How to use the Trulicity (dulaglutide) pen per Lilly's Instructions for Use. Step-numbered procedure, supplies, common mistakes. Not medical advice.
Key points
- 01Inspect the pen. Confirm the dose on the label matches the prescription. Lilly's Instructions for Use specifies that the solution be clear and colourless. A cloudy, discoloured, or particle-containing solution is grounds to discard the pen.
- 02Clean the injection site. Swab the chosen site with the alcohol prep pad and let the alcohol air-dry for at least 10 to 15 seconds. Wet alcohol carried into subcutaneous tissue is a common cause of stinging.
- 03Pull off the grey base cap. Pull the grey base cap straight off and set it aside. Do not touch the clear end, where the hidden needle deploys. Do not recap the pen.
- 04Place the pen flat on the skin. Hold the clear, flat end of the pen firmly against the cleaned site at a right angle. The hidden needle stays retracted until you press the green button.
- 05Press and hold the green button. Press the green injection button and hold it down. A first loud click signals the injection has started. The pen inserts the needle automatically and begins delivering the medication.
- 06Hold flat until the second click. Keep the pen held flat and firm against the skin. A second click signals delivery is complete. Lilly's Instructions for Use describes this as roughly 5 to 10 seconds.
- 07Confirm and lift. Confirm through the inspection window that the grey plunger is visible at the top, which indicates the full dose was delivered. Only then pull the pen straight up off the skin. Lifting early can cause an incomplete dose.
- 08Dispose of the pen. Drop the entire used pen into an FDA-cleared sharps container immediately. The Trulicity pen is single-use and is not reusable. Do not recap and do not handle the needle.
Pre-injection checklist
- ✓Wash hands for at least 20 seconds, or use an alcohol-based hand rub.
- ✓Check the expiry date and inspect the solution through the inspection window. Lilly's Instructions for Use describes the solution as clear and colourless. Discard the pen if it is cloudy, discoloured, or contains particles.
- ✓Let the pen warm to room temperature for about 30 minutes if it has just come out of the fridge.
- ✓Choose an injection site (abdomen, front of either thigh, or back of either upper arm if a caregiver is administering). Rotate weekly.
After the injection
- Press a clean cotton ball or gauze square to the site for 10 to 15 seconds if any bleeding occurs.
- Log the date, dose, and injection site for rotation tracking.
- Store the pen at room temperature (≤ 86°F / 30°C) for up to 14 days once removed from the fridge.
Common mistakes
Lifting the pen before the second click
FixKeep the pen held flat against the skin until the second click sounds and the grey plunger appears in the inspection window. Lifting early can cause an incomplete dose.
Touching the clear needle end or recapping
FixAfter removing the grey base cap, do not touch the clear end and do not put the cap back on. Either can damage the hidden needle or cause an injury.
Injecting a refrigerated pen straight away
FixLet the pen warm to room temperature for about 30 minutes. A refrigerated dose is associated with more stinging in the patient-education literature.
Same-site injections every week
FixRotate across the abdomen and the two thighs. Repeated same-site injections increase the risk of lipohypertrophy.
When to call a clinician
- A lump or swelling in the neck, hoarseness, or trouble swallowing, Trulicity carries a boxed warning for thyroid C-cell tumours.
- Severe upper abdominal pain (possibly radiating to the back), pancreatitis is in the Trulicity warnings.
- Swelling of the face, lips, tongue, or throat, or difficulty breathing, possible serious allergic reaction.
- Severe right-upper-quadrant pain with fever, nausea, or yellowing skin, possible gallbladder disease.
- Persistent vomiting or diarrhoea preventing fluid intake, risk of acute kidney injury.
