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Dulaglutide

Sounds like ‘due-lah-gloo-tide’

Key points about dulaglutide

Dulaglutide is used to treat type 2 diabetes.
Dulaglutide is also called Trulicity.
Find out how to take it safely and possible side effects.

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Dulaglutide is used to treat type 2 diabetes and to protect you from having a heart attack or stroke. Dulaglutide may also protect your kidneys and may help you to live longer. Read more about type 2 diabetes.

Dulaglutide lowers your blood glucose in several ways, including by helping your pancreas produce more insulin after meals, slowing down food absorption and reducing your appetite. This is one reason why people on dulaglutide usually lose weight.

Dulaglutide can be used alone or with other diabetes medicines (eg, metformin, insulin, glipizide or gliclazide), along with healthy eating and regular exercise. Dulaglutide is available as an injection given under your skin.

Dulaglutide is NOT the same as insulin

Although dulaglutide is an injection, it is not insulin.

Dulaglutide helps your body to release its own insulin just when you need it, improving blood glucose control throughout the week.
Unlike insulin it won't cause weight gain or low blood glucose levels (hypoglycaemia) when it's used alone.
Unlike insulin, which requires 1 or more daily injections, you only need to have a dulaglutide injection once a week.

Dulaglutide is given as an injection

Dulaglutide comes as a ready-to-use injection pen containing 1 dose (1.5 mg).
It's pre-filled with the medicine and the needle is already fitted onto the pen.
The injection is given under the skin of your thigh or tummy (abdomen/puku).
It comes as a single-use pen, which means that each pen is used only once for one injection.
The pen is very easy to use – you don't need to measure or mix anything, or see, fit or handle a needle.

Dulaglutide pen and injection technique images courtesy of Eli Lilly and Company (NZ) Limited. Reproduced with permission.

Inject dulaglutide ONCE A WEEK

Dulaglutide is injected once a week, on the same day each week.

It can be injected any time of day, with or without meals.
You can mark your calendar or set a reminder on your phone to remind you to take your next dose.
You can also change the day of the week on which you take dulaglutide if necessary, as long as it has been at least 3 days since your last dose of dulaglutide.

Change (rotate) your injection site each week

Inject dulaglutide under the skin on your thigh or on your abdomen (belly) at least 5 cm from your belly button.
If the injection is given by someone else, it may be injected into your upper arm.
Change (rotate) your injection site each week.
You may use the same area of your body, but be sure to choose a different injection site in that area.
Don't inject into skin that's sore, bruised, red, hard or scarred or skin that has stretch marks or psoriasis plaques.

Image credit: Amgen

Here are some things to know when you're using dulaglutide. Other things may be important as well, so ask your healthcare provider what you should know about.

If you are unwell: Dulaglutide doesn't usually cause problems if you're slightly unwell, but if you're dehydrated from vomiting and diarrhoea and not eating and drinking as usual, you can withhold the next injection until you're better.
If you forget your dose of dulaglutide: If you forget your dose, you can inject the missed dose up to 3 days later. Otherwise skip the dose and carry on as normal next week. Don't inject 2 doses around the same time.
Other medicines: Dulaglutide can interact with some medicines and herbal supplements, so check with your doctor or pharmacist before starting dulaglutide and before starting any new products.
Store dulaglutide pens in the fridge, in the original package. Do not freeze. If your pen has been frozen, don't use it. When refrigeration isn't possible (eg, when you're on holiday), you can keep your pen at room temperature (less than 30°C) for up to 14 days.
Note, dulaglutide can be injected cold, but it may sting. It's best to take your dulaglutide pen out of the fridge and leave it at room temperature for 15–30 minutes before injecting. Don't warm dulaglutide in any other way, eg, in the microwave or hot water.
Get rid of your used injection pens safely: It's important to get rid of your used injection pens safely. Keep them out of reach of children and pets, and places where they could hurt others. You can buy a sharps container from your pharmacy. This is a special container made of hard plastic that has a tight-fitting lid so used needles and syringes can be stored securely. Don't flush used needles and syringes down the toilet or put them in household or public rubbish or recycle bins. Once your sharps container is full, take it to your pharmacy for safe disposal.

Like all medicines, dulaglutide can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Nausea (feeling sick)	This is quite common with dulaglutide especially 2–3 days after the injection and then gets better. Eat smaller meals and more slowly. Avoid eating 2 hours before bed. Avoid fried or fatty foods and alcohol.
Stinging, pain, redness or bruising at the injection site	Some people may get mild redness, itch or bruising at the injection site. Remember to change the injection site every week. You can use the same part of your body but try not to use exactly the same spot. Avoid injecting dulaglutide cold, because it's more likely to sting. Take your dulaglutide pen out of the fridge and leave it at room temperature for 15–30 minutes before injecting. Don't warm dulaglutide in any other way, eg, in the microwave or hot water.
Runny poo (diarrhoea) Constipation Tummy pain Decreased appetite	Tell your doctor if they bother you.
Signs of an inflamed pancreas (pancreatitis) such as severe pain in your stomach and back.	Tell your doctor immediately or ring Healthline on 0800 611 116.
Signs of low blood sugar such as feeling weak, faint, dizzy or irritable. You may also get a headache, tremor (shakes) or blurred vision.	Low blood glucose is very rare if you're taking dulaglutide alone, but if you're taking it with other medicines for diabetes (eg, glipizide, gliclazide or insulin), there is a risk of low blood glucose. This is most likely to occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual or can't eat because of nausea or vomiting. If this happens, drink something sweet such as a small glass of sweetened soft drink or fruit juice, or eat something sweet like lollies. Follow this up with a carbohydrate snack, eg, a sandwich. Tell your doctor or nurse if this happens. Read more about low blood glucose and diabetes sick day plan.
Signs of an allergic reaction such as swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.	Tell your doctor immediately or ring Healthline on 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.