Dulaglutide Injection

Why is this medicine prescribed?

Dulaglutide injection is used for the following:

• to lower blood sugar levels in people with type 2 diabetes (condition in which blood sugar is too high because the body does not produce or use insulin normally).
• to reduce the risk of a heart attack, stroke, or death in adults with type 2 diabetes who also have heart disease or who are at risk of developing heart disease.

Dulaglutide injection is in a class of medications called incretin mimetics. It works by helping the pancreas to release the right amount of insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues where it is used for energy. Dulaglutide injection also slows the emptying of the stomach and may decrease appetite and cause weight loss.

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Dulaglutide injection comes as a solution (liquid) in a prefilled dosing pen to inject subcutaneously (under the skin) in your stomach, thigh, or upper arm. Inject once a week without regard to meals. Use dulaglutide injection on the same day each week at any time of day.

Use dulaglutide injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Dulaglutide injection controls diabetes but does not cure it. Continue to use dulaglutide injection even if you feel well. Do not stop using dulaglutide injection without talking to your doctor.

Dulaglutide comes in prefilled dosing pens that contain enough medication for one dose. Always inject dulaglutide in its own prefilled dosing pen; never mix it with any other medication.

Always look at dulaglutide solution before you inject it. It should be clear, colorless, and free of solid particles.

You can inject dulaglutide in your upper arm, thigh, or stomach area. Never inject dulaglutide into a vein or muscle. Change (rotate) the injection site within the chosen area with each dose. You can inject dulaglutide and insulin in the same body area, but you should not give the injections right next to each other.

Never reuse or share dosing pens. Dispose of pens in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture resistant container.

What special precautions should I follow?

Before using dulaglutide,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using dulaglutide injection. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had pancreatitis (inflammation of the pancreas); diabetic retinopathy (damage to the eyes caused by diabetes); severe stomach problems, including gastroparesis (slowed movement of food from the stomach to the small intestine) or other problems digesting food; or gallbladder, kidney, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using dulaglutide injection, call your doctor.
• ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of dulaglutide you may need.

What special dietary instructions should I follow?

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian.

What should I do if I forget to take a dose?

Inject the missed dose as soon as you remember it and then continue your regular weekly schedule. However, if there are less than 3 days until your next scheduled dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222

. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• nausea, vomiting
• symptoms of hypoglycemia

What side effects can this medicine cause?

Dulaglutide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• heartburn
• decreased appetite
• feeling tired

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, stop using dulaglutide and call your doctor immediately or get emergency medical treatment:

• ongoing pain that begins in the upper left or middle of the stomach but may spread to the back
• vomiting
• hives, rash, itching
• difficulty breathing or swallowing
• swelling of lips, tongue, face, or throat
• vision changes
• fast heartbeat
• dizziness or fainting
• pain in the upper stomach, fever, yellowing of skin or eyes, or clay-colored stools

Dulaglutide may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone (

What should I know about storage and disposal of this medication?

Keep this medication in the original carton in the refrigerator, protected from light. Do not freeze. If necessary, each prefilled dosing pen can be kept at room temperature for up to 14 days. Keep dulaglutide out of reach of children.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What other information should I know?

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.