Trulicity ® (dulaglutid) injektion

För fullständig produktresumé för Trulicity® se FASS.

Denna information är endast avsedd för sjukvårdspersonal verksam i Sverige och som svar på din fråga. Informationen nedan är på engelska

Trulicity® (dulaglutid): Hospitalisering

Användning av dulaglutid hos patienter på sjukhus har inte studerats.

Use in the Hospital Setting

There are no published studies or case reports regarding the use of dulaglutide in hospitalized patients or in patients undergoing routine surgical procedures.

Indication

Dulaglutide is indicated for the treatment of adults with insufficiently controlled T2DM as an adjunct to diet and exercise

  • as monotherapy when metformin is considered inappropriate due to intolerance or contraindications

  • in addition to other medicinal products for the treatment of diabetes. 1

Dosing

Each weekly dose of dulaglutide can be administered at any time of day, with or without meals.1

Steady‑state plasma dulaglutide concentrations were achieved between 2 to 4 weeks of once‑weekly administration of dulaglutide (1.5 mg).1

Pharmacodynamics

Dulaglutide improves glycaemic control through the sustained effects of lowering fasting, pre-meal and postprandial glucose concentrations in patients with type 2 diabetes starting after the first dulaglutide administration and is sustained throughout the once weekly dosing interval.1

Drug Interactions

Dulaglutide delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products. In the clinical pharmacology studies, dulaglutide did not affect the absorption of the orally administered medications tested to any clinically relevant degree. However, for patients receiving oral medicinal products requiring rapid gastrointestinal absorption or prolonged release formulations the potential for altered drug exposure should be considered.1

Precautions

Dulaglutide should not be used in patients with T1DM or for the treatment of DKA. Dulaglutide is not a substitute for insulin. DKA has been reported in insulin- dependent patients after rapid discontinuation or dose reduction of insulin.1

Dehydration, sometimes leading to acute renal failure or worsening renal impairment, has been reported in patients treated with dulaglutide, especially at the initiation of treatment. Many of the reported adverse renal events occurred in patients who had experienced nausea, vomiting, diarrhoea, or dehydration. Patients treated with dulaglutide should be advised of the potential risk of dehydration, particularly in relation to gastrointestinal side-effects and take precautions to avoid fluid depletion.1

Dulaglutide has not been studied in patients with severe GI disease, including severe gastroparesis, and is therefore not recommended in these patients.1

Patients receiving dulaglutide in combination with sulphonylurea or insulin may have an increased risk of hypoglycaemia. The risk of hypoglycaemia may be lowered by a reduction in the dose of sulphonylurea or insulin. 1

Use of GLP‑1 RAs has been associated with a risk of developing acute pancreatitis. In clinical trials, acute pancreatitis has been reported in association with dulaglutide.1

Patients should be informed of the characteristic symptoms of acute pancreatitis. If pancreatitis is suspected, dulaglutide should be discontinued. If pancreatitis is confirmed, dulaglutide should not be restarted. In the absence of other signs and symptoms of acute pancreatitis, elevations in pancreatic enzymes alone are not predictive of acute pancreatitis.1

References

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

Glossary

DKA = diabetic ketoacidosis

GI = gastrointestinal

GLP-1 RA = glucagon-like peptide-1 receptor agonist

T1DM = type 1 diabetes mellitus

T2DM = type 2 diabetes mellitus

Datum fӧr senaste ӧversyn 2018 M10 12


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