Dulaglutide Injection

Dulaglutide injection is approved for two main uses, both in people with type 2 diabetes mellitus:

• Blood sugar control: Trulicity is used alongside diet and exercise to improve glycemic control in adults and in children 10 years of age and older with type 2 diabetes mellitus.
• Cardiovascular risk reduction: Trulicity is used in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors, to lower the risk of cardiovascular death, non-fatal heart attack, or non-fatal stroke.
• Trulicity is not indicated for type 1 diabetes mellitus.
• Trulicity has not been studied in patients with a history of pancreatitis and is not recommended in patients with severe gastrointestinal disease, including severe gastroparesis.

Dulaglutide is a GLP-1 receptor agonist — meaning it activates the same receptor that the body's own blood-sugar-regulating hormone, GLP-1, uses. When blood sugar rises, it prompts the pancreas to release insulin and reduces the release of glucagon (a hormone that raises blood sugar). It also slows how quickly food moves out of the stomach, which helps prevent sharp spikes in blood sugar after meals.

Trulicity is injected under the skin once weekly, at any time of day, with or without food. The dose is started low and increased gradually to reduce the chance of stomach side effects. You can inject into the abdomen, thigh, or upper arm — rotating sites each time. If you miss a dose, you can still take it if your next scheduled dose is at least 3 days (72 hours) away; otherwise, skip it and resume your regular schedule.

• Inject once weekly — the day of the week can be changed as long as the last dose was at least 3 days before.
• Never mix Trulicity in the same syringe as insulin; they can be injected in the same body area but not adjacent to each other.
• Check the solution before injecting — it should be clear and colorless; do not use if it looks cloudy or contains particles.

The most common side effects of Trulicity are stomach-related, especially when first starting or after a dose increase:

• Nausea
• Diarrhea

• Thyroid tumor risk (boxed warning): Dulaglutide caused thyroid tumors in animals; the risk in humans is unknown. Do not use Trulicity if you or a family member has had medullary thyroid carcinoma (MTC) or MEN 2. Watch for a neck lump, hoarseness, trouble swallowing, or shortness of breath.
• Acute pancreatitis: Serious, sometimes fatal pancreatic inflammation has been reported. Stop Trulicity and contact your doctor immediately if you have severe, persistent abdominal pain.
• Low blood sugar (hypoglycemia): Risk is higher if you also take insulin or a sulfonylurea. Your prescriber may lower those doses when starting Trulicity.
• Serious allergic reactions: Including anaphylaxis and angioedema (severe swelling). Discontinue immediately and seek emergency care.
• Acute kidney injury: Can occur, especially with severe nausea, vomiting, or diarrhea leading to dehydration. Monitor kidney function if GI side effects are severe.
• Diabetic retinopathy complications: Patients with a history of diabetic eye disease should be monitored, especially during early treatment.
• Gallbladder disease: Cases of gallstones and gallbladder inflammation have been reported.
• Risk during surgery/anesthesia: Trulicity slows stomach emptying, which can increase the risk of inhaling stomach contents during general anesthesia. Always tell your surgical team you are taking it.

Trulicity can affect how your body absorbs other medications because it slows digestion. Here are the key interactions to know:

• All oral medications: May be absorbed more slowly when taken at the same time as Trulicity — most significant after the first dose, and lessens over time.
• Narrow therapeutic index drugs (e.g., warfarin): Blood levels of these drugs should be monitored more closely when starting or adjusting Trulicity, as even small changes in absorption can matter.
• Insulin and sulfonylureas (e.g., glipizide, glimepiride): Using these together with Trulicity increases the risk of low blood sugar. Your prescriber may reduce those doses.

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

• Do not use Trulicity if you or a close family member has a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use Trulicity if you have had a serious allergic reaction to dulaglutide or any of its ingredients.
• Tell your doctor if you have ever had pancreatitis — other diabetes medications may be safer for you.
• Tell your doctor if you have severe stomach or intestinal problems, including severe gastroparesis (slow stomach emptying).
• If you are pregnant or planning to become pregnant, discuss the risks and benefits with your doctor. Animal studies showed potential fetal harm; Trulicity should be used in pregnancy only if clearly needed.
• If you are breastfeeding, talk with your doctor — it is not known whether dulaglutide passes into human breast milk.
• Trulicity is approved for children 10 years and older with type 2 diabetes. It has not been studied in children under 10.
• Older adults (65+) can use Trulicity safely; no dose adjustment is needed based on age alone.
• Use with caution if you have kidney disease, especially end-stage renal disease (ESRD). No dose adjustment is required, but monitor kidney function if GI side effects are severe.
• Use with caution if you have liver disease. There is limited experience with Trulicity in moderate or severe hepatic impairment.

If too much Trulicity is taken, the most likely effects are nausea, vomiting, and low blood sugar. If an overdose is suspected, contact the Poison Help line at 1-800-222-1222 or seek medical attention. Supportive care, including close monitoring of blood sugar levels, is the main approach.

Trulicity lowers both fasting blood sugar (before meals) and postprandial blood sugar (after meals) in people with type 2 diabetes — an effect that can be seen even after a single dose. It works by stimulating insulin release from the pancreas in a glucose-dependent way (meaning it mainly acts when blood sugar is elevated), reducing glucagon secretion, and slowing gastric emptying (how fast food leaves the stomach). The slowing of stomach emptying is most pronounced after the first dose and becomes less pronounced with ongoing treatment.

After a subcutaneous injection, dulaglutide reaches peak blood levels within about 24 to 72 hours, with a median of 48 hours. Its elimination half-life is approximately 5 days, which is why it only needs to be taken once a week. The body breaks it down through normal protein breakdown pathways. Factors such as age, sex, race, body weight, and mild-to-moderate kidney or liver impairment do not meaningfully change how the body handles dulaglutide, and the injection site (abdomen, thigh, or upper arm) does not significantly affect absorption.

Store TRULICITY in the refrigerator at 36°F to 46°F (2°C to 8°C). Do not freeze TRULICITY. of TRULICITY in the original carton is recommended until time of administration.