Dulaglutide delays gastric emptying and has the potential to reduce the rate of absorption of concomitantly administered oral medications. Monitor drug levels of oral medications with a narrow therapeutic index when concomitantly administered with dulaglutide.1

If pancreatitis is suspected, promptly discontinue dulaglutide and do not restart if pancreatitis is confirmed. Dulaglutide has not been evaluated in patients with a prior history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.1

Patients receiving dulaglutide in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogue) or insulin.1

No dose adjustment is recommended in patients with renal impairment, including end-stage renal disease, when using dulaglutide. In patients treated with glucagon-like peptide-1 receptor agonists, including dulaglutide, there have been postmarketing reports of acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis. Some of these events were reported in patients without known underlying renal disease. A majority of reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Because these reactions may worsen renal function, use caution when initiating or escalating doses of dulaglutide in patients with renal impairment. Monitor renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions.1

Use of dulaglutide may be associated with gastrointestinal adverse reactions, sometimes severe. Dulaglutide has not been studied in patients with severe gastrointestinal disease, including severe gastroparesis, and is therefore not recommended in these patients.1

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