Trulicity Injection
Dulaglutide
1.5 mg/0.5 ml
Healthcare Pharmaceuticals Ltd.
| Pack size | 4's |
|---|---|
| Unite Price | 3395.00 BDT |
Indications
Trulicity Injection is used for:
Type 2 diabetes mellitus
Adult Dose
Subcutaneous
Indicated as adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM)
Adult: Initial: 0.75 mg SC once weekly
May increase dose to 1.5 mg once weekly for additional glycemic control
If additional glycemic control needed, increase to 3 mg once weekly after at least 4 weeks on the 1.5-mg dose
If additional glycemic control needed, increase to maximum dose of 4.5 mg once weekly after at least 4 weeks on the 3-mg dose
Hepatic impairment (any severity): No dosage adjustment required; owing to limited data, caution advised
Child Dose
Renal Dose
Renal impairment (any severity): No dosage adjustment required
Administration
SC Preparation
Inspect visually before use; solution should appear clear and colorless; do not use if particulate matter or coloration observed
SC Administration
Administer once weekly at any time of day
May take with or without food
Inject SC in abdomen, thigh, or upper arm; rotate injection site with each dose
If needed, can change day of weekly administration if last dose was administered ?3 days before
Contra Indications
Personal or family history of medullary thyroid carcinoma (MTC), patient with multiple endocrine neoplasia syndrome type 2 (MEN 2).
Precautions
Patient with history of hypersensitivity, pancreatitis, severe gastrointestinal disease (e.g. gastroparesis) and those at risk for developing conduction abnormalities (e.g. ischaemic heart disease, cardiomyopathies). Not intended for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis. Renal and hepatic impairment. Pregnancy and lactation.
Pregnancy-Lactation
Pregnancy
Limited data in pregnant women are not sufficient to determine a drug associated risk for major birth defects and miscarriage
There are clinical considerations regarding the risks of poorly controlled diabetes in pregnancy (eg, diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth, delivery complications)
Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus
Animal studies
Based on animal reproduction studies, there may be risks to the fetus from exposure to dulaglutide during pregnancy
In pregnant rats and rabbits administered dulaglutide during organogenesis, early embryonic deaths, fetal growth reductions, and fetal abnormalities occurred at systemic exposures at least 13 to 14-times human exposure at the maximum recommended human dose (MRHD) of 1.5 mg/week
Clinical considerations
Poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications
Poorly controlled diabetes increases fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity
Lactation
There are no data on presence of dulaglutide in human milk, the effects on breastfed infant, or effects on milk production
Consider developmental and health benefits of breastfeeding along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition
Interactions
Increased risk of hypoglycaemia with sulfonylureas or insulin. May delay gastric emptying and reduce the rate of absorption of oral medications.
Side Effects
Side effects of Dulaglutide :
>10%
Nausea (12.4-21.1%)
Increased amylase (20%)
Increased lipase (14%)
Diarrhea (7-12.6%)
1-10%
Abdominal pain (6.5-9.4%)
Vomiting (5.6-9.3%)
Decreased appetite (4.9-8.6%)
Fatigue (4.2-5.6%)
Dyspepsia (2.3-5.8%)
Constipation (3.7-3.9%)
Severe hypoglycemia with prandial insulin (2.7-3.4%)
Flatulence (1.4-3.4%)
Sinus tachycardia (2.8-3%)
Abdominal distension (2.3-2.9%)
Gastroesophageal reflux disease (1.7-2%)
AV block (0.9-1.7%)
Eructation (0.6-1.6%)
<1%
Hypersensitivity, sometimes severe (eg, severe urticaria, systemic rash, facial edema, lip swelling)
Injection-site reactions
Pancreatitis
Cholelithaisis and cholecystitis
Mode of Action
Dulaglutide is an analogue of glucagon-like peptide-1 (GLP-1), an incretin hormone linked to a modified human Ig G4 fragment and act as GLP-1 receptor agonist. Activation of GLP-1 stimulates insulin release by increasing intracellular cyclic AMP (cAMP) in pancreatic beta cells and suppression of glucagon secretion in a glucose-dependent manner. It also slows gastric emptying thus reduces postprandial glucose (PPG) concentration.
Note
Trulicity 1.5 mg/0.5 ml Injection generic name is Dulaglutide. Trulicity 1.5 mg/0.5 ml Injection is manufactured by Healthcare Pharmaceuticals Ltd.Trulicity is availble in all over Bangladesh.
Mes BD drug index information on Trulicity Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.