What is Trulicity (Dulaglutide)?
Trulicity is a once-weekly injectable antidiabetic medication that is used to control blood sugar levels in patients with type 2 diabetes. Trulicity belongs to a drug class called glucagon-like peptide-1 (GLP-1) agonist, it is not insulin. Trulicity should be used with diet and exercise to improve blood sugar levels in patients with type 2 diabetes. This medication is also used to reduce the risk of serious heart problems such as stroke and heart attack in adults who have type 2 diabetes and heart disease. Trulicity is not used in the treatment of type 1 diabetes.
How does Trulicity work?
Trulicity works by mimicking the action of GLP-1. GLP-1 is a natural hormone within the body that helps to regulate blood sugar levels. It works by binding to GLP-1 receptors, therefore, increasing insulin production and lowering sugar secretion from the liver and slowing stomach emptying. Trulicity has also been known to reduce the risk of cardiovascular events in adults with type 2 diabetes who also have cardiovascular disease.
How it’s Used?
Trulicity should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C) until it is ready to be used. Trulicity can be left out of the refrigerator at a room temperature that is not over 86°F (30°C), for up to 14 days. It must be discarded after 14 days at room temperature.
How to Take
Trulicity comes in a once-weekly injectable pen. The Trulicity Pen is easy to self-administer and should be injected subcutaneously once a week into the stomach, thigh, or upper arm. Trulicity can be administered at any time of day but should be given on the same day weekly and the time should be kept as consistent as possible. Injection sites should be rotated with each use. Each pen contains a single dose of Trulicity and should be discarded into a sharp’s container after use.
Trulicity is available in the form of a single-dose pen in the following strengths
- 75 mg/0.5 mL solution in a single-dose pen
- 5 mg/0.5 mL solution in a single-dose pen
- 3 mg/0.5 mL solution in a single-dose pen
- 5 mg/0.5 mL solution in a single-dose pen
Dosing for Adults
The recommended starting dose of Trulicity is 0.75 mg injected subcutaneously (under the skin) once weekly.
The dose can be increased to 1.5mg once weekly as needed for additional blood sugar control. The dose can further be increased to 3 mg once weekly after four weeks on the 1.5 mg dose. If further blood sugar control is needed, the dose can be increased to 4.5 mg once weekly after 4 weeks on the 3mg dose.
The maximum weekly dose of Trulicity is 4.5 mg weekly.
Dosing for Children
Trulicity is not recommended in children and should only be used if aged 18 years and older.
If you miss a dose of Trulicity, administer it as soon as possible if there are at least three days or 72 hours until your next scheduled dose. If less than 3 days until your next scheduled dose, skip the missed dose and administer the next dose on your regularly scheduled day. Do not take 2 doses within 72 hours.
If you take too much Trulicity, serious side effects can occur including significant hypoglycemia.
If you suspect an overdose, seek emergency medical attention or call the poison control helpline at 1-800-222-1222.
If you experience signs and symptoms of an allergic reaction, such as hives, rash, itching, difficulty breathing, or swelling of the face, mouth, or throat, seek medical attention immediately.
The most common side effects of Trulicity include:
- Nausea, vomiting or stomach pain
- Loss of appetite
- Injection site discomfort
Some severe side effects can also occur; call your doctor if you experience any of the following symptoms
- Severe pain in your upper stomach that spreads to your back, nausea and vomiting (signs of pancreatitis)
- Swelling or lump in the neck, trouble swallowing, a hoarse voice or shortness of breath (signs of a thyroid tumor)
- Headache, hunger, weakness, sweating, confusion, irritability, fast heart rate or feeling jittery (signs of low blood sugar)
- Little or no urination, lower extremity swelling, fatigue and shortness of breath (signs of kidney problems)
- Increased vomiting or diarrhea, increased sweating (signs of dehydration that can lead to kidney failure)
Warnings & Precautions
Trulicity is contraindicated in those with a known allergy or sensitivity to Trulicity or any of its ingredients.
Trulicity has not been studied or approved in children under 18 years old.
Pregnancy and Breastfeeding
Trulicity is not recommended in pregnant or breastfeeding women. No studies have been performed to test the safety and efficacy in these patients.
Type 1 Diabetes
Trulicity is not indicated in the treatment of type 1 diabetes.
Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2)
Trulicity is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
Pancreatitis has been reported in some patients who have taken Trulicity. Patients should be monitored for signs and symptoms of pancreatitis including persistent, severe abdominal pain that radiates to the back and vomiting. Other antidiabetic therapies should be considered in patients with a history of pancreatitis.
Patients who take Trulicity with an insulin secretagogue (sulfonylurea) or insulin may have an increased risk of hypoglycemia. Patients should be monitored for hypoglycemia while taking these medications in combination.
Patients who have taken Trulicity have reported anaphylactic reactions and angioedema. Trulicity should be discontinued immediately if a hypersensitivity reaction occurs. Caution should be used in patients with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.
Acute Kidney Injury
Patients who have taken GLP-1 receptor agonists like Trulicity have developed acute renal failure or worsening of chronic renal failure, sometimes requiring hemodialysis. Caution should be used when using Trulicity in patients with known renal failure.
Severe Gastrointestinal Disease
Trulicity has been associated with adverse gastrointestinal reactions including severe gastroparesis. Caution should be used in patient with known gastrointestinal diseases.
Complications related to diabetic retinopathy have been reported in patients taking Trulicity. Patients with a history of diabetic retinopathy should be monitored for worsening of the disease while taking Trulicity.
This is not a complete list of potential drug interactions. Before taking Trulicity, tell your doctor if you take any medications, herbal supplements, or vitamins.
Bexarotene is a cancer treatment for cutaneous T-cell lymphomas. Bexarotene when used with Trulicity can increase the risk of pancreatitis. Alternative medications should be considered. If alternative medications are not appropriate, close patient monitoring is recommended.
Gatifloxacin is an eye drop used in the treatment of bacterial conjunctivitis. Gatifloxacin when used with Trulicity can affect blood sugar levels and should not be used in patients with diabetes.
There are other injectable drugs available to treat type 2 diabetes. Speak to your doctor to discuss other medications.
These medications mimic the hormone amylin. Amylin analogs work by slowing the movement of food through the stomach after meals which reduced blood sugar and decreases appetite.
Trulicity is a GLP-1 agonist, they work by mimicking the action of GLP-1. GLP-1 is a natural hormone within the body that helps to regulate blood sugar levels. It works by binding to GLP-1 receptors and increasing insulin production, lowering sugar secretion from the liver and slowing stomach emptying.
- Dulaglutide (Trulicity), Exenatide extended release (Bydureon), Exenatide (Byetta), Semaglutide (Ozempic), Semaglutide (Rybelsus), Liraglutide (Victoza), Lixisenatide (Adlyxin).
Insulin replaces the insulin that the body would usually make. There are different types of insulin available. There are variations as to how quickly they act and how long they work.
- Insulin glulisine (Apidra), insulin aspart (Novolog), insulin lispro U-100/U-200 (Humalog), regular insulin (Novolin R, Humulin R), NPH insulin (Novolin N, Humulin N), Insulin detemir (Levemir), Insulin U-100 (Lantus), insulin glargine U-300 (Trujeo), insulin degludec U-100/U-200 (Tresiba)