Dulaglutide
Trulicity
Trulicity (Dulaglutide) is an FDA-approved injection for the treatment of type 2 diabetes mellitus. Acting as a GLP-1 receptor agonist, it regulates blood sugar levels by stimulating insulin release and reducing glucagon secretion. It is administered via weekly subcutaneous injection. It is available in prefilled pens in strengths 0.75 mg, 1.50 mg, 3 mg, & 4 mg. The initial dose is typically 0.75 mg, and adjustments are made based on individual needs, with a maximum weekly dose of 4.5 mg. Side effects like gastrointestinal disturbances may occur, requiring regular blood sugar monitoring. Caution is advised for those with pancreatitis or medullary thyroid carcinoma. If a dose is missed, take it soon unless the next dose is near. Store Trulicity pens refrigerated but not frozen; once used, they’re safe at room temperature for up to 14 days. Follow healthcare providers’ guidance and warnings diligently.
Product Overview
Trulicity is an FDA-approved medication formulated with the active ingredient Dulaglutide. It is primarily utilized for managing type 2 diabetes mellitus. The medication functions as a glucagon-like peptide-1 (GLP-1) receptor agonist, working to regulate blood sugar levels by stimulating insulin release and decreasing glucagon secretion. This helps in reducing both fasting and postprandial blood glucose levels, ultimately aiding in the management of diabetes.
Trulicity is conveniently available in prefilled pens, offering strengths of 0.75 mg, 1.5 mg, 3 mg, and 4 mg. Normally, the initial dose starts at 0.75 mg, with subsequent adjustments tailored to individual requirements. The maximum weekly dosage permissible is 4.5 mg.
It is administered via subcutaneous injection once weekly, preferably on the same day each week. Trulicity is suitable for adults with type 2 diabetes who require additional glycemic control beyond oral medications or basal insulin. Trulicity may cause side effects such as gastrointestinal disturbances, including nausea, vomiting, and diarrhea. It’s important to follow healthcare provider advice and monitor blood sugar levels regularly while on Trulicity.
Precautions should be taken in individuals with a history of pancreatitis or medullary thyroid carcinoma. In case of a missed dose, it should be taken as soon as possible unless it’s almost time for the next scheduled dose. Storage of Trulicity pens should be in the refrigerator, but not in the freezer, and once in use, they can be stored at room temperature for up to 14 days. Patients should be mindful of guidance and warnings provided by healthcare professionals regarding the use of Trulicity.
Uses
Targeted Treatment
- Type 2 diabetes mellitus
[Important Warning: Trulicity is not approved for treating type 1 diabetes.]
Benefits
- It aids in weight management due to its potential to reduce appetite.
- It lowers the risk of cardiovascular events in diabetic patients with existing heart conditions.
[Note: Do not take Trulicity injections without consulting your doctor. They will determine whether you need this medication based on your conditions.]
Trulicity Dosage
Forms & Strengths
Form: Prefilled pen
Strengths: 0.75 mg/0.5 ml, 1.5 mg/0.5 ml, 3 mg/0.5 ml, 4.5 mg/0.5 ml
Recommended Dosages
For Type 2 Diabetes
Adults:
- Initial Dose: Start with 0.75 mg administered subcutaneously once weekly.
- Maintenance Dose: If more glycemic management is needed, increase the dosage to 1.5 mg once weekly after at least 4 weeks on the initial 0.75 mg dosage.
- Maximum Dose: The highest recommended dosage is 4.5 mg, injected subcutaneously once weekly.
Children:
- Starting Dose: Begin with 0.75 mg injected subcutaneously once weekly.
- Additional Control: If further glycemic control is required, increase the dosage to the maximum recommended dose of 1.5 mg once weekly after at least 4 weeks on the 0.75 mg dosage.
Geriatric Patients:
- Follow the same dosing pattern as for adults. Start with 0.75 mg and adjust as needed.
[Note: These Trulicity injection suggestions may differ from person to person. Consult your doctor and let them customize your dosage accordingly.]
How to Take It?
Here are the steps to administer Trulicity injection:
- Wash your hands thoroughly with soap and water.
- Choose a clean and dry injection site, typically the abdomen (avoid areas with scars or bruises).
- Remove the Trulicity pen from the refrigerator and let it sit at room temperature for 30 minutes.
