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[21] [22] Some more serious side effects include: [12] Ongoing pain that begins in the upper left or middle of the stomach but may spread to the back Vomiting Hives, rash, itching Difficulty breathing or swallowing Swelling of lips, tongue, face, or throat Vision changes Fast heartbeat Dizziness or fainting Pain in the upper stomach, fever, yellowing of skin or eyes, or clay-colored stools Other reported adverse effects of dulaglutide include a small mean increase in heart rate, small decrease in systolic blood pressure and increases in pancreatic enzymes