What is this medication?

DULAGLUTIDE (DOO la GLOO tide) treats type 2 diabetes. It works by increasing insulin levels in your body, which decreases your blood sugar (glucose). It also reduces the amount of sugar released into your blood and slows down your digestion. It can also be used to lower the risk of heart attack and stroke in people with type 2 diabetes. Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Trulicity

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Endocrine tumors (MEN 2) or if someone in your family had these tumors
• Eye disease, vision problems
• History of pancreatitis
• Kidney disease
• Liver disease
• Stomach or intestine problems
• Thyroid cancer or if someone in your family had thyroid cancer
• An unusual or allergic reaction to dulaglutide, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is injected under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label on the same day of each week. Do NOT prime the pen. Keep taking it unless your care team tells you to stop.

If you use this medication with insulin, you should inject this medication and the insulin separately. Do not mix them together. Do not give the injections right next to each other. Change (rotate) injection sites with each injection.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 10 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can unless it is more than 3 days late. If it is more than 3 days late, skip the missed dose. Take the next dose at the normal time.

What may interact with this medication?

• Other medications for diabetes

Many medications may cause changes in blood sugar, these include:

• Alcohol containing beverages
• Antiviral medications for HIV or AIDS
• Aspirin and aspirin-like medications
• Certain medications for blood pressure, heart disease, irregular heart beat
• Chromium
• Diuretics
• Female hormones, such as estrogens or progestins, birth control pills
• Fenofibrate
• Gemfibrozil
• Isoniazid
• Lanreotide
• Male hormones or anabolic steroids
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Medications for allergies, asthma, cold, or cough
• Medications for depression, anxiety, or psychotic disturbances
• Medications for weight loss
• Niacin
• Nicotine
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Octreotide
• Pasireotide
• Pentamidine
• Phenytoin
• Probenecid
• Quinolone antibiotics such as ciprofloxacin, levofloxacin, ofloxacin
• Some herbal dietary supplements
• Steroid medications such as prednisone or cortisone
• Sulfamethoxazole; trimethoprim
• Thyroid hormones

Some medications can hide the warning symptoms of low blood sugar (hypoglycemia). You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:

• Beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)
• Clonidine
• Guanethidine
• Reserpine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress.

Check with your care team if you have severe diarrhea, nausea, and vomiting, or if you sweat a lot. The loss of too much body fluid may make it dangerous for you to take this medication.

A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.

Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. Get medical help at once.

Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you may need to change the dose of your medication.

Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.

Pens should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.

Wear a medical ID bracelet or chain. Carry a card that describes your condition. List the medications and doses you take on the card.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Change in vision
• Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
• Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Diarrhea
• Loss of appetite
• Nausea
• Stomach pain
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Refrigeration (preferred): Store unopened pens in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Keep it in the original carton until you are ready to take it. Do not freeze or use if the medication has been frozen. Protect from light. Get rid of any unused medication after the expiration date on the label.

Room Temperature: The pen may be stored at room temperature below 30 degrees C (86 degrees F) for up to a total of 14 days if needed. Protect from light. Avoid exposure to extreme heat. If it is stored at room temperature, throw away any unused medication after 14 days or after it expires, whichever is first.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.