Trulicity (dulaglutide) is officially listed as being in shortage, though the situation is more nuanced than a straightforward “out of stock.” The FDA lists dulaglutide as in shortage, while the manufacturer, Eli Lilly, reports that all four dosage strengths are available. The gap between those two statements explains much of the confusion patients are experiencing at the pharmacy counter.
What “In Shortage” Actually Means Right Now
As of the most recent FDA update, dulaglutide injection remains on the agency’s drug shortage list. However, Eli Lilly has reported that all presentations of Trulicity are available: the 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg pen injectors. The FDA notes that when a manufacturer reports a product as “available,” that reflects the company’s own assessment and is not an FDA determination that the shortage has been resolved.
In practical terms, this means the medication is being manufactured and shipped, but you may still have trouble filling your prescription at your local pharmacy. Supply chain dynamics, including distributor allocation, regional demand, and pharmacy ordering patterns, can create pockets where Trulicity is genuinely hard to find even though the manufacturer has stock. Your experience will vary depending on where you live and which pharmacy you use.
Why Your Pharmacy Might Still Be Out
The broader context is the enormous surge in demand for GLP-1 receptor agonist medications over the past two years. Trulicity is prescribed for type 2 diabetes, but the entire GLP-1 drug class has seen unprecedented demand driven partly by the popularity of similar medications for weight loss. This has strained manufacturing and distribution infrastructure across the category. Even when a manufacturer is producing at full capacity, distributors may limit how much each pharmacy can order to prevent hoarding, which creates the frustrating scenario where a drug exists in the supply chain but isn’t on the shelf in front of you.
In the UK, supply pressure became significant enough that regulators approved a batch-specific variation allowing Lilly to use US-packaged Trulicity pens to supplement British supply, a measure that underscores how tight global inventory has been.
What to Do If You Can’t Fill Your Prescription
If your pharmacy can’t get Trulicity, you have several options. The most straightforward is calling other pharmacies in your area. Because the shortage is distribution-driven rather than a total manufacturing halt, a pharmacy across town may have stock when yours doesn’t.
Eli Lilly operates LillyDirect, a home delivery service for its medications. Through LillyDirect, you can get Trulicity shipped directly to you if prescribed, with coordination of insurance prior authorizations and savings support built into the process. You can reach them at 1-844-559-3471. This route bypasses the local pharmacy supply chain entirely, which can help when the issue is regional availability rather than overall production.
If neither option works, talk to your prescriber about switching to another GLP-1 medication. Clinical guidance for switching between once-weekly GLP-1 drugs is well established: you stop the current medication and start the new one a week later, on the same day of the week you normally injected. For patients who were on a full dose of Trulicity and tolerating it well, the alternative is typically started at a moderate dose for four weeks before stepping up, to reduce the chances of nausea and other digestive side effects that often come with GLP-1 medications.
If you were already experiencing side effects on Trulicity, the recommendation is to wait until those symptoms resolve before starting a new GLP-1 drug, then begin at the lowest available dose.
Insurance Coverage During a Shortage
One complication with switching medications is insurance. If Trulicity is your plan’s preferred drug, an alternative like semaglutide may require prior authorization or a formulary exception. Most insurers have processes for these situations, and a documented shortage of your prescribed medication strengthens the case for an exception. Your prescriber’s office typically handles this paperwork, but it can take days to resolve, so start the conversation early rather than waiting until you’ve missed doses.
Be Cautious With Compounded Versions
When brand-name GLP-1 medications are hard to find, some patients turn to compounded alternatives. These are custom-mixed versions produced by compounding pharmacies, and they carry meaningfully higher risk. The FDA has received reports of adverse events from compounded GLP-1 injectables, some requiring hospitalization, primarily due to dosing errors.
The core problem is that compounded injectables come in vials that patients must draw from using a syringe, unlike the pre-filled pen injectors most people are used to. Concentrations vary between compounders, and even a single compounder may offer multiple concentrations. Instructions sometimes list doses in “units” rather than milligrams or milliliters, and patients have received syringes significantly larger than needed for their prescribed dose. This combination of unfamiliar equipment and inconsistent labeling has led to overdoses causing severe nausea, vomiting, fainting, dehydration, acute pancreatitis, and gallstones.
The FDA’s position is clear: compounded drugs do not undergo premarket review for safety, quality, or effectiveness, and should only be used when no FDA-approved option can meet a patient’s medical needs. Given that Trulicity and several alternative GLP-1 medications remain available through various channels, compounding is rarely the best path.
Long-Term Supply Outlook
Eli Lilly is investing heavily in manufacturing capacity. The company has announced plans for new production facilities in Texas, Virginia, and Alabama, plus an expansion of an existing site in Puerto Rico. The Alabama facility alone represents a $6 billion investment focused on producing active pharmaceutical ingredients for GLP-1 medications, including orforglipron, Lilly’s oral GLP-1 drug currently under regulatory review. Construction on the Alabama site is expected to begin in 2026, with completion anticipated in 2032.
That timeline means the current supply constraints are unlikely to vanish overnight. The immediate picture is one of gradual improvement as existing manufacturing catches up with demand, with major capacity expansions still years away. For now, persistence in sourcing your medication, whether through multiple pharmacy calls, LillyDirect, or a supervised switch to an alternative, remains the most reliable strategy.