Trulicity ® (dulaglutide)

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How should other medications be administered with Trulicity® (dulaglutide)?

Consider a reduction of insulin and/or sulfonylurea dose to address the risk of hypoglycaemia. Dulaglutide delays gastric emptying and can alter the absorption of oral medications with rapid absorption or prolonged release.


Differences in the risk of hypoglycaemia from concomitant use of dulaglutide and other antidiabetics

Insulin or sulphonylurea

Patients receiving dulaglutide in combination with sulphonylurea or insulin may have an increased risk of hypoglycaemia.1  

  • The risk of hypoglycaemia may be lowered by a reduction in the dose of sulphonylurea or insulin.
  • Blood glucose self-monitoring is usually not required with dulaglutide, but is necessary to adjust the dose of sulphonylurea or insulin, particularly when dulaglutide therapy is started and insulin is reduced. A stepwise approach to insulin dose reduction is recommended.1

SGLT2i or pioglitazone

When dulaglutide is added to an existing therapy with

  • metformin and/or sodium-glucose co-transporter 2 inhibitor (SGLT2i) therapy or
  • metformin and/or pioglitazone

the current dose of metformin and/or SGLT2i or pioglitazone, respectively, can be continued.1

Impact of altered gastric emptying on concomitant oral medications

Dulaglutide delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products.1

In the clinical pharmacology studies including

  • paracetamol
  • atorvastatin
  • digoxin
  • the antihypertensives lisinopril and metoprolol
  • warfarin
  • the contraceptives norgestimate and ethinylestradiol
  • metformin

dulaglutide doses up to 1.5 mg did not affect the absorption of the orally administered medicinal products tested to any clinically relevant degree.1  

For the 4.5 mg dose, absence of major clinically relevant interactions was predicted by physiologically-based pharmacokinetic (PBPK) modelling simulations.1

No dose adjustment of the medicinal products as listed above is necessary when administered with dulaglutide.1

For patients receiving dulaglutide in combination with oral medicinal products with rapid gastrointestinal absorption or prolonged release, there is a potential for altered medicinal product exposure, particularly at the time of dulaglutide treatment initiation.1


1Trulicity [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

Date of Last Review: 13 July 2020

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