Dulaglutide: Dose, Proper Use, Side Effects

used in the treatment of type 2 diabetes. It is a relatively recently approved drug that can be used both on its own and in combination therapy with other antidiabetic drugs.

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Going into more detail, dulaglutide belongs to the group of so-called incretin mimetics or analogues of the GLP-1 receptor. To perform its action, it must be administered parenterally by subcutaneous injection.

Medicines based on dulaglutide can be dispensed only on presentation of a repeatable prescription limitation - RRL (drugs sold to the public only on prescription from hospitals or specialists). Their cost is very high, however, since they are classified as class A drugs, they can be dispensed at the expense of the National Health System (NHS).

Examples of Specialty Medicines Containing Dulaglutide

Trulicity®

type 2 to lower blood glucose levels:

In monotherapy, when diet and physical activity interventions alone are not sufficient to control blood sugar and / or when the patient cannot take metformin (an oral antidiabetic drug);
In combination therapy with other antidiabetic medicines (oral or insulin) when these are not sufficient to control the disease.

Please Note

Dietary treatment and physical activity must NOT be interrupted even when you are taking antidiabetic drugs. In fact, the latter must be combined with a normoglycemic diet and regular exercise and not be used as an alternative to them.

, since in such cases the use of dulaglutide is not recommended;

You have type 1 diabetes mellitus;

You have diabetic ketoacidosis (a complication of diabetes that occurs when the body is unable to lower the blood glucose level because there is not enough insulin; the signs include: rapid weight loss, nausea o vomiting, sweet smell of the breath, perception of a sweet or metallic taste, alteration of the smell of urine or sweat);

You have severe digestive problems or slowed gastric emptying (including gastroparesis);

He suffered from pancreatitis;

You are taking other antidiabetic drugs and, in particular, sulphonylureas, as there is an increased risk of hypoglycaemia.

In any case, before taking any type of dulaglutide-based medicine, it is necessary to inform your doctor of your health conditions, making him aware of the possible presence of ailments or diseases of any kind, even if not listed in the above list.

Please Note

Due to the lack of adequate studies, the use of dulaglutide in children and adolescents less than 18 years of age is not recommended.
When dulaglutide is used in combination with sulphonylureas or insulins, there is an increased risk of hypoglycaemia which may manifest itself with symptoms affecting the ability to drive and use machines; for this reason, extreme caution is recommended. .

(OTC), herbal and phytotherapeutic products and homeopathic products.

experiencing undesirable effects that differ in type and intensity, or not showing them at all.

Very common and common side effects

Among the very common and common side effects that can arise during therapy with dulaglutide we find:

Nausea and / or vomiting;
Abdominal pain;
Diarrhea or constipation
Flatulence;
Bloated stomach
Belching;
Decreased appetite;
Digestive disorders;
Gastroesophageal reflux disease;
Tiredness;
Increased heart rate
Slowing of the electrical conduction of the heart;
Hypoglycaemia: This is a common side effect when dulaglutide is used in combination with metformin, sulphonylureas and / or insulin, or when used in combination with pioglitazone and / or sodium-glucose transporter type 2 (SGLT2) inhibitors. Hypoglycaemia can manifest itself with symptoms such as: headache, drowsiness, weakness, dizziness, feeling hungry, confusion, irritability, tachycardia and sweating. Should such symptoms arise, the doctor should be alerted immediately.

Uncommon and rare side effects

Among the uncommon and rare side effects that can occur during treatment with dulaglutide, we find instead:

Reactions at the injection site (eg redness, rash, etc.);
Allergic reactions, including severe allergic reactions which can manifest themselves with symptoms such as:
- Skin rashes;
- Itching;
- Angioedema;
- Urticaria;
- Respiratory difficulties.

Of course, in such cases, you should immediately contact your doctor and go to the nearest emergency room.

Inflammation of the gallbladder;
Gallstones;
Pancreatitis.

Finally, it should be noted that cases of intestinal obstruction have also been reported during treatment with dulaglutide, the frequency of which, however, is not known.

Overdose

In the event of dulaglutide overdose, gastrointestinal disturbances and hypoglycaemia may arise. There is no specific antidote, the treatment is symptomatic and supportive.

In case of overdose - whether it is ascertained or presumed to be - it is advisable to contact your doctor immediately or go to the nearest hospital, taking care to take the package of the medicine taken with you.

particular hormones called incretins are produced whose levels increase following food intake. There are basically two types of incretins: GLP-1 (Glucagon-like peptide 1) and GIP (Glucose-dependent insulinotropic peptide). GLP-1, in particular, is responsible for blood sugar control, especially after meals.

Dulaglutide is a long-acting GLP-1 receptor agonist, which means that when it binds to it, it produces the same effect as if the endogenous GLP-1 substrate binds to the receptor. In other words, dulaglutide mimics its action (hence the name of "incretin-mimetics"). Thanks to its mechanism of action, therefore, dulaglutide is able to determine the release of insulin from the beta cells of the pancreas (through the increase of cyclic intracellular AMP) and to suppress the secretion of glucagon, whose levels are elevated in patients with type 2 diabetes (lower glucagon concentrations lead to a reduction in hepatic glucose output). Furthermore, dulaglutide is able to slow down gastric emptying.

if the injection is given by someone else.

When used on its own, the usually administered dose of dulaglutide is 0.75 mg once weekly. However, when dulaglutide is given in combination therapy, the usually recommended dose is 1.5 mg per week. However, in some cases (eg elderly patients over 75 years of age), this dose may be reduced to 0.75 mg per week.

The medicine can be administered at any time of the day, regardless of meals, preferably on the same day each week.

Blood glucose should be monitored regularly during dulaglutide treatment.

Forgetfulness of a dose

Depending on the day you realize you have forgotten to take the dose of dulaglutide, you can act in different ways:

If you forget to take a dose of the active substance and there are at least 3 days to the next dose, the missed dose can be given as soon as possible. The next dose should then be injected on the regularly scheduled day.
If it is less than 3 days until the next dose, the missed dose should be skipped and the next dose should be injected on the regularly scheduled day.

A double dose should NOT be used to make up for a forgotten one.

If desired, it is possible to change the day of the week on which dulaglutide is administered, provided that at least three days have passed since the last injection.

and a risk to the baby cannot be excluded, the use of the active ingredient is NOT recommended in breastfeeding mothers.