Dulaglutide

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.

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.

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.

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.

• Drink enough water to avoid dehydration. When starting dulaglutide, it can cause nausea (feeling sick), vomiting (being sick) and diarrhoea (runny poo), that can last for a few days. This increases your risk of dehydration, which can cause serious kidney problems. Be sure to drink plenty of water or non-sugary beverages. Avoid alcohol, as it can affect your blood glucose. Contact your healthcare provider if you have ongoing nausea, vomiting and diarrhoea or get symptoms of dehydration such as headache, feeling lightheaded or dizzy, weakness, feeling very tired, no energy and peeing (urinating) less than usual.
• 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 delay the next injection until you're better. Talk to your healthcare provider if you have any questions.
• 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. If you don't have a fridge (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. If you're concerned about any symptoms you think might be related to your medicine, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.

Common side effects

Tell your healthcare provider if they bother you.

• Nausea (feeling sick). This is quite common with dulaglutide especially 2 to 3 days after the injection and then gets better. Eat smaller meals and more slowly. Avoid eating 2 hours before bed and avoid fried or fatty foods and alcohol. If you are vomiting or dehydrated, delay your next dose until you feel better and are eating and drinking normally. 
• Stinging, pain, redness 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. 
• Runny poo (diarrhoea), constipation, tummy pain, reduced appetite. If you have diarrhoea or are dehydrated, delay your next dose until you feel better and are eating and drinking normally.

Signs of low blood glucose

Signs of low blood glucose 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.

Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur

• Signs of an inflamed pancreas (pancreatitis) such as severe pain in your stomach and back.

Phone 111 for an ambulance or go to your nearest accident and emergency (A&E) clinic if these occur

• Signs of an allergic reaction such as itchy skin, and rash, swollen lips or tongue, problems breathing, like a tight chest or shortness of breath.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.