Trulicity (Dulaglutide) Shortage Guide for Healthcare Providers

The GLP-1 receptor agonist shortage has put Trulicity (dulaglutide) supply under significant pressure across the United States, creating real clinical challenges for providers managing patients with type 2 diabetes and cardiovascular risk. This guide covers what's driving the shortage, how to navigate therapeutic switching, what to expect from prior authorization hurdles, how to talk to patients, and how FindUrMeds can serve as a practical resource for your practice.

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The Current Trulicity Shortage Landscape

Trulicity has faced intermittent supply constraints as a downstream consequence of the broader GLP-1 receptor agonist shortage — driven largely by explosive demand for semaglutide-based medications (Ozempic, Wegovy) that strained the entire drug class's manufacturing and distribution infrastructure.

While Eli Lilly has worked to maintain dulaglutide supply, many pharmacies — particularly independent and smaller chain locations — have experienced inconsistent stock of specific doses. The 0.75 mg and 1.5 mg starter doses have been most reliably available at times, while the 3 mg and 4.5 mg titration doses have seen more frequent stockouts in certain regions.

The FDA's drug shortage database has not consistently listed Trulicity as an official shortage, but that doesn't reflect what providers and patients are experiencing on the ground. Localized shortages, distribution gaps, and payer-driven access barriers have all contributed to a fragmented supply picture.

What this means for your practice: Patients may be calling your office frustrated after striking out at multiple pharmacies. Your team may be fielding more prior authorization appeals. And some patients may be going without doses — which carries real clinical consequences for glycemic control and, in high-risk patients, cardiovascular outcomes.

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Therapeutic Alternatives and Switching Protocols

If a patient cannot access Trulicity, you have several evidence-based alternatives within and adjacent to the GLP-1 class. Here's a practical overview.

GLP-1 Receptor Agonist Alternatives

Semaglutide (Ozempic — weekly injectable) The most pharmacologically similar switch. Semaglutide is a more potent GLP-1 agonist with strong cardiovascular outcome data (SUSTAIN-6). However, Ozempic itself remains under shortage pressures, and prior authorization requirements are common.

• Typical starting dose: 0.25 mg subcutaneously weekly × 4 weeks, then 0.5 mg weekly
• Efficacy: Generally superior A1C reduction and weight loss versus dulaglutide
• Cardiovascular benefit: Established for patients with existing CVD

Exenatide extended-release (Bydureon BCise — weekly injectable) A longer-standing weekly GLP-1 option with a different delivery mechanism (microsphere suspension). Generally considered less potent than dulaglutide or semaglutide for A1C lowering, but may be more accessible and has a favorable payer coverage profile at some plans.

• Starting dose: 2 mg subcutaneously weekly (fixed dose)
• Note: Patients transitioning from Trulicity do not need a titration period

Liraglutide (Victoza — daily injectable) A once-daily option with established cardiovascular data (LEADER trial). Less convenient than weekly agents but may be stocked more reliably in some areas. Generally well tolerated.

• Starting dose: 0.6 mg subcutaneously daily × 1 week, then 1.2 mg daily (max 1.8 mg)

Tirzepatide (Mounjaro) If the patient has commercial insurance and meets criteria, tirzepatide — a dual GIP/GLP-1 agonist — offers superior glycemic and weight outcomes. Payer coverage remains variable, and shortages have also affected some tirzepatide doses. Worth considering for patients where coverage aligns.

Non-GLP-1 Alternatives

When GLP-1 access is completely blocked, consider:

• SGLT-2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) — particularly in patients with heart failure or CKD where cardio-renal benefits are a priority
• DPP-4 inhibitors (sitagliptin, linagliptin) — well tolerated, weight neutral, widely available, but modest A1C reduction
• Basal insulin — appropriate for patients with significant hyperglycemia who need rapid control

Clinical Considerations When Switching

A few things worth keeping in mind before you write the new prescription:

Don't assume equivalent dosing. GLP-1 agents differ in receptor selectivity, half-life, and potency. A patient well-controlled on Trulicity 1.5 mg may need a titration period on a new agent to allow for GI side effect accommodation — even if the new agent is technically more potent.

Watch for hypoglycemia in combination regimens. If a patient is on insulin or a sulfonylurea alongside Trulicity, switching GLP-1s doesn't necessarily require insulin dose adjustment on day one — but monitor closely in the first few weeks.

Renal function matters. Exenatide is renally cleared and is not recommended in patients with eGFR < 45. Confirm renal status before switching.

Cardiovascular indication. If Trulicity was prescribed specifically for cardiovascular risk reduction (in patients with established CVD), prioritize alternatives with proven CVOT data — semaglutide or liraglutide. Not all GLP-1 agents carry the same level of CV outcome evidence.

Document the clinical rationale. When switching due to a shortage, document in the chart that the change was supply-driven, not driven by clinical failure. This matters for future prior authorization requests and for reverting to Trulicity once supply stabilizes.

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Prior Authorization Considerations

Switching GLP-1 agents almost always triggers a new prior authorization process — and this is where your team's time is most likely to be consumed during a shortage.

