Table of Contents

1. What is Trulicity?
2. Constituents and Mechanism of action
3. Indications of Trulicity
4. Trulicity Dosage
5. Contraindications of Trulicity
6. Effects of Trulicity on Organs
7. Drug Interactions of Trulicity
8. Reported Allergic Reactions
9. Is Trulicity Addictive?
10. Can I take it while pregnant?
11. Can I take it while breastfeeding?
12. Is it recommended for pediatric population?
13. Is it safe to take alcohol while under this medication?
14. Is it safe to drive after taking Trulicity injection?
15. How long does the effect stay?
16. Storage requirements
17. What if I take an expired Injection of Trulicity?
18. Substitutes of Trulicity

What is Trulicity?

Trulicity is an injectable medicine used to treat Type 2 Diabetes Mellitus. Trulicity is the trade name for Dulaglutide. This drug is used along with a well-controlled diet and exercise.

Trulicity is not used as the first-line treatment for controlling blood sugar levels. Although it’s an injectable form of the anti-diabetic drug, Trulicity is not a substitute for insulin. Trulicity was approved by US FDA in 2014. The manufacturer of Trulicity is ELI and LILLY Company.

Here are the uses, contraindications, side effects, and everything to know about this drug…

Constituents and Mechanism of action

Trulicity (Dulaglutide) is classified under Incretin mimeticdrug. Incretins are hormones produced in the small intestine during a meal that enter the blood vessels and trigger insulin release by pancreatic beta cells from Islets of Langerhans in the liver by a blood glucose-dependent mechanism thereby reducing blood glucose levels. The two incretins are glucagon-like peptide (GLP-1) and gastric inhibitory peptide (GIP). Dulaglutide mimics the action of incretins. It reduces both fasting and postprandial blood glucose levels.

Following are some of the drugs used to treat Type2 Diabetes Mellitus

Novomix, Jardiance, Tenglyn, Novolog, Tenepan.

Indications of Trulicity

It is indicated for the treatment of Type 2 Diabetes Mellitus in adjunct to well-controlled diet and exercise. Type 2 diabetes is the most common type, accounting for an estimated 90 to 95 percent of all diabetes cases.

Incidence of Diabetes:

• In youth: About 193,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.24% of that population.
• In Elderly: The percentage of Americans age 65 and older remains high, at 25.2%, or 12.0 million seniors (diagnosed and undiagnosed).
• In urban India, type 2 diabetes is reaching epidemic proportions (2–5). Diabetes develops at a younger age in Indians, i.e., at least a decade or two earlier than in the Western population

Diabetes by race/ethnicity:

The rates of diagnosed diabetes in adults by race/ethnic background are

• 7.4% of non-Hispanic whites
• 8.0% of Asian Americans
• 12.1% of Hispanics
• 12.7% of non-Hispanic blacks
• 15.1% of American Indians/Alaskan Native

Trulicity Dosage

Dosage forms and strengths available:

• Injection: 0.75 mg/0.5 mL solution in a single-dose pen
• Injection: 1.5 mg/0.5 mL solution in a single-dose pen
• Injection: 0.75 mg/0.5 mL solution in a single-dose prefilled syringe
• Injection: 1.5 mg/0.5 mL solution in a single-dose prefilled syringe

Dosage Instructions

• It should be taken subcutaneously in the abdomen, thigh, or upper arm.
• Initial dose recommended is 0.75mg once weekly with or without food at any time of the day.
• The day of weekly administration can be changed if necessary as long as the last dose was administered 3 or more days before.
• Increase in dose strength to 1.5mg is needed only when additional control in blood sugar levels is needed and only when advised by your healthcare provider.
• Effects of Missed Dose: If a dose is missed, inject the dose as soon as possible if there are at least 3 days (72 hours) until the next scheduled dose. If less than 3 days remain before the next scheduled dose, skip the missed dose and administer the next dose on the regularly scheduled day. Please contact your health care provider and follow the instructions before administering the skipped dose.
• Effects of OverDose: Overdosage causes mild or moderate gastrointestinal events (e.g., nausea, vomiting) and non-severe hypoglycemia. Appropriate care with frequent blood glucose monitoring should be started immediately. Immediately contact your healthcare provider.
• Trulicity along with Insulin: While using Trulicity with an Insulin Secretagogue (e.g., Sulfonylurea) or with Insulin consider reducing the dosage of concomitantly administered insulin secretagogues (e.g., sulfonylureas) or insulin to reduce the risk of hypoglycemia.
• Trulicity with insulin should be taken as separate injections.  It is acceptable to inject Trulicity and insulin in the same body region but the injections should not be adjacent to each other. When injecting in the same body region, use a different injection site each week.

Read about Insulin available with brand names such as Human mixtard, Flexpen, Lantus.

