What You Should Know About Dulaglutide (Trulicity)

GLP-1 medications have become popular recently because they help treat type 2 diabetes and can aid in weight loss.

Dulaglutide, also known as Trulicity, is one of these GLP-1 receptor agonist medications. It works like a hormone called glucagon-like peptide-1 (GLP-1), which helps:

Stimulate the pancreas to release insulin when blood sugar is high.
Lower the amount of glucose the liver produces.
Slow how quickly your stomach empties.

Those actions help regulate blood sugar (glucose) levels and reduce your risk of serious complications from type 2 diabetes such as heart disease, kidney problems and nerve damage.

Paul Thompson, a pharmacist with Banner Pharmacy Services, explained more about this medication.

Who can benefit from dulaglutide (Trulicity)?

Dulaglutide is specifically approved for adults with type 2 diabetes. It may help you manage your blood sugar throughout the day, both after meals and when you’re fasting.

Some people with type 2 diabetes may not get enough blood sugar control with lifestyle changes and medication they take by mouth. Dulaglutide may help with this part of diabetes management.

A lot of people with type 2 diabetes also struggle to manage their weight. Dulaglutide may help with weight loss since it helps you feel full longer after meals, so you may eat less and take in fewer calories.

Dulaglutide may also lower your risk of heart attack, stroke and death from certain heart conditions.

People who would prefer a once-weekly dose may also benefit from dulaglutide. It can be more convenient and make it easier to follow a medication schedule versus medications you need to take every day.

Dulaglutide may significantly improve your health and quality of life if you have type 2 diabetes. Talk with your health care provider to find out if Trulicity might be a good choice for your diabetes management plan.

How to use dulaglutide

Dulaglutide comes in a prefilled pen so you can inject it under your skin. Wash your hands thoroughly before you handle the pen. Follow the instructions that come with it for assembly and the injection process.

You can inject it into your abdomen, thigh or upper arm. You should change the injection location each time to lower the risk of reactions. Don't inject the medication into areas where your skin is tender, bruised, red or hard. Dispose of used Trulicity pens according to your local regulations.

Most people start with a dose of 0.75 milligrams once a week. You should inject dulaglutide on the same day each week, at any time of day and with or without food. “If you miss a dose, take it as soon as you remember. But if it is within three days of your next scheduled dose, skip the dose and go back to your regular dosing schedule,” Dr. Thompson said.

Your provider may adjust your dose based on how you respond to the medication and your needs.

Store the dulaglutide pens in the refrigerator between 36°F to 46°F (2°C to 8°C). Do not freeze them. After you take them out of the refrigerator, you can keep them at room temperature (68°F to 77°F or 20°C to 25°C) for up to 14 days.

Possible side effects

If you take dulaglutide, watch for these common side effects:

Nausea or vomiting
Diarrhea
Abdominal pain
Decreased appetite
Fatigue
Redness, swelling or itching where you injected the medication

Talk to your health care provider if you have any side effects, especially if they are severe or don’t go away. “Side effects usually decrease over time,” Dr. Thompson said.

If you have nausea or diarrhea, stay hydrated and eat easy-to-digest foods. Talk to your doctor before taking medication for any symptoms.

Keep track of your symptoms and how severe they are. If the side effects are bothering you and they don't ease up, contact your provider. They may recommend adjusting your dose or switching to a different medication.

Dulaglutide could also cause these serious side effects:

Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain that may spread to the back, along with nausea and vomiting. Seek immediate medical attention for these symptoms.
Allergic reactions: These are rare but possible. Signs include rash, itching, dizziness or difficulty breathing. Seek emergency medical help if you have these signs.

Dulaglutide precautions and warnings

Most people tolerate dulaglutide well, but you should not take it if you have:

A personal or family history of medullary thyroid carcinoma (MTC), or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2). These conditions increase the risk of a rare type of thyroid cancer.
A history of severe gastrointestinal disease, such as gastroparesis (delayed gastric emptying) or other conditions that affect the way food moves through your digestive system.

If you take dulaglutide, it can increase the effects of insulin and similar medications like sulfonylureas. This interaction may increase your risk of high blood sugar. Your doctor may monitor you for signs of low blood sugar and adjust your insulin dosage if needed.

“While Trulicity alone doesn't usually cause low blood sugar, the risk increases if you take it with other medications like insulin or sulfonylureas,” Dr. Thompson said.

Tell your provider about all the medications you take, including prescriptions, over-the-counter (OTC) drugs and any vitamins or supplements. Some medications could interact with dulaglutide’s effectiveness or increase the risk of side effects.

Only use Trulicity that you get from a legitimate pharmacy. “Avoid compounding pharmacies and unauthorized generics from wellness spas where good manufacturing practices and ingredients can't be verified,” Dr. Thompson said.

Regular check-ups are important when you’re taking dulaglutide. Your provider may want to check:

Kidney function, especially if you have kidney disease or risk factors for kidney problems.
Pancreatic health, to look for signs and symptoms of pancreatitis.
Blood sugar and A1c levels to see how well dulaglutide is controlling your blood sugar.
Overall health and any potential side effects or concerns.

Lifestyle considerations for type 2 diabetes

“Trulicity works best when combined with a healthy lifestyle,” Dr. Thompson said. These tips can help:

Aim to eat a balanced diet that includes a variety of fruits, vegetables, lean proteins and healthy fats.
Focus on controlling your portion sizes and monitoring the amount of calories you eat. Limit processed foods, sugary snacks and sweetened drinks.
Monitor your carbohydrate intake and choose complex carbohydrates. They are digested more slowly and have less impact on blood sugar levels.
Drink water throughout the day. Water helps manage blood sugar levels and supports overall health.
Aim for at least 150 minutes of moderate-intensity aerobic exercise, such as brisk walking, cycling or swimming, each week. Physical activity helps lower blood sugar levels and improves the way your body reacts to insulin.
Include muscle-strengthening activities such as weightlifting or bodyweight exercises at least two days a week.
Stay active throughout the day by taking short walks, stretching or doing household chores.
Before starting an exercise program, talk to your provider to make sure it is safe and to get their recommendations based on your health status and fitness level.
Check your blood sugar levels regularly to better understand how your food choices, physical activity and medication affect them. Keep a log so you can spot patterns and adjust your diabetes management plan.

The bottom line

Dulaglutide (Trulicity) is a medication you inject once a week that mimics the action of the GLP-1 hormone. It may help lower blood sugar levels, support weight loss and reduce the risk of heart attack and stroke in people with type 2 diabetes.

Dulaglutide has certain side effects and risks, and it isn’t right for everyone. Talk to your health care provider or an expert at Banner Health about whether dulaglutide is a good option for you, based on your health status, medication history and goals.

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Dulaglutide (Trulicity): What You Need to Know