A few practical considerations:

Start the PA early. Don't wait for the pharmacy to reject the claim. If you know Trulicity is unavailable, proactively initiate PA for the intended alternative before the patient runs out of medication.

Prepare for step therapy requirements. Many payers require documented failure of metformin and/or a DPP-4 inhibitor before approving a GLP-1. If your patient has already tried these agents, make sure that history is clearly documented in your PA submission.

Use the shortage as supporting documentation. Some payers will accept a documented shortage-related supply failure as a qualifying reason for a non-preferred formulary switch. Include a brief clinical note confirming the shortage and unsuccessful pharmacy attempts.

Appeal if needed. First-level PA denials are not the end of the road. A peer-to-peer review with the payer's medical director — especially for patients with established CVD or significant A1C elevation — frequently results in approval.

For cost-saving strategies your patients can use while navigating coverage changes, see how to help patients save money on Trulicity.

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Communicating With Patients About Shortages

How you frame a shortage conversation matters. Patients who feel well-managed on Trulicity may feel anxious or frustrated — especially if their A1C has been stable and they're being asked to switch.

Lead with reassurance. Let them know the medication change is supply-driven, not because Trulicity stopped working for them. Reinforce that you're monitoring the situation and may return to Trulicity when it's available.

Set realistic expectations about GI side effects. Patients switching to a new GLP-1 should expect that GI symptoms (nausea, loose stools) may temporarily worsen as the body adjusts to a new agent — even if they had good tolerability on Trulicity. Prepare them for this and give guidance on dose timing and dietary adjustments.

Explain the prior authorization delay. If coverage approval for the alternative will take several days, let your patient know what to expect and whether there are bridge options (samples, manufacturer assistance programs) to cover the gap.

Don't rely entirely on patients to find the medication. Asking a patient to call around to 15 pharmacies is a real burden — and many patients, particularly older adults, won't do it effectively. This is where using a service like FindUrMeds can take that burden off both your patient and your staff.

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Using FindUrMeds as a Provider Resource

FindUrMeds was built for exactly this kind of situation.

When a patient's prescription can't be filled locally — whether due to shortage, controlled substance stocking limits, or specialty distribution gaps — FindUrMeds contacts pharmacies on the patient's behalf and locates stock across 15,000+ pharmacy locations nationwide, typically within 24–48 hours. The network includes CVS, Walgreens, Rite Aid, Walmart, Kroger, Publix, Costco, Sam's Club, and more.

For providers, this means:

• Fewer calls to your office from frustrated patients
• A practical referral you can make in seconds ("Go to findurmeds.com")
• A 92% success rate finding medications that patients couldn't locate on their own
• No cost to your practice — patients use the service directly

If you're regularly dealing with shortage-related access problems for Trulicity or other GLP-1s, directing patients to FindUrMeds before they've spent hours on the phone is a small workflow change that can meaningfully reduce your team's administrative burden.

For a patient-facing version of this resource, see how to help patients find Trulicity in stock.

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FAQ

Is Trulicity officially listed as a shortage by the FDA?

Not consistently. The FDA's drug shortage database reflects manufacturer-reported supply disruptions at the national level. Trulicity's shortage is largely a localized and distribution-level issue — meaning your patient's pharmacy may be out while a pharmacy 10 miles away has stock. This makes it less visible in official channels but no less real for patients trying to fill their prescription.

If I switch a patient from Trulicity to semaglutide, do I need to restart them at the lowest dose?

Generally, yes — unless you have good reason to believe the patient will tolerate a higher starting dose. Semaglutide's standard titration (0.25 mg weekly for 4 weeks before increasing to 0.5 mg) exists to minimize GI side effects. Patients with excellent tolerability on Trulicity may still experience GI adjustment on a new GLP-1 agent. Err toward starting low and titrating.

How do I handle a patient who can't afford the alternative GLP-1 while waiting for PA approval?

Eli Lilly (Trulicity's manufacturer) and other GLP-1 manufacturers offer patient assistance programs and copay cards. Samples from your office can bridge a short gap. If the patient is uninsured or underinsured, GoodRx and similar discount platforms may offer partial relief — though GLP-1 list prices remain high. For a more complete overview of cost options, see how to help patients save money on Trulicity.

Should I document a shortage-related switch differently in the medical record?

Yes — and it matters. Note clearly that the therapeutic change was supply-driven and that the patient was clinically stable on Trulicity. This supports prior authorization for the new agent, facilitates reverting to Trulicity once supply is restored, and ensures clinical continuity for any provider who reviews the chart later.

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Need help finding Trulicity in stock? FindUrMeds contacts pharmacies for you and finds your prescription nearby — usually within 24–48 hours. No more calling around.

Find Trulicity Near You →

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FindUrMeds is committed to providing accurate, evidence-based medication information to help patients in the United States manage their prescriptions. This content is for informational purposes only and does not constitute medical advice. Always consult your doctor or pharmacist before making any changes to your medication regimen.

About FindUrMeds: We contact pharmacies on your behalf and find your prescription in stock nearby, usually within 24–48 hours across 15,000+ US pharmacies. Learn how it works →