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.

How should other medications be administered with Trulicity® (dulaglutide)?

Consider reducing insulin/insulin secretagogue dose when initiating Trulicity (dulaglutide). Dulaglutide may reduce absorption of orally co-administered drugs.

Detailed Information

Concomitant Use an Insulin Secretagogue or With Insulin

To reduce the risk of hypoglycemia when initiating dulaglutide treatment, consider reducing the dosage of concomitantly administered

  • insulin secretagogues, such as sulfonylureas, or

  • insulin.1

Potential for Dulaglutide to Influence the Pharmacokinetics of Other Drugs

Dulaglutide delays gastric emptying and has the potential to reduce the rate of absorption of concomitantly administered oral medications. The delay in gastric emptying is dose-dependent but is attenuated with the recommended dose escalation to higher doses of dulaglutide.1

The delay is largest after the first dose and diminishes with subsequent doses. The delay in gastric emptying following the administration of a GLP-1 RA is well recognized and has been hypothesized as one of the factors contributing to BG lowering.2-4

Because dulaglutide slows gastric emptying, it may reduce the extent and rate of absorption of orally co-administered medications. Monitor drug levels of oral medications with a narrow therapeutic index, like warfarin, when concomitantly administered with dulaglutide.1

In clinical pharmacology studies, dulaglutide 1.5 mg did not affect the absorption, to any clinically relevant degree, of the tested orally administered medications that included 

  • lisinopril

  • metoprolol

  • digoxin

  • norelgestromin

  • ethinylestradiol

  • atorvastatin

  • metformin

  • acetaminophen

  • S-warfarin

  • R-warfarin, and

  • sitagliptin.1

There is limited experience with the use of concomitant medications in clinical trials with dulaglutide doses of 3 mg and 4.5 mg.1

Potential for Co-Administered Drugs to Influence the Pharmacokinetics of Dulaglutide

The co-administration of a single dose of 1.5 mg dulaglutide, with a steady-state dose of 100 mg sitagliptin, caused an increase in dulaglutide AUC and Cmax of approximately 38% and 27%. This was not considered to be clinically relevant, respectively.1

Enclosed Prescribing Information

TRULICITY® (dulaglutide) injection, for subcutaneous use, Lilly

Reference

The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).

1. Trulicity [package insert]. Indianapolis, IN: Eli Lilly and Company; 2020.

2. Flint A, Raben A, Ersbøll AK, et al. The effect of physiological levels of glucagon-like peptide-1 on appetite, gastric emptying, energy and substrate metabolism in obesity. Int J Obes. 2001;25(6):781-792. https://doi.org/10.1038/sj.ijo.0801627

3. Marathe CS, Rayner CK, Jones KL, Horowitz M. Effects of GLP-1 and incretin-based therapies on gastrointestinal motor function. Exp Diabetes Res. 2011;2011:279530. https://doi.org/10.1155/2011/279530

4. Smits MM, Tonneijck L, Muskiet MH, et al. Gastrointestinal actions of glucagon-like peptide-1-based therapies: glycaemic control beyond the pancreas. Diabetes Obes Metab. 2016;18(3):224-235. https://doi.org/10.1111/dom.12593

Glossary

AUC = area under the curve

BG = blood glucose

Cmax = maximum serum concentration

GLP-1 RA = glucagon-like peptide-1 receptor agonist

Date of Last Review: September 10, 2020

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