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Trulicity ® (dulaglutide) injection
0.75 mg/0.5 mL, 1.5 mg/0.5 mL, 3mg/0.5mL, 4.5mg/0.5mL
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
Can Trulicity® (dulaglutide) be administered with DPP-4 inhibitors?
The use of DPP-4 inhibitors, such as sitagliptin, in combination with dulaglutide was not evaluated in clinical trials sponsored by Eli Lilly and Company.
See important safety information, including boxed warning, in the attached prescribing information.
Clinical Trials
The use of dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, in combination with dulaglutide, was not evaluated in the Eli Lilly and Company–sponsored clinical trials assessing dulaglutide.
Clinical Pharmacology Study: Coadministration of Dulaglutide With Sitagliptin
An open-label, 2-period, crossover, clinical pharmacology study was done in 29 adult patients with type 2 diabetes that evaluated the mutual effects on the pharmacokinetics (PK) of both dulaglutide 1.5 mg and sitagliptin 100 mg.1
Effect of Dulaglutide on the Pharmacokinetics of Sitagliptin
Based on the analysis,
- no clinically significant effect on the PK of sitagliptin was seen, and
- no dose adjustment was recommended for sitagliptin when coadministered with dulaglutide (Impact of Dulaglutide on the Pharmacokinetics of Coadministered Dipeptidyl Peptidase-4 Inhibitor, Sitagliptin).1,2
Figure 1 description: The ratio and 90% confidence interval for sitagliptin coadministered with dulaglutide is displayed in a Forest plot. The ratio relative to reference scale from left to right is 0.0 to 2.0. Sitagliptin area under the curve appears on the plot just above 1.0. Sitagliptin maximum concentration appears on the plot below 1.0 at approximately 0.9.
Abbreviations: AUC = area under the time-concentration curve; Cmax = maximum concentration; PK = pharmacokinetics.
Note: Reference group is coadministered sitagliptin given alone.
Effect of Sitagliptin on the Pharmacokinetics of Dulaglutide
Compared with dulaglutide being taken alone, the coadministration of a single dose of dulaglutide 1.5 mg with steady-state sitagliptin 100 mg resulted in increases for dulaglutide
Potential for Dulaglutide to Influence the Pharmacokinetics of Other Drugs
Dulaglutide is a human glucagon-like peptide-1 receptor agonist (GLP-1 RA) that causes a delay in gastric emptying.2
The delay is largest after the first dose of dulaglutide and diminishes with subsequent doses.2
Because dulaglutide delays gastric emptying, it has the potential to reduce the extent and rate of absorption of concomitantly administered oral medications.2
Monitor drug levels of oral medications with a narrow therapeutic index (eg, warfarin) when concomitantly administered with dulaglutide.2
Enclosed Prescribing Information
References
1Geiser J, de la Peña A, Cui X, et al. No dose adjustment is needed when coadministering dulaglutide with once-daily sitagliptin. Poster presented at: American Society for Clinical Pharmacology and Therapeutics (ASCPT) Annual Meeting: March 15-18, 2017; Washington, D.C.
2Trulicity [package insert]. Indianapolis, IN: Eli Lilly and Company; 2022.
Date of Last Review: January 11, 2023