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Dulaglutide

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.

Dulaglutide is used to treat type 2 diabetes and to protect you from having a heart attack or stroke. Dulaglutide also probably protects 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 how fast food is absorbed and reducing your appetite. This is one reason people on dulaglutide usually lose weight.

Dulaglutide can be used alone or with other diabetes medicines (such as metformin or insulin), along with healthy eating and regular exercise. Dulaglutide is available as an injection that is given under your skin. It comes as a ready-to-use injection pen that contains one dose (1.5 mg).

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 will not cause weight gain or low blood glucose levels (hypoglycaemia) when used alone.
Unlike insulin, which requires 1 or more daily injections, you only need to take dulaglutide once a week.

Dulaglutide comes as a single-use pen injection, which means that each pen is used only once for one injection. The pen is ready to use. It is pre-filled with the medicine, and the needle is already fitted onto the pen. The pen is very easy to use – you do not 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.

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.

Store dulaglutide in the fridge, in the original package. Do not freeze. If your pen has been frozen, do not use it.

Take your dulaglutide pen out of the fridge and leave it at room temperature for 15–30 minutes before injecting. Do not warm dulaglutide in any other way, eg, in the microwave or hot water.

When refrigeration is not possible (eg, when you are on holiday), you can keep your pen at room temperature (less than 30°C) for up to 14 days.

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. Do not inject into skin that is sore, bruised, red, hard, scarred or that has stretch marks or psoriasis plaques.

Image: Amgen

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. Do not inject 2 doses at the same time.

If you are unwell
Dulaglutide usually does not cause problems if your are slightly unwell, but if you are at risk of dehydration, with vomiting and diarrhoea and not eating and drinking as usual, you can withhold the next injection when it is due.

It is 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 do this by buying 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.

Common side effects
These are usually mild and go away with time. Talk to your healthcare team if these side effects cause you problems or don’t go away. Nausea (feeling sick) This is quite a common side effect with dulaglutide. It is worst 2–3 days following the injection and gets better with time. Here are some tips to ease the nausea: eat smaller meals and more slowly avoid eating 2 hours before bed avoid fried or fatty foods and alcohol. Reaction 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. Other side effects Runny poo (diarrhoea), constipation, tummy pain and decreased appetite.

Common side effects

These are usually mild and go away with time. Talk to your healthcare team if these side effects cause you problems or don’t go away.

Nausea (feeling sick)

This is quite a common side effect with dulaglutide. It is worst 2–3 days following the injection and gets better with time. Here are some tips to ease the nausea:

eat smaller meals and more slowly
avoid eating 2 hours before bed
avoid fried or fatty foods and alcohol.

Reaction 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.

Other side effects

Runny poo (diarrhoea), constipation, tummy pain and decreased appetite.

Rare, serious side effects
Tell your healthcare team or phone Healthline 0800 611 116 immediately if you notice these side effects and tell them you are taking dulaglutide. Signs of low blood sugar (hypoglycaemia) Sgins include feeling weak, faint, dizzy or irritable. You may also get a headache, tremor (shakes) or blurred vision. Low blood sugar is very rare if you are taking dulaglutide alone, but if you are taking dulaglutide with other medicines for diabetes, such as glipizide, gliclazide or insulin, there is a risk of low blood sugar. 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 snack such as a sandwich. Tell your doctor or nurse if this happens. Read more about low blood glucose and diabetes sick day plan. Other side effects Signs of an inflamed pancreas (pancreatitis) such as severe pain in your stomach and back. 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.

Rare, serious side effects

Tell your healthcare team or phone Healthline 0800 611 116 immediately if you notice these side effects and tell them you are taking dulaglutide.

Signs of low blood sugar (hypoglycaemia)

Sgins include feeling weak, faint, dizzy or irritable. You may also get a headache, tremor (shakes) or blurred vision.
Low blood sugar is very rare if you are taking dulaglutide alone, but if you are taking dulaglutide with other medicines for diabetes, such as glipizide, gliclazide or insulin, there is a risk of low blood sugar.
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 snack such as a sandwich. Tell your doctor or nurse if this happens.
Read more about low blood glucose and diabetes sick day plan.

Other side effects

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

Dulaglutide may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting dulaglutide and before starting any new medicines.

Medicines for type 2 diabetes
Type 2 diabetes | Mate huka