Dulaglutide Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on May 20, 2024.

1. How it works

• Dulaglutide is an injectable GLP-1 receptor agonist that may be used to treat type 2 diabetes or to reduce the risk of future cardiovascular events in people with type 2 diabetes. Dulaglutide is available as the brand name Trulicity. There is no generic Trulicity.
• Dulaglutide mimics the actions of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. By binding to and activating the GLP-1 receptor, it stimulates insulin secretion and lowers glucagon secretion when blood glucose levels are high. It also causes a slowing down in how fast the stomach empties.
• Dulaglutide belongs to the class of medicines called GLP-1 receptor agonists.

2. Upsides

• Dulaglutide may be used in the treatment of type 2 diabetes alongside diet modification and increased exercise.
• Dulaglutide may also be given to reduce the risk of future cardiovascular events, such as a heart attack or stroke, in people with type 2 diabetes who also have heart disease.
• Dulaglutide is effective at reducing blood glucose levels and it also reduces body weight.
• Dulaglutide is given once a week, preferably on the same day each week (for example, every Monday). The day of weekly administration can be changed if necessary, as long as the last dose was administered three or more days before.
• There are two different strengths of dulaglutide (Trulicity): 0.75mg and 1.5mg.
• The dosage of dulaglutide does not need to be adjusted in people with kidney disease. There is limited information about using dulaglutide in people with liver disease; use with caution.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Common side effects of dulaglutide include hypoglycemia (low blood sugar levels) when used with other insulin-lowering medications, nausea, vomiting, diarrhea, abdominal pain, decreased appetite, dyspepsia, and fatigue.
• Dulaglutide needs to be given by injection under the skin (subcutaneous). However, self-administration is easy to learn for most people.
• Dulaglutide does not take the place of insulin and is not effective in people with type 1 diabetes or for the treatment of diabetic ketoacidosis.
• Animal studies have reported thyroid C-cell tumors in rats given dulaglutide. One case of thyroid tumors was reported in a phase 3 clinical trial. It is not known how much dulaglutide increases the risk in humans of these tumors, but the use is contraindicated in people with a family history of thyroid cancer or those with Multiple Endocrine Neoplasia syndrome type 2.
• Dulaglutide may increase the risk of pancreatitis. If this occurs, dulaglutide should be discontinued and not restarted. There have also been reports of kidney damage, which may require hemodialysis, in people treated with GLP-1 receptor agonists (RA), such as dulaglutide. Anaphylaxis and angioedema have also been reported with GLP-1 RAs and the initial administration of dulaglutide should preferably be done in a medical facility.
• Dulaglutide has not been adequately studied in pregnant women and should not be used unless the perceived benefits outweigh the risks of uncontrolled diabetes, which include preeclampsia, spontaneous abortions, and preterm delivery. Animal studies indicate there may be a risk to the fetus from exposure to dulaglutide.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Dulaglutide mimics the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. It lowers blood glucose levels in people with type 2 diabetes and may reduce body weight; however, it does not appear to be as effective as Ozempic. It is given by subcutaneous injection under the skin once weekly. Dulaglutide is available as the brand name Trulicity. There is no generic Trulicity.

5. Tips

• Ask your doctor or nurse to show you how to self-administer dulaglutide before you first do it yourself. Dulaglutide should be injected just under the skin into the abdomen, thigh, or upper arm. Change injection sites each week so that you are not injecting into the same bit of skin every week. Always inspect the injection and do not use dulaglutide if it contains particles or discoloration is seen.
• If you also need to self-administer insulin, administer the insulin at a different site to the dulaglutide, at least 15cm apart. Never mix insulin with dulaglutide and never share your injection with another person. Taking dulaglutide with insulin (as well as other medications such as sulfonylureas that also lower blood sugar levels) increases your risk of hypoglycemia (low blood sugar levels) so monitor yourself for symptoms of low blood sugar which include sweating, shaking, dizziness, a fast heartbeat, and mood changes.
• If you need to change the day you administer dulaglutide, you can, as long as you allow at least 72 hours between two doses (for example, you can change from a Monday morning administration to a Thursday morning administration).
• If you miss a dose of dulaglutide, administer it as soon as possible, but within 4 days of the missed dose. If there are less than 3 days (72 hours) until the next scheduled dose, skip the missed dose and just administer the next dose on the regularly scheduled day.
• Report any symptoms of a possible thyroid tumor (such as a lump in the neck, shortness of breath, difficulty swallowing, or persistent hoarseness) to your doctor immediately.
• If you develop persistent, severe, abdominal pain, which may radiate to the back or be accompanied by vomiting, ring your doctor immediately as Dulaglutide can increase your risk of developing pancreatitis.
• Dulaglutide may temporarily worsen diabetic retinopathy, an eye condition. Tell your doctor if you notice any change in your vision.
• If you are a woman, then use adequate contraception to ensure you do not become pregnant while taking dulaglutide. For a planned pregnancy, it is recommended that dulaglutide is discontinued at least two months before conception. Tell your doctor if you inadvertently become pregnant while taking dulaglutide.

6. Response and effectiveness

• Treatment with dulaglutide 0.75mg subcutaneously reduced HbA1c levels by 9% and blood glucose levels by 16.1% when fasting. Bodyweight was reduced by 1.5%.
• Treatment with dulaglutide 1.5mg subcutaneously reduced HbA1c levels by 10.5% and blood glucose levels by 17.7% when fasting. Bodyweight was reduced by 2.3%.
• In comparison trials, dulaglutide appears more effective than sitagliptin (Januvia), but not as effective as Ozempic at improving blood glucose control and reducing body weight.

7. Interactions

Medicines that interact with dulaglutide may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with dulaglutide. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with dulaglutide include:

• acetazolamide
• anticonvulsants such as phenytoin
• antidepressants such as tricyclic antidepressants (such as amitriptyline and nortriptyline) or monoamine oxidase inhibitors (MAOI) (eg, selegiline, isocarboxazid, and phenelzine)
• antipsychotics, such as aripiprazole
• beta-blockers, such as atenolol, labetalol, and metoprolol, may enhance the hypoglycemic effects
• bexarotene
• ciprofloxacin
• corticosteroids, such as prednisone or cortisone
• diuretics, such as bumetanide, HCTZ, and bendroflumethiazide
• HIV medications, such as amprenavir, atazanavir, and fosamprenavir
• hormones, such as ethinylestradiol and hydroxyprogesterone
• insulin (may increase the risk of hypoglycemia)
• isoniazid
• other medications that affect blood sugar levels or are used for diabetes, such as glimepiride, or metformin.

Dulaglutide may also enhance the toxic effects of alcohol, causing flushing.

Because dulaglutide causes a delay in gastric emptying, it may impact the absorption of any medication taken orally. However, in clinical trials, this did not appear to change the effects of other medications.

Note that this list is not all-inclusive and includes only common medications that may interact with dulaglutide. You should refer to the prescribing information for dulaglutide for a complete list of interactions.

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Frequently asked questions

• Trulicity vs Ozempic: Which is right for you?
• Does Trulicity cause weight loss?
• Does Trulicity need to be refrigerated?
• Trulicity and diet: What foods should you avoid?
• How do you use/inject Trulicity?
• Can Trulicity be injected cold?
• Can Trulicity be used with insulin?
• Is Trulicity a form of insulin?
• How does Trulicity work?

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use dulaglutide only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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