Trulicity

What is Trulicity (Dulaglutide)?

Trulicity is a weekly injectable prescription medication used to help improve blood sugar levels in adults with type 2 diabetes. Its chemical name is dulaglutide, which belongs to the GLP-1 agonist family of drugs.

What is it used for?

Trulicity is used to improve blood sugar control in adults with type 2 diabetes in combination with:

• A healthy diet and regular exercise in patients who cannot use Metformin due to a contraindication or an intolerance
• Metformin, when a healthy diet and regular exercise have not reached acceptable levels of blood sugar control
• Metformin and a sulfonylurea, when a healthy diet along with regular exercise plus dual therapy with Metformin and a sulfonylurea have not reached acceptable levels of blood sugar control
• Mealtime insulin with Metformin, when a healthy diet and regular exercise plus insulin therapy (up to two injections of mealtime insulin per day) with or without oral diabetes medications, have not reached acceptable levels of blood sugar control

Trulicity should not be used if you have type 1 diabetes, diabetic ketoacidosis, or a history of severe gastrointestinal (GI) disease. This is not a substitute for insulin therapy, and has not been approved for use in children under 18 years of age.

How does it work?

Trulicity belongs to a type of medicines called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists). It can help to lower your blood sugar levels by helping your body release more insulin when your blood sugar is high.

It increases the release of insulin by beta cells in the pancreas, slows the time it takes food to leave the stomach and also reduces glucagon secretion by the pancreas, which normally increases blood sugar levels.

How to take this medication

Trulicity is a solution for subcutaneous (under the skin) injection. It is available as single-use, pre-filled pens or single-use, pre-filled syringes in either 0.75 mg/0.5 mL or 1.5 mg/0.5 mL strengths. Each pen contains one weekly dose.

Do not change your dose or stop treatment without speaking with your doctor first. Your doctor will likely start you on a healthy diet and regular exercise program. Stay on this program throughout your treatment unless advised otherwise by your doctor.

Your doctor will instruct you about how to properly use this product. Make sure to familiarize yourself with the instructions for use in the package. The injection pen has been shown to be easy to learn and easy to use. It is an injection which is given under the skin. Do not inject into your muscle or vein. Suitable injection sites are around your stomach area (abdomen), your upper leg (thigh),or your upper arm.

• Change your injection site every week. Never use the same site for each injection
• You can give yourself the injection at any time of the day
• If you give yourself insulin along with Trulicity, do not mix them in the same container. Give yourself separate injections of both. You may give both injections in the same area of the body, but not the same injection site. For example, you may use your stomach area, but do not inject too close to one another.
• Never share your needles, pen, or syringe with another person. You may give another person an infection or get an infection from them, even if they are family
• Keep all pens and needles out of the reach of children

Dosage

The recommended starting adult dose is 0.75 mg once weekly administered subcutaneously (under the skin). Your dosage may be increased to 1.5mg once-weekly based on your blood sugar response. The maximum recommended dose is 1.5 mg once weekly. It can be taken any time of the day, with or without food.

Your dose of Trulicity and other diabetic drugs you take may need to change because of changes in the level of physical activity or exercise, weight loss or gain, illness, increased stress, changes in diet, or because of the other medications you are taking. The response on your blood sugar control should be monitored by periodic measurements of blood sugar levels.

Missed Doses:

If you happen to miss a dose, take the missed dose as soon as possible if there are at least three days (72 hours) until your next scheduled dose. If there are less than three days remaining until your next scheduled dose, skip the dose you missed and take your next dose on the next regularly scheduled day. Do not take two doses within three days of one another. The dosing day of your weekly administration can be changed if necessary, as long as there are at least three days in between doses.

Warnings and Precautions

Do not use this medication if you:

• Have allergies to this drug, or to any ingredient in the formulation or component of the container
• Or any family member has ever had medullary thyroid cancer
• Suffer from Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Are currently pregnant or breastfeeding

Talk to your doctor about any health conditions or problems you may have, including if you:

• Have type 1 diabetes
• Are taking an anti-diabetic medicine known as a sulfonylurea (e.g. glyburide, gliclazide, glimepiride) or insulin
• Have ever had diabetic ketoacidosis (increased ketone level in your blood or urine)
• Have or have had pancreas problems such as inflammation of the pancreas
• Have severe problems with your stomach (gastroparesis) or food digestion
• Have a fast pulse
• Have any heart disease, angina, heart rhythm problems or congestive heart failure, or if you previously had a heart attack
• Have kidney problems
• Have liver problems
• Have severe diarrhea or vomiting and dehydration
• Have bradycardia, otherwise called heart block

More information about Trulicity

• Product Monograph – Health Canada
• U.S. Food and Drug Administration Medication Guide