Trulicity dosage, forms, and strengths

Trulicity (dulaglutide) has been an option for Type 2 diabetes mellitus treatment since 2014. Since its release, the popularity of this injectable medication has grown based on its once-weekly dosing schedule, ease of use, and some desirable side effects, namely potential weight loss and cardiovascular event prevention. Trulicity’s primary goal of lowering blood sugar levels derives from the stimulation of the glucagon-like peptide-1 (GLP-1) receptor. It comes as 0.75 mg/0.5 mL, 1.5 mg/0.5 mL, 3 mg/0.5 mL, and 4.5 mg/0.5 mL pen-injectors.

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Trulicity forms and strengths

• Trulicity pen-injector for subcutaneous (under the skin) injection: 0.5 mL of 0.75 mg/0.5 mL, 0.5 mL of 1.5 mg/0.5 mL, 0.5 mL of 3 mg/0.5 mL, and 0.5 mL of 4.5 mg/0.5 mL

Trulicity dosage for adults

In addition to its original FDA indication in 2014 for Type 2 diabetes treatment, Trulicity gained approval in 2020 for cardiovascular event reduction in those with both Type 2 diabetes and cardiovascular disease or multiple risk factors for cardiovascular disease. Cardiovascular disease consists of blockages in arteries, the most important arteries being the coronaries which supply the heart with blood, and cerebral vessels that supply the brain with blood. Blockages in the coronary arteries can lead to heart attacks, while blockages in cerebral vessels can lead to strokes. Since heart attacks and strokes are a major concern for individuals with diabetes, the potential to reduce the risk of these life-threatening events is vitally important.

Other GLP-1 agonist options exist for Type 2 diabetes treatment. These include options like Victoza (liraglutide), which needs to be taken daily, as well as other weekly dosing options like Ozempic (semaglutide). Rybelsus (semaglutide) is an oral GLP-1 agonist. These new generation diabetes medications can be expensive, but a SingleCare discount card can help.

Trulicity dosage for Type 2 diabetes mellitus treatment

GLP-1 receptor stimulation assists in glucose (sugar) control by a number of mechanisms. After a meal, activation of this receptor leads to more insulin and less glucagon release, thereby reducing blood glucose levels via both of these hormonal effects. GLP-1 activation also slows gastric emptying, so the stomach stays full longer and food consumption is reduced.

Trulicity can be used alone as monotherapy for Type 2 diabetes or can be combined with other agents, such as metformin, Actos (pioglitazone), sulfonylureas like Amaryl (glimepiride), and sodium-glucose cotransporters like Jardiance (empagliflozin). Metformin is still typically the first-line medication for Type 2 diabetes, but Trulicity is often considered next. Trulicity and other GLP-1 agonists are not used with DPP-4 inhibitors like Januvia (sitagliptin), because there is unlikely to be an additive benefit given their similar mechanisms. 

Trulicity is begun at a 0.75 mg weekly dose, delivered by a pen-injector that easily injects the dose under the skin. If diabetic control goals are not reached after four weeks, the dose can be increased to a 1.5 mg dose per week. Furthermore, the dose can be increased if needed to achieve better sugar control every four weeks to the higher dosing options of 3 mg weekly and 4.5 mg weekly.

RELATED: Is it safe to take Trulicity and metformin together?

Trulicity dosage for prevention of cardiovascular events in certain individuals with Type 2 diabetes mellitus

While having a cardiovascular event, like a heart attack or a stroke, is a concern for everyone with diabetes, this indication for Trulicity use applies only to those at the highest risk. Studies have demonstrated this particular benefit to those with known cardiovascular disease or with multiple risk factors for cardiovascular disease. One example would be an individual with diabetes who has had a previous heart attack or coronary blockage for example. Another example of a reasonable candidate for this usage would be someone with Type 2 diabetes who smokes cigarettes, has high blood pressure, and has a family history of heart disease. 

Initial dosing and subsequent dosage escalation guidelines are the same for this indication. Since there are multiple different drug options for glucose control in Type 2 diabetes, the potential to reduce cardiovascular events can be a deciding factor in choosing Trulicity over other non-GLP-1 options.

Trulicity dosage for children 

Currently, there is no FDA approval or standard dosing for children.

Trulicity dosage restrictions

Dosage adjustments are not necessary in the setting of kidney disease or liver disease. However, caution is advised in the setting of advanced renal impairment or hepatic disease due to the lack of clinical studies in such patients.

