From the Guidelines
Patients should typically have lab tests checked before increasing their Trulicity (dulaglutide) dose to ensure safe and effective glycemic control. Specifically, patients should have their HbA1c (glycated hemoglobin) levels and fasting blood glucose levels checked, as these tests help assess how well the current dose is controlling blood sugar 1. Additionally, kidney function tests (eGFR and creatinine) should be performed, as Trulicity dosing may need adjustment in patients with impaired renal function. The standard starting dose of Trulicity is 0.75 mg once weekly, which can be increased to 1.5 mg once weekly if needed for better glycemic control, as part of the management of hyperglycemia in type 2 diabetes, as reported by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) in 2018 1. Some key points to consider when increasing the dose of Trulicity include:
- Confirming whether a dose increase is actually necessary based on glycemic control
- Identifying any potential safety concerns, particularly related to kidney function
- Providing a baseline for comparison to assess the effectiveness of the dose increase Patients should work closely with their healthcare provider to determine the appropriate timing for lab tests and any dose adjustments, with HbA1c typically checked every 3-6 months, but more frequent testing may be needed when adjusting medication doses. Key considerations for healthcare providers include:
- Monitoring for potential hypoglycemia when combining Trulicity with insulin or sulfonylureas
- Adjusting the dose of Trulicity based on individual patient response and kidney function
- Educating patients on the importance of regular lab testing and close medical supervision when increasing the dose of Trulicity.
From the Research
Laboratory Results and Trulicity Dosage
- Patients taking Trulicity (dulaglutide) may need to monitor their laboratory results, particularly pancreatic enzyme levels, as dulaglutide use has been known to cause a mild elevation of these levels 2.
- The case report of a patient who developed acute pancreatitis after increasing the dose of Trulicity highlights the importance of monitoring pancreatic enzyme levels in patients taking dulaglutide 2.
- However, there is no direct evidence to suggest that patients need to check laboratory results before increasing the Trulicity dosage, but rather that healthcare providers should monitor patients for potential adverse effects, such as pancreatitis, when adjusting the dose 2, 3, 4.
Dosage Adjustments and Monitoring
- The dosage of Trulicity can be increased as needed for adequate glycemic control, but patients should be monitored for potential adverse effects, such as gastrointestinal side effects 3, 4.
- Healthcare providers should consider the individual patient's characteristics, such as age, weight, and medical history, when adjusting the dose of Trulicity 5, 6.
- Regular monitoring of laboratory results, including pancreatic enzyme levels, can help healthcare providers identify potential adverse effects and adjust the dose of Trulicity accordingly 2, 4.