- Pull off the pen cap and wipe the injection site with an alcohol swab.
- Hold the pen with the needle pointing upwards and remove the paper tab covering the needle.
- Insert the needle into the skin at a 90-degree angle and press the button to start the injection.
- Keep the button pressed until the dose indicator shows “0,” and then release.
- Remove the needle from the skin and dispose of the pen safely in a puncture-resistant container.
- Apply gentle pressure to the injection site with a cotton ball or gauze pad if needed.
[Note: Your doctor will decide the right dosage and procedure for administering Trulicity injection for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]
How Does Trulicity Work?
Trulicity works as a glucagon-like peptide-1 (GLP-1) receptor agonist. Upon administration, it triggers the GLP-1 receptors, which stimulate insulin release and inhibit glucagon release. This process helps regulate blood sugar levels, decreasing both fasting and postprandial glucose levels in individuals with type 2 diabetes mellitus. By enhancing insulin production and reducing glucagon, Trulicity aids in the management of diabetes, contributing to improved glycemic control.
Important Safety Information
Side Effects
Common side effects of Trulicity may include:
- Gastrointestinal discomfort such as nausea, vomiting, or diarrhea
- Decreased appetite
- Fatigue or weakness
- Headache
- Dizziness
Mild side effects of Trulicity may include:
- Injection site reactions like redness, itching, or swelling
- Indigestion or heartburn
- Mild allergic reactions such as itching or rash
Serious side effects of Trulicity may include:
- Pancreatitis, characterized by severe abdominal pain
- Hypoglycemia (low blood sugar)
- Kidney problems, indicated by changes in urination or swelling in the feet or ankles
- Thyroid tumors or cancer (rare but serious)
[Note: Remember, this list may not cover all possible side effects of Trulicity injection. Always consult with your healthcare giver for medical advice about side effects.]
Warnings
- Hypoglycemia: Trulicity may increase the risk of hypoglycemia, particularly when used in combination with insulin secretagogues (e.g., sulfonylureas) or insulin. Patients should be educated on recognizing and managing hypoglycemic episodes.
- Acute Kidney Injury: Trulicity has been associated with acute kidney injury, especially in patients with renal impairment or dehydration. Adequate hydration should be maintained, and renal function should be monitored regularly.
- Pancreatitis: Cases of pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, have been reported with the use of Trulicity. Patients should be monitored for signs and symptoms of pancreatitis, such as severe abdominal pain, and treatment should be discontinued if pancreatitis is suspected.
Boxed Warning
- Thyroid C-Cell Tumors: Trulicity has been shown to cause thyroid C-cell tumors in rodents. It is unspecified whether Trulicity leads to thyroid C-cell tumors, such as medullary thyroid carcinoma (MTC), in humans. Patients with a family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should be evaluated before initiating Trulicity and monitored during treatment.
Precautions
- Hypersensitivity Reactions: If you experience severe allergic reactions like anaphylaxis, angioedema, or urticaria after taking Trulicity, stop using it immediately and seek medical attention.
- Pancreatitis: Be vigilant for signs of pancreatitis, such as persistent severe abdominal pain, and discontinue Trulicity if you suspect pancreatitis.
- Hypoglycemia: If you’re using Trulicity with insulin or insulin secretagogues, be aware of the increased risk of low blood sugar. Learn to recognize and manage hypoglycemia symptoms and adjust your insulin dosage as necessary under medical supervision.
- Renal Impairment: Before starting Trulicity, your doctor will assess your kidney function, especially if you have existing renal issues. Stay hydrated to minimize the risk of acute kidney injury.
- Gastrointestinal Adverse Reactions: If you experience nausea, vomiting, or diarrhea while taking Trulicity, inform your doctor. These symptoms are common but should be monitored.
- Thyroid C-Cell Tumors: Your doctor will evaluate your risk factors for thyroid C-cell tumors before starting Trulicity and may monitor your thyroid function periodically during treatment.
- Cardiovascular Risk: While Trulicity’s cardiovascular effects haven’t been fully studied, discuss your cardiovascular risk factors with your doctor, especially if you have a history of heart disease.
- Immune-mediated Reactions: If you develop severe immune reactions like rash or urticaria, stop using Trulicity and seek medical advice.
Contraindications
- Allergic reactions to Dulaglutide or any of its components.
