to resolve. Once lipohypertrophy develops, the affected areas should be avoided for future injections.
Repeated trauma to the same site can also cause localised inflammation, scarring, and reduced subcutaneous tissue integrity, which may result in increased injection discomfort. Some patients may develop areas of lipoatrophy (loss of fatty tissue), though this is uncommon with modern GLP-1 receptor agonists.
Recommended rotation strategy: Use different areas within each injection site, keeping at least 1–2 cm from the previous injection point. Rotate between the abdomen, thighs, and upper arms as appropriate. For example, if using the abdomen, mentally divide it into sections and move through these areas over consecutive weeks. According to the SmPC, dulaglutide exposure is similar across all approved injection sites, so you may rotate freely without concern for differences in effectiveness. Keep a written or digital log of injection sites to ensure systematic rotation. If you notice any lumps, hardened areas, or persistent tenderness at injection sites, inform your diabetes care team promptly, as these areas should be avoided until fully healed. The FIT UK (Forum for Injection Technique) and Diabetes UK provide further guidance on safe injection site rotation.
Common Injection Site Reactions and How to Manage Them
Whilst Trulicity is generally well-tolerated, injection site reactions can occur and are amongst the most frequently reported adverse effects. Understanding what is normal versus what requires medical attention helps patients manage their treatment confidently.
Mild, expected reactions include temporary redness, slight swelling, or minor bruising at the injection site. These typically resolve within a few hours to a few days without intervention. Some patients report mild itching or a small raised area immediately after injection, which usually subsides quickly. Applying a cool (not ice-cold) compress for 10–15 minutes after injection may provide relief if discomfort occurs.
Less common but manageable reactions include small nodules or firm areas under the skin. Injection site reactions with GLP-1 receptor agonists are generally less common than with insulin. If nodules develop, avoid injecting into the affected area, ensure proper site rotation, and discuss the issue with your diabetes team. Persistent bruising may suggest injection technique issues—ensure you are not injecting too quickly or into areas with prominent blood vessels.
When to seek medical advice: Contact your GP, diabetes specialist nurse, or call NHS 111 if you experience:
-
Persistent lumps or hardened areas that do not resolve
-
Signs of infection such as warmth, pus, spreading redness, or fever
-
Unexplained bruising or bleeding that seems excessive
-
Severe pain or extensive swelling at the injection site
Emergency care: Call 999 or attend A&E immediately if you develop:
-
Difficulty breathing
-
Swelling of the face, lips, tongue, or throat
-
Widespread rash, hives, or collapse
These may be signs of a severe allergic reaction (anaphylaxis), which requires urgent treatment. According to the SmPC and European Public Assessment Report (EPAR), serious injection site reactions with Trulicity are rare. However, as with any subcutaneous medication, there is a small risk of cellulitis or abscess formation if bacteria are introduced during injection. Maintaining meticulous hygiene, using proper technique, and never reusing pens are essential preventive measures.
If you develop recurrent injection site problems, your healthcare team may review your technique, consider alternative injection sites, or assess whether any underlying factors (such as anticoagulant therapy or skin conditions) are contributing to the issue. You can report any suspected side effects via the MHRA Yellow Card scheme at https://yellowcard.mhra.gov.uk, which contributes to ongoing medication safety monitoring in the UK.
Frequently Asked Questions
Can I inject Trulicity in the same spot each week?
No, you should rotate injection sites systematically, keeping at least 1–2 cm from the previous injection point. Repeated injections in the same location can cause lumps, reduced absorption, and increased discomfort over time.
Is the abdomen or thigh better for injecting Trulicity?
Both sites are equally effective, as dulaglutide absorption is similar across all approved injection sites (abdomen, thigh, upper arm). Choose the site you can access comfortably and rotate regularly between available sites.
What should I do if my Trulicity injection site becomes red or swollen?
Mild redness and swelling typically resolve within hours to days. Apply a cool compress for comfort and avoid injecting into the affected area. Contact your GP or diabetes nurse if symptoms persist, worsen, or show signs of infection such as warmth, pus, or fever.
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.
Heading 1
Heading 2
Heading 3
Heading 4
Heading 5
Heading 6
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur.
Block quote
Ordered list
- Item 1
- Item 2
- Item 3
Unordered list
- Item A
- Item B
- Item C
Bold text
Emphasis
Superscript
Subscript
