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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.
How should other medications be administered with Trulicity® (dulaglutide)?
Consider reducing insulin/insulin secretagogue dose when initiating dulaglutide. As dulaglutide slows gastric emptying, it may reduce the extent and rate of absorption of orally co-administered drugs.
See important safety information, including boxed warning, in the attached prescribing information.
Administration of Dulaglutide With Other Drugs
Concomitant Use With 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 extent and 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. The delay is largest after the first dose and diminishes with subsequent doses.1
The delay in gastric emptying following the administration of a glucagon-like peptide-1 receptor agonist (GLP-1 RA) is well recognized and has been hypothesized as one of the factors contributing to blood glucose lowering.2,3
Caution should be exercised when oral medications are concomitantly administered with dulaglutide. Drug levels of oral medications with a narrow therapeutic index such as warfarin should be adequately monitored 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
In a clinical pharmacology study, the co-administration of a single dose of 1.5 mg dulaglutide with steady-state dose of 100 mg sitagliptin caused an increase in dulaglutide area under the time-concentration curve (AUC) and maximum serum concentration (Cmax) of approximately 38% and 27%, which is not considered clinically relevant.1
Enclosed Prescribing Information
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1Trulicity [package insert]. Indianapolis, IN: Eli Lilly and Company; 2022.
2Marathe 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
3Smits 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
Date of Last Review: June 06, 2023