• Patients with Renal Impairment: No dose adjustment is recommended in patients with renal impairment including end-stage renal disease (ESRD). Monitoring renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions is needed.

Contraindications of Trulicity

• Medullary Thyroid Carcinoma: Trulicity is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Hypersensitivity: Trulicity is contraindicated in patients with a prior serious hypersensitivity reaction to dulaglutide or to any of the product components.
• Pancreatitis: Trulicity is not recommended in patients with a history of pancreatitis.
• Trulicity should not be used in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
• Gastrointestinal: Trulicity is not recommended in patients with severe gastrointestinal disease, including severe gastroparesis.

Adverse reactions

• Hypoglycemia
• Diarrhea
• vomiting  
• abdominal pain and discomfort
• gastrointestinal pain
• Injection site reactions
• Hypersensitivity reactions
• Increased heart rate. Immediately contact your doctor if you observe any of the above side effects.

The occurrence of adverse reactions was evaluated in a larger pool of patients with type 2 diabetes. The mean age of patients was 56 years, 2% were 75 years or older and 51% were male. The population in these studies was 71% White, 7% Black or African American, 11% Asian; 32% were of Hispanic or Latino ethnicity. At baseline, the population had diabetes for an average of 8.2 years and had a mean HbA1c of 7.6-8.5%.

Effects of Trulicity on Organs

• Pancreas: Inflammation of pancreas. Increase in the levels of pancreatic enzymes like amylase and lipase.
• GIT: severe digestive problems with diarrhea, vomiting, nausea, abdominal pain and discomfort have been noted in few cases.
• hypoglycemia (low blood sugar)
• Skin: severe allergic reaction and injection site reactions have been observed.
• Thyroid:  Increased risk for thyroid C-cell tumors.
• Kidneys: Signs of renal failure has been observed in the patients taking Trulicity with underlying renal disease. Symptoms can include:
• dark urine
• urinating less than usual
• shortness of breath
• swelling in your legs
• Heart: Increased heart rate and QT prolongation are the effects on heart, in rare cases.

Drug Interactions

Trulicity may decrease the gastric emptying of all orally taken medications.  It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without talking to your doctor.

Reported Allergic Reactions

Allergic reactions with Trulicity (Dulaglutide) have been reported. Inform your doctor if you are allergic to any of its ingredients. Signs of an allergic reaction include:

• Rashes/itching of the skin
• Shortness of breath
• Swelling of face, lips, tongue, or throat
• Loss of consciousness.
• Angioedema (painless swelling under the skin)

Is Trulicity Addictive?

This drug is not addictive. However, over-dependence on these medicines should be avoided.

Can I take it while pregnant?

It is not safe to use this drug during pregnancy. Poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth, and delivery complications. Trulicity should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus only when prescribed by your health care provider and obstetrician as well.

Can I take it while breastfeeding?

Trulicity should be used while breastfeeding only if the potential benefits justify the potential risks. Consult your doctor before taking this drug.

Is it recommended for pediatric population?

Trulicity is not recommended for use in pediatric patients younger than 18 years.

Is it safe to take alcohol while under this medication?

Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia.

Is it safe to drive after taking Trulicity injection?

It is safe to drive after taking a prescribed Dose of injection. But should be careful while driving and working with machines when used along with insulin or sulphonylureas, as there is a chance of hypoglycemia.

How long does the effect stay?

The maximum efficacy of Trulicity single dose for both 0.75mg and 1.5mg is observed within 24 to 72 hrs. This drug stays in the body (elimination half-life) for approximately 5 days.

Storage requirements

• Store Trulicity in the refrigerator at 36°F to 46°F (2°C to 8°C). Do not use Trulicity beyond the expiration date.
• If needed, each single-dose pen or prefilled syringe can be kept at room temperature, not to exceed 86°F (30°C) for a total of 14 days.
• Do not freeze Trulicity. Do not use Trulicity if it has been frozen.
• Trulicity must be protected from light.
• Storage of Trulicity in the original carton is recommended until the time of administration.
• Discard the Trulicity single-dose pen or prefilled syringe after use in a puncture-resistant container.

What if I take an expired Injection of Trulicity?

A single dose of expired Trulicity may not cause any major adverse effect. However, the potency of the medicine may well have decreased over time and it may cause hyperglycemia (increased blood glucose levels). Immediately consult your doctor if injected expired medicine.

Substitutes of Trulicity – (Dulaglutide)

• Tanzeum – (Albiglutide)
• Bydureon, Byetta – (Exenatide)
• Saxenda, Victoza- ( Liraglutide)
• Symlin- ( Pramlintide)
• Ozempic- (Semaglutide)

Note:

Information in this article is published for awareness only and shouldn’t be used for self-prescription or usage without the directions from a licensed medical practitioner.

Reference: trulicity.com

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