Key takeaways:
Trulicity (dulaglutide) is a once-weekly injection. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists.
Trulicity can interact with other diabetes medications to cause your blood glucose (sugar) levels to drop too low. Examples include insulin, sulfonylureas, and meglitinides.
Trulicity may interfere with how you absorb oral medications. Your prescriber may need to monitor these medications more closely or adjust your regimen.
Be sure to share your medication list with your healthcare team. They can identify potential Trulicity interactions before they become an issue.
Save on related medications
If you’re living with Type 2 diabetes, you may be prescribed an injectable medication like Trulicity (dulaglutide). But if you’re starting Trulicity or adding a medication to your routine, there are interactions to be aware of.
Some medications may affect how well Trulicity works or increase the risk of side effects. In other cases, Trulicity may interfere with how your body absorbs other medications. The good news is that most Trulicity interactions can be managed with a few adjustments. Here are six key Trulicity interactions to keep on your radar.
1. Insulin
Insulin is a hormone that helps your body use glucose (sugar) for energy. This helps regulate your blood sugar levels. Sometimes, people with Type 2 diabetes need to use supplemental insulin. You may be prescribed Trulicity with insulin.
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 use insulin and Trulicity together, your blood sugar may drop too low. This is called hypoglycemia.
Hypoglycemia symptoms can include fast heartbeat, sweating, and shakiness. Make sure you understand how to recognize these symptoms and treat them as soon as possible. If left untreated, severe hypoglycemia can be life-threatening.
Your prescriber 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. If you’re experiencing hypoglycemia episodes, tell your prescriber.
2. Sulfonylureas
Sulfonylureas are a class of oral diabetes medications. They include glipizide (Glucotrol XL), glimepiride (Amaryl), and glyburide (DiaBeta, Glynase). Like Trulicity, they stimulate your pancreas to release insulin. But they do this even if you haven’t eaten, which can raise the risk of hypoglycemia.
Combining sulfonylureas with Trulicity can increase this risk. To help prevent hypoglycemia, your prescriber may lower your sulfonylurea dose when starting Trulicity. As with insulin, be sure to monitor your blood sugar regularly with this combination. If your levels are often too low, your prescriber may need to make further adjustments.
3. Glinides
Meglitinides (also called glinides) work similarly to sulfonylureas. Examples include nateglinide (Starlix) and repaglinide. They also stimulate your pancreas to release insulin. But they work faster and for a shorter amount of time. Because of this, you typically take them before each meal.
When combined with Trulicity, glinides can increase the risk of hypoglycemia. To reduce this risk, your prescriber may adjust your glinide dose when starting Trulicity. Regular blood sugar monitoring can also help ensure your levels stay in a safe range.
4. Fluoroquinolones
Fluoroquinolones are antibiotics that can affect blood sugar levels. Examples include ciprofloxacin (Cipro) and levofloxacin. This risk is higher if you’re older or taking other medications that lower blood sugar. When combined with Trulicity, these antibiotics may cause your blood sugar to go too high (hyperglycemia) or too low.
To stay safe, be sure to monitor your blood sugar while taking a fluoroquinolone. If your readings are outside your usual range, tell your prescriber. They can make adjustments as needed.
Trulicity side effects: Do you experience nausea after injecting Trulicity? Here’s a list of Trulicity side effects and tips for managing them.
How to store Trulicity: Trulicity pens last longest if you keep them in the refrigerator. Learn how to store Trulicity to ensure it stays safe and effective.
How they compare: Learn about the key differences between Trulicity and Ozempic for Type 2 diabetes.
5. Thiazide diuretics
Thiazide diuretics, often called water pills, include medications such as hydrochlorothiazide (Microzide). They can raise blood sugar levels. This may make Trulicity less effective at keeping your blood sugar in range.
If your blood sugar levels start trending higher after starting a thiazide diuretic, your prescriber may adjust your treatment plan. Keep track of your readings, and report any significant changes.
6. Oral medications
Trulicity can slow gastric emptying, meaning it takes longer for food to move out of your stomach. This can help manage postmeal sugar spikes and make you feel full. But it can also affect how your body absorbs medications that you take by mouth.
In studies, Trulicity didn’t significantly affect the absorption of most tested oral medications. But it’s still a good idea to be aware of this potential interaction. With medications such as warfarin, small differences in blood levels can have serious effects.
Trulicity’s effect on gastric emptying is usually greatest when you start the medication and after your dose is increased. It tends to lessen over time as your body gets used to Trulicity. Your prescriber can determine if this interaction could affect you and how to manage it.
Are there foods to avoid with Trulicity?
