Dulaglutide interactions

Food & lifestyle

• alcohol

  Moderate

  Others

  Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

  What to do: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

  9 sources

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72

  Show all 9 sourcesShow fewer sources

  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60

Conditions

Conditions in which Dulaglutide needs care, as documented in this source.

• Gastroparesis

  Major

  Dulaglutide slows gastric emptying and has not been studied in patients with gastroparesis, therefore it is not recommended in these patients.

  1 source

  1. "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company (2014):

• Pancreatitis

  Major

  The use of GLP-1 receptor agonists has been associated with rare reports of acute pancreatitis. Other antidiabetic therapies should be considered in patients with a previous history of pancreatitis, although it is not known if they are at increased risk. Patients receiving treatment with GLP-1 receptor agonists should be observed carefully for signs and symptoms of pancreatitis. If this diagnosis is suspected, the treatment should be discontinued immediately and appropriate management should be initiated. Treatment with GLP-1 receptor agonists should be permanently discontinued if pancreatitis is confirmed.

  4 sources

  1. "Product Information. Byetta (exenatide)." Amylin Pharmaceuticals Inc (2005):
  2. "Product Information. Tanzeum (albiglutide)." GlaxoSmithKline (2014):
  3. "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company (2014):
  4. "Product Information. Saxenda (liraglutide)." Novo Nordisk Pharmaceuticals Inc (2015):

• Thyroid Neoplasms

  Major

  GLP-1 receptor agonist antidiabetic drugs are contraindicated in patients with a personal or family history of medullary thyroid carcinoma and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN2). Carcinogenicity studies in rodents and limited postmarketing data suggest that GLP-1 inhibitors may cause a dose-related and treatment duration-related increase in risk of thyroid C-cell tumors, although a causal relationship has not been established.

  5 sources

  1. "Product Information. Byetta (exenatide)." Amylin Pharmaceuticals Inc (2005):
  2. "Product Information. Victoza (liraglutide)." Novo Nordisk Pharmaceuticals Inc (2010):
  3. "Product Information. Tanzeum (albiglutide)." GlaxoSmithKline (2014):
  4. "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company (2014):
  5. "Product Information. Saxenda (liraglutide)." Novo Nordisk Pharmaceuticals Inc (2015):

• Kidney Diseases

  Moderate

  There have been reports of acute renal failure and worsening of chronic renal failure sometimes requiring hemodialysis in patients treated with GLP-1 receptor inhibitors. Some of these events occurred in patients without known underlying renal disease. These drugs should be used with caution in patients with renal impairment, especially during treatment initiation or dose escalation. Patients should be monitored, especially if they report severe gastrointestinal reactions such as nausea, vomiting, diarrhea, or dehydration. The frequency of gastrointestinal events is increased as renal function declines. There is limited clinical experience with most of these drugs in patients with severe renal impairment.

  4 sources

  1. "Product Information. Symlin (pramlintide)." Amphastar Pharmaceuticals Inc (2005):
  2. "Product Information. Byetta (exenatide)." Amylin Pharmaceuticals Inc (2005):
  3. "Product Information. Victoza (liraglutide)." Novo Nordisk Pharmaceuticals Inc (2010):
  4. "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company (2014):

Therapeutic duplication

Drug classes that overlap with Dulaglutide, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Insulin degludec/liraglutide

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Soliqua

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Steglujan

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Metformin/sitagliptin

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Simvastatin/sitagliptin