Trulicity (Dulaglutide) belongs to a group of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It is used along with other medications to improve blood glucose (sugar) levels for people with Type 2 Diabetes. Trulicity (Dulaglutide) may also be used alone when Metformin cannot be used or is not tolerated. It works by helping your body make more insulin and control blood glucose levels. Trulicity (Dulaglutide) should be used as part of an overall diabetes management plan that includes a diet and exercise program.

Trulicity (Dulaglutide) is not a substitute for insulin. However, it may be used at the same time as insulin.

Trulicity (Dulaglutide) may be available under multiple brand names and/or in several different forms. Any specific brand name of Trulicity (Dulaglutide) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Trulicity (Dulaglutide) may not be used for all of the conditions discussed here.

Your doctor may have suggested Trulicity (Dulaglutide) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Trulicity (Dulaglutide), speak to your doctor. Do not stop taking Trulicity (Dulaglutide) without consulting your doctor.

Do not give Trulicity (Dulaglutide) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Trulicity (Dulaglutide) if their doctor has not prescribed it.

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The recommended adult starting dose of Trulicity (Dulaglutide) is 0.75 mg, injected subcutaneously (under the skin), once a week. It may be injected at any time of the day, without regard to meals. If necessary, your doctor may increase the dose to a maximum of 1.5 mg once weekly. Do not change your dose unless your doctor has told you to do so. Your doctor or diabetes educator will show you how to inject Trulicity (Dulaglutide).

If you are also using insulin, each medication should be injected separately. Trulicity (Dulaglutide) should be clear and colourless. Do not use Trulicity (Dulaglutide) if you notice anything unusual in the appearance of the solution, such as cloudiness, discolouration, or clumping.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Trulicity (Dulaglutide) exactly as prescribed by your doctor. If you miss a dose, inject it as soon as possible and continue with your regular schedule. If it is less than 3 days until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Trulicity (Dulaglutide) in the refrigerator; do not allow it to freeze. Protect it from direct heat and light. Keep this and all medication out of the reach of children. These single-use prefilled pens and syringes may be stored at room temperature for up to 14 days.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Trulicity (Dulaglutide). If you are concerned about side effects, discuss the risks and benefits of Trulicity (Dulaglutide) with your doctor.

The following side effects have been reported by at least 1% of people taking Trulicity (Dulaglutide). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• bloating
• Constipation
• decreased appetite
• Diarrhea
• fatigue
• gas
• heartburn
• reaction at the injection site (e.g., redness, swelling, pain)
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• rapid or pounding heartbeat
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness)
• symptoms of a thyroid tumour (e.g., lump in neck, trouble swallowing, breathing, or hoarseness)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, Fever, chills, rapid heartbeat, swollen abdomen)
• symptoms of severe low blood sugar (e.g., disorientation, loss of consciousness, seizures)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Trulicity (Dulaglutide).

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0.75 mg/0.5 mL
Each single-use prefilled pen or prefilled syringe contains 0.75 mg of Trulicity (Dulaglutide) per 0.5 mL of solution. Nonmedicinal ingredients: trisodium citrate dehydrate, citric acid anhydrous, mannitol, and polysorbate 80 in water for injection.

1.5 mg/0.5 mL
Each single-use prefilled pen or prefilled syringe contains 1.5 mg of Trulicity (Dulaglutide) per 0.5 mL of solution. Nonmedicinal ingredients: trisodium citrate dehydrate, citric acid anhydrous, mannitol, and polysorbate 80 in water for injection.

Do not take Trulicity (Dulaglutide) if you:

• are allergic to Trulicity (Dulaglutide) or any ingredients of the medication
• have Type 1 Diabetes
• have had or have a family member who has had medullary Thyroid cancer
• have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body)
• are pregnant or breast-feeding

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There may be an interaction between Trulicity (Dulaglutide) and any of the following:

• androgens (e.g., testosterone)
• atypical antipsychotics (e.g., Aripiprazole, Clozapine, Quetiapine, Risperidone)
• corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• chloroquine
• Dabrafenib
• diabetes medications (e.g., chlorpropamide, glyburide, insulin, metformin, Rosiglitazone)
• Disopyramide
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Glucagon
• Hepatitis C (e.g., daclatasvir, ledipasvir, paritaprevir, sofosbuvir)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• hydroxychloroquine
• Lanreotide
• Leuprolide
• loop diuretics (e.g., bumetanide, Furosemide)
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Niacin
• Octreotide
• Pasireotide
• Pegvisomant
• pentamidine
• progestins (e.g., Levonorgestrel, medroxyprogesterone)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• salicylates (e.g., acetylsalicylic acid, aminosalicylic acid, Bismuth Subsalicylate)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• somatostatin
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Sunitinib
• Tacrolimus
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• Triptorelin
• Vorinostat

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Trulicity (Dulaglutide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health.

Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking medication to manage your blood glucose levels.

Heart problems: Trulicity (Dulaglutide) may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease (e.g., recent Heart Attack, Angina, heart failure) or an abnormal heart rhythm (e.g., heart block or fast heart rate), discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.

Intestinal problems: The safety and effectiveness of using Trulicity (Dulaglutide) have not been established for people who have problems with slowed movement of food through the digestive tract. If you have digestive system problems, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.

Kidney function: The safety and effectiveness of using Trulicity (Dulaglutide) for people with reduced kidney function has not been studied. Ensure that you are drinking enough water to prevent dehydration if you experience nausea or vomiting with Trulicity (Dulaglutide). If you have reduced kidney function or Kidney Disease, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.

Liver function: The safety and effectiveness of using Trulicity (Dulaglutide) for people with reduced liver function have not been studied. If you have reduced liver function or liver disease, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.

Low blood glucose (Hypoglycemia): People who use Trulicity (Dulaglutide) and are also taking a sulfonylurea (e.g., Glyburide, Gliclazide) or insulin to control high blood sugar are more at risk of experiencing hypoglycemia (low blood sugar). If you experience symptoms of hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling of the tongue or lips, contact your doctor. Your doctor may need to adjust the dose of your medication(s).

Pancreatitis (inflammation of the pancreas): Trulicity (Dulaglutide) can cause pancreatitis. If you experience symptoms of pancreatitis such as severe and persistent abdominal pain that may move to the back with or without vomiting, contact your doctor immediately. If you have previously had pancreatitis, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.

Risk of thyroid cancer: In rare cases, people have developed thyroid cancer while using Trulicity (Dulaglutide). People with a personal or family history of thyroid cancer or people who have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body) should not use Trulicity (Dulaglutide). If you develop symptoms of a thyroid tumour, such as difficulty swallowing, a mass in the neck or persistent hoarseness, contact your doctor as soon as possible.

Pregnancy: Trulicity (Dulaglutide) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Trulicity (Dulaglutide), contact your doctor immediately.

If you are planning to become pregnant, talk to your doctor about discontinuing Trulicity (Dulaglutide). You should not become pregnant for at least 4 weeks after stopping Trulicity (Dulaglutide), to give the medication enough time to completely leave the body.

Breast-feeding: It is not known if Trulicity (Dulaglutide) passes into breast milk. If you are a breast-feeding mother and are taking Trulicity (Dulaglutide), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Trulicity (Dulaglutide) have not been established for children.

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