Trulicity should not be used by anyone with a history of multiple endocrine neoplasia syndrome type 2 (MEN 2) or a personal or family history of medullary thyroid carcinoma (type C thyroid cancer). The reason is that Trulicity causes an increase in the incidence of this thyroid cancer type in rodents, but it is not known if this effect occurs in humans.

Trulicity is not used for Type 1 diabetes management.

Trulicity dosage for pets

There is no FDA-approved dosing or indication for Trulicity use in pets.

How to take Trulicity

Trulicity pen-injectors contain a single dose, so a new single-dose pen is used each week. The weekly dose can be given at any time of day, regardless of meals. Here are some important tips for taking Trulicity.

• Your doctor will prescribe your exact dose. This medicine is usually given once a week, on the same day of the week. It is given as a shot at the injection site under the skin of your stomach, thighs, or upper arms.

• You may be taught how to use Trulicity at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.

• If you use insulin for additional glycemic control, do not mix insulin and Trulicity in the same syringe. You may give the shots in the same area (including the stomach), but do not give the shots right next to each other.

• If the medicine in the pen or prefilled syringe has changed color, looks cloudy, or has particles in it, do not use it.

• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.

• Use a new needle and syringe each time you inject your medicine.

• This medicine should come with a medication guide. Ask your pharmacist for a copy if you do not have one.

• If you miss a dose of Trulicity, use it as soon as possible within three days after your missed dose. If you miss a dose by more than three days, wait until your next scheduled dose.

• Store your medicine pens or prefilled syringes in the refrigerator and keep them in the original carton. Protect the pens from light. You may also store the pens at room temperature for up to 14 days. Do not freeze the medicine, and do not use the medicine if it has been frozen.

Trulicity dosage FAQs

How long does it take for Trulicity to work?

Trulicity gets to peak levels within one to three days after injection.

How long does Trulicity stay in your system?

Trulicity’s half-life is five days, so it takes that long for the concentration in the body to be reduced in half. After Trulicity is stopped, 97% of the drug is eliminated within about 25 days. 

How long can you take Trulicity?

Trulicity can be used indefinitely. Stopping Trulicity could be considered if serious side effects of Trulicity such as low blood sugar or nausea are experienced or if a thyroid lump is found.

How do I stop taking Trulicity?

Stopping Trulicity can generally be done without tapering or fear of withdrawal effects. Ask a healthcare professional for medical advice before stopping Trulicity.

Can you overdose on Trulicity?

Excessive Trulicity dosing can cause adverse reactions, including the risk of hypoglycemia (low blood sugar) when taken in the setting of other antidiabetic medications. Seeking emergency medical care and calling the Poison Control Helpline at 1-800-222-1222 is advisable.

What interacts with Trulicity?

The primary drug interaction of concern with Trulicity is severe hypoglycemia. Numerous other medications can heighten the potential risk for low blood sugar, including not only other diabetic medications and insulin but also other drug classes, such as some antidepressants and antibiotics. A healthcare provider will need to review the medication list for any potential interactions.

Cidofovir can have additive side effects on kidney and bone marrow function and is not to be used together with Trulicity.

What happens when you mix Trulicity and alcohol?

Alcohol use should be avoided with Trulicity due to the potential for alcohol to contribute to dangerous drops in blood sugar.

Is it safe to take Trulicity during pregnancy?

Blood sugar control is of the utmost importance during pregnancy. Due to insufficient clinical trials including pregnant women on Trulicity, other treatment options are advised. Always speak to your healthcare provider before starting a new medication during pregnancy or while breastfeeding.

Is lab monitoring done while taking Trulicity?

As usual in Type 2 diabetes management, glucose control needs to be repeatedly assessed. Hemoglobin A1C (HbA1C) measurements provide an estimate of what the blood sugar has been on average in the three months leading up to the test, and HbA1C should be checked every three to six months. Weight monitoring is also a good idea since weight loss can be experienced while taking Trulicity.

Situationally, additional monitoring may apply. For example, kidney function should be checked if someone is experiencing severe gastrointestinal side effects during treatment. Pancreatitis is an uncommon adverse effect of Trulicity, but in the event of abdominal pain, blood work to look for pancreatitis may be recommended.

Related resources for Trulicity dosages:

• Trulicity prescribing information, FDA

• Trulicity is approved to reduce cardiovascular events in adults, Eli Lilly and Company

• Adult dosing, Epocrates

• Pregnancy and lactation, Epocrates

• Manufacturer consumer website, Eli Lilly and Company

• Effects of glucagon-like peptide-1 receptor agonists on weight loss, The BMJ

• Dulaglutide and cardiovascular outcomes in Type 2 diabetes, The Lancet