6 Trulicity Interactions You Should Know About

If you have Type 2 diabetes, you may be taking a medication like Trulicity (dulaglutide). Trulicity is a popular once-weekly injection used to manage blood sugar levels. And it can lower the risk of heart attack and stroke in certain people, too. 

If you’re just getting started on Trulicity, you may be concerned about potential interactions. Or perhaps you’ve been taking it for a while, and you’re adding a new medication into the mix. While Trulicity interactions are possible, many can be managed with dosage changes or extra monitoring. Let’s discuss a few important ones you should know about.

1. Insulin

Insulin is a hormone that helps your body use sugar for energy, which helps regulate your blood sugar levels. Sometimes, people with Type 2 diabetes need to take supplemental insulin. Examples of common insulin products include Novolog (insulin aspart) and Lantus (insulin glargine). In some cases, you may be prescribed Trulicity with insulin.

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Like insulin, Trulicity helps lower your blood sugar — but it’s not insulin. Instead, it works by stimulating your pancreas to release insulin in response to a meal. When you take insulin and Trulicity together, your blood sugar may drop too low. This is called hypoglycemia.

Hypoglycemia symptoms can include fast heartbeat, sweating, and shakiness. It’s important to be able to recognize these symptoms and treat them as soon as possible. If left untreated, severe hypoglycemia can be life-threatening.

Your healthcare provider may adjust your insulin dosage before you start taking Trulicity. This can help lower the risk of hypoglycemia. But it’s still important to monitor your blood sugar and let them know if you’re experiencing hypoglycemia episodes. 

2. Sulfonylureas

Sulfonylureas are a class of medications that help manage blood sugar levels in people with Type 2 diabetes. Examples include glipizide (Glucotrol XL), glimepiride (Amaryl), and glyburide (Diabeta, Glynase). 

Sulfonylureas stimulate your pancreas to release insulin. But unlike Trulicity, this happens whether or not you’ve eaten a meal. So, combining these medications can also increase the risk of hypoglycemia. Your healthcare provider may lower your sulfonylurea dosage to manage this interaction ahead of time.

As with insulin, it’s important to regularly monitor your blood sugar with this combination. If your blood sugar is too low, your healthcare provider may need to make further adjustments.

3. Glinides

Glinides are a class of medications that also stimulate your pancreas to release insulin. Compared to sulfonylureas, they work faster and for a shorter amount of time. Because of this, they’re typically taken before each meal. Examples include nateglinide (Starlix) and repaglinide. 

Both nateglinide and repaglinide can cause low blood sugar. When combined with Trulicity, there can be a higher risk of hypoglycemia. Similar to the interactions covered above, your healthcare provider may adjust your glinide dosage while you’re starting Trulicity. 

4. Fluoroquinolones

Fluoroquinolones are a class of antibiotics. They’re used to treat many different types of bacterial infections. Though, they may not be prescribed as often because of their serious side effects. Examples of fluoroquinolones include ciprofloxacin (Cipro), levofloxacin, and moxifloxacin (Avelox).

Fluoroquinolones can affect your blood sugar levels. This risk is higher if you’re older, or if you’re also taking medications that lower your blood sugar. Combining one with Trulicity may cause your blood sugar to get too high (hyperglycemia) or too low (hypoglycemia). 

So, it’s important to regularly monitor your blood sugar levels during treatment. Let your healthcare provider know if your readings are higher or lower than normal. Know how to recognize hypoglycemia symptoms and treat it quickly.

5. Thiazide diuretics

Thiazide diuretics (also called “water pills”) are used to treat high blood pressure and swelling. Examples include hydrochlorothiazide (Microzide) and chlorothiazide (Diuril). Thiazide diuretics are one of several medications that can increase your blood sugar. But experts don’t know for sure how this happens. 

If you’re starting a thiazide diuretic, your current Trulicity dose may not control your blood sugar as well. If needed, your healthcare provider may need to make adjustments. Let them know if your blood sugar readings are higher than usual during treatment.

6. Other oral medications

Trulicity is a glucagon-like peptide-1 (GLP-1) agonist. In addition to stimulating insulin release, GLP-1 agonists also slow gastric emptying. This means it takes longer for food to move from your stomach into your small intestine. 

But this effect can slow down the movement of oral medications, too. In some cases, this may change how you absorb them into your bloodstream. Medications where small differences in blood levels can have serious effects (like warfarin) may require additional monitoring.

Slowed gastric emptying is more likely to happen as your dosage increases. And it tends to improve over time as your body gets used to Trulicity. Your healthcare provider can determine if this interaction potentially affects you and how to manage it.

When should I contact my healthcare provider about a Trulicity interaction?

Contact your healthcare provider if you’re concerned about a Trulicity interaction. This is especially important if you’re starting or stopping another medication. They’ll determine if the interaction potentially affects you and how to manage it. 

Be sure to follow up with them if you’re having frequent episodes of low blood sugar. If needed, they may need to make adjustments to your regimen. The same is true if your blood sugar readings are above your target range.

Many Trulicity interactions can be identified and managed in advance. So, it’s important to provide your current medication list to your healthcare provider and pharmacist for review. 

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Written by:

Lejla Rahmanovic

Lejla Rahmanovic is a PharmD candidate at the University of Health Sciences and Pharmacy in St. Louis, Missouri. She has experience working in both retail and hospital pharmacy settings.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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