- History of MTC or MEN 2 (multiple endocrine neoplasia syndrome type 2).
Missed Dose
- If a dose is forgotten, take it promptly upon recall unless it’s close to your next scheduled dose.
- Avoid taking additional or doubled doses to compensate for missed ones.
- Return to your usual dosing routine and seek advice from your healthcare provider if uncertain about the course of action.
[Note: If you have missed a dose of Trulicity injection and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]
Overdose
Symptoms of overdose may include:
- Nausea
- Severe hypoglycemia
- Gastrointestinal discomfort
[Note: If you consumed more than the recommended dose of Trulicity injection, get medical help right away or call the Poison Help line at 1-800-222-1222.]
Storage
- Store Trulicity injections in the refrigerator between 36°F to 46°F (2°C to 8°C).
- Do not freeze Trulicity injections.
- Keep injections in their original carton to protect them from light.
- Once in use, Trulicity injections can be stored at room temperature below 86°F (30°C) for up to 14 days.
- Discard injection if not used within 14 days or if exposed to temperatures above 86°F (30°C).
- Keep Trulicity injection out of reach of children and pets.
- Do not use Trulicity injection after the expiration date printed on the label.
[Note: Discuss with your healthcare professional about the proper disposal of any unused Trulicity injection and any questions you may have regarding its storage.]
Trulicity Interactions
- Albuterol
- Amlodipine
- Aspirin
- Atorvastatin
- Bupropion
- Carvedilol
- Cyclobenzaprine
- Duloxetine
- Farxiga (dapagliflozin)
- Fenofibrate
- Furosemide
- Gabapentin
- Glimepiride
- Glipizide
- Hydrochlorothiazide
- Jardiance (empagliflozin)
- Levothyroxine
- Lisinopril
- Losartan
- Metformin
- Metoprolol
- Montelukast
- Omeprazole
- Pantoprazole
- Rosuvastatin
- Tamsulosin
- Tramadol
- Trazodone
- Vitamin B12 (cyanocobalamin)
- Vitamin D3 (cholecalciferol)
[Note: This isn’t a complete list, and there could be other drugs that interact with Trulicity. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]
Trulicity Alternatives
- Ozempic (semaglutide)
- Victoza (liraglutide)
- Byetta (exenatide)
- Bydureon Bcise (exenatide)
- Mounjaro (tirzepatide)
- Rybelsus (semaglutide)
- Adlyxin (lixisenatide)
- Synjardy XR (empagliflozin/metformin ER)
- Steglatro (ertugliflozin)
- Jardiance (empagliflozin)
- Farxiga (dapagliflozin)
- Invokana (canagliflozin)
- Invokamet ER (canagliflozin/metformin ER)
- Tradjenta (linagliptin)
- Tresiba (insulin degludec)
- Humalog Kwikpen (insulin lispro)
[Note: Your doctor will choose the best Trulicity alternative for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]
Frequently Asked Questions
1. Can I take Trulicity with food?
Trulicity can be taken with or without food. Since it’s an injected medication, its absorption isn’t affected by food. While there are no specific foods to avoid, maintaining a balanced diet with lean protein, healthy fats, and low-glycemic carbohydrates is recommended for effective diabetes management. Remember to take Trulicity consistently on the same day each week. If you experience severe or bothersome side effects, consult your healthcare provider.
2. How should I store Trulicity injections?
Trulicity injections should be stored in the refrigerator at a temperature between 36°F and 46°F (2°C to 8°C). Keep them in their original carton to protect them from light. Do not freeze. If unopened, they can be stored at room temperature (up to 77°F or 25°C) for up to 14 days. Once opened, use within 8 weeks. Always check the expiration date and discard any expired pens.
3. Is it safe to take Trulicity during pregnancy?
Trulicity should only be prescribed to pregnant women if the potential benefit outweighs the potential risk to the developing baby. While there is insufficient human data to determine specific risks, animal studies suggest possible fetal harmUncontrolled diabetes during pregnancy can lead to complications, so consult your healthcare provider for personalized advice.
4. How does Trulicity affect breastfeeding?
Trulicity should only be prescribed to breastfeeding mothers if the potential benefit outweighs the risk. Limited data exist, but because dulaglutide is a large protein molecule, its presence in breast milk is likely low. Absorption by the infant’s gut is improbable. Consult your healthcare provider for personalized advice.
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