There aren’t any foods that you have to avoid while using Trulicity. But Trulicity can affect digestion, causing side effects such as nausea and bloating. Certain foods may make these symptoms worse, especially when you start treatment or increase your dose.
To help reduce side effects, try minimizing the following foods and drinks:
Greasy or fried foods, which are harder to digest and may trigger nausea
Spicy foods, which can irritate your stomach and worsen discomfort
Sugary snacks and drinks, which can spike your blood sugar and contribute to stomach upset
Large meals, which may worsen nausea or fullness
Instead, focus on smaller, well-balanced meals with lean protein, fiber, and complex carbohydrates. Drink plenty of water, and avoid skipping meals to help keep your blood sugar stable.
Can you drink coffee on Trulicity?
Yes, you can drink coffee while taking Trulicity. But if you notice more nausea, acid reflux, or jitteriness, it may be helpful to limit how much coffee you drink. Here are a few tips for drinking coffee with Trulicity:
Avoid drinking coffee on an empty stomach.
Cut back on high-caffeine and sugary coffee drinks.
Watch for added ingredients, such as creamer or artificial sweeteners.
Can Trulicity interact with supplements?
Trulicity doesn’t have any known major interactions with vitamins or over-the-counter supplements. But it’s a good idea to talk to your healthcare team before starting anything new. Here’s why:
Trulicity slows digestion. This could change how your body absorbs supplements taken by mouth.
Some supplements can affect blood sugar. Supplements such as chromium and berberine might increase the risk of low blood sugar if taken with diabetes medications.
There may be hidden ingredients. Herbal and weight-loss supplements may contain compounds that interfere with diabetes medications or trigger side effects.
Be sure to share your medication and supplement list with your healthcare team so they can help you manage potential risks.
Frequently asked questions
Both Ozempic (semaglutide) and Trulicity are considered safe and effective when used as prescribed. They belong to the same medication class and have similar risks and side effects. But people can respond differently to medications. Your prescriber may recommend one over the other based on your health history, risk factors, and how you respond to treatment.
There’s no true natural substitute for Trulicity, which works by mimicking a natural gut hormone called glucagon-like peptide-1 (GLP-1). But certain foods and supplements increase GLP-1 naturally. Examples of these include:
Healthy fats, such as omega-3 fatty acids
Lean protein food, such as chicken, fish, and cottage cheese
Soluble fiber, such as whole grains, beans, and flaxseeds
Yerba mate
Curcumin
Similar to other GLP-1 medications, Trulicity commonly causes digestive side effects. These are usually more noticeable when you start treatment or increase your dose. Examples of common side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Upset stomach
Decreased appetite
Fatigue
Both Ozempic (semaglutide) and Trulicity are considered safe and effective when used as prescribed. They belong to the same medication class and have similar risks and side effects. But people can respond differently to medications. Your prescriber may recommend one over the other based on your health history, risk factors, and how you respond to treatment.
There’s no true natural substitute for Trulicity, which works by mimicking a natural gut hormone called glucagon-like peptide-1 (GLP-1). But certain foods and supplements increase GLP-1 naturally. Examples of these include:
Healthy fats, such as omega-3 fatty acids
Lean protein food, such as chicken, fish, and cottage cheese
Soluble fiber, such as whole grains, beans, and flaxseeds
Yerba mate
Curcumin
Similar to other GLP-1 medications, Trulicity commonly causes digestive side effects. These are usually more noticeable when you start treatment or increase your dose. Examples of common side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Upset stomach
Decreased appetite
Fatigue
The bottom line
Trulicity (dulaglutide) is an injectable diabetes medication. It can interact with insulin, sulfonylureas, and meglitinides. This increases the risk of low blood glucose (sugar). Trulicity may also interfere with how your body absorbs oral medications.
There are many potential interactions. Ask your healthcare team about Trulicity interactions before starting or stopping a medication.
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References
ClinCalc.com. (n.d.). Dulaglutide.
Eli Lilly and Company. (2022). Trulicity- dulaglutide injection, solution [package insert].
Endocrine Society. (2022). Pancreas hormones.
Hira, T., et al. (2021). Improvement of glucose tolerance by food factors having glucagon-like peptide-1 releasing activity. International Journal of Molecular Sciences.
Nauck, M. A., et al. (2021). GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art. Molecular Metabolism.
Rehman, A., et al. (2011). Drug-induced glucose alterations part 2: Drug-induced hyperglycemia. Diabetes Spectrum.
U.S. Food and Drug Administration. (2018). FDA reinforces safety information about serious low blood levels and mental health side effects with fluoroquinolone antibiotics; requires label changes.
