Trulicity vs Metformin

Metformin is recommended as the first-line treatment for Type 2 diabetes mellitus by the American Diabetic Association. It is a generic anti-diabetic medication used as part of a treatment plan for Type 2 diabetes. It can be used alone or in combination with other medications.

Trulicity is a brand-name medication also used to treat Type 2 diabetes. It can be used in combination with a healthy diet, and physical exercise, on its own, or with other medications that also treat Type 2 diabetes. It helps lower blood sugar levels by enhancing insulin secretion.

Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.

What is Trulicity?

Trulicity is manufactured by Eli Lilly and Company. It has FDA approval for use in adults who have type 2 diabetes to:

• Reduce blood sugar levels, when used alongside exercise and diet changes
• Reduce the risk of serious cardiovascular problems, like strokes or heart attacks, in people with heart disease or reduce the risk factors for heart problems. Examples of risk factors for an increased risk of heart disease include having high cholesterol, being older, having high blood pressure, and smoking

Trulicity is not approved by the FDA for weight loss. Currently, the only GLP-1 agonists approved for weight loss are Wegovy (semaglutide) and Saxenda (liraglutide).

If you have type 2 diabetes, you may not produce enough insulin, or you may even become resistant to insulin. If this happens, you will absorb less sugar from your blood, resulting in your blood glucose levels remaining too high.

Trulicity encourages your pancreas to secrete more insulin and reduces how much sugar is released into your blood. This helps to reduce your diabetes symptoms and the likelihood of developing other serious health conditions if taken alongside changes to your daily life like increased exercise and a healthier diet. Trulicity is usually taken once a week by injecting it under your skin using a pre-filled injection pen.

The active ingredient dulaglutide in Trulicity is classed as a GLP-1 receptor agonist (glucagon-like peptide 1), which can lower your A1C levels. It is absorbed into your digestive system where it has two effects. It binds with areas on some of your cells called GLP1R receptors, which encourages your pancreas to make more insulin. This allows other cells in your body to more effectively remove sugar from your blood. At the same time, dulaglutide also reduces how much sugar your pancreas secretes into your blood. The combination of these two processes can reduce your blood sugar levels.

Trulicity dosage

Trulicity is available in injection form, in the following doses: 0.75 mg/0.5 mL solution in a single-dose pen, and 1.5 mg/0.5 mL solution in a single-dose pen.

Inject subcutaneously in the abdomen, thigh, or upper arm once weekly at any time of the day. Initiate at 0.75 mg once weekly. The dose can be increased to 1.5 mg once weekly for additional glycemic control.

What is metformin?

Metformin is an FDA (U.S. Food and Drug Administration) approved medication manufactured by various generic manufacturers. Metformin is in the drug class of biguanide, used as a first-line treatment for diabetes because of its mode of action in increasing your body’s insulin sensitivity. Also, metformin does not cause weight gain.

It is used in combination with changes to diet and exercise to improve glycemic control in adults and pediatric patients with type 2 diabetes mellitus. It works by reducing the amount of glucose absorbed from your intestines, decreasing how much glucose is made in your liver, and improving your insulin sensitivity.

Metformin dosage

Metformin is available as an immediate release or extended-release oral tablet, or as an oral suspension.

Metformin is taken with a meal unless your doctor tells you otherwise. Do not crush, chew, or break the extended-release tablet. Swallow it whole. Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. You may also be prescribed extra vitamin B12 while you are taking this medicine.

Common side effects of Trulicity and metformin

The most common side effects of Trulicity in clinical trials include:

• Injection-site reactions like swelling, pain, or itching
• Nausea, vomiting
• Gastrointestinal side effects include diarrhea, constipation, and abdominal pain
• Reduced appetite

More serious side effects of Trulicity include:

• Severe allergic reactions to the medication
• Thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma
• Inflammation of your pancreas (pancreatitis)
• Kidney problems, including kidney failure
• Hypoglycemia – your blood sugar falling too low – particularly when used with other medications like insulin or sulfonylurea
• Severe stomach problems
• Changes in your vision

The most common side effects of metformin in clinical trials include:

• Low blood sugar
• Nausea
• Diarrhea

More serious side effects of metformin include

• Unusual muscle pain
• Problems breathing
• Dizziness, feeling faint
• Feeling tired
• Stomach pain
• Vomiting
• Slow or irregular heart rate
• Lactic acidosis – symptoms include unusual muscle pain, difficulty breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired

These aren’t all the side effects Trulicity or metformin can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or pharmacist.

Trulicity and metformin drug interactions

Trulicity can interact with other medications. These include:

• Any other diabetes medications, like insulin or sulfonylureas
• Diuretics
• Corticosteroids
• Estrogens
• Oral contraceptives
• Nicotinic acid
• Calcium channel blocking drugs
• Any medications absorbed through your stomach, as Trulicity may increase the absorption of these drugs by keeping them in your stomach for longer

Metformin can interact with other medications. These include:

• Antibiotics
• Diuretics
• NSAIDs
• Corticosteroids
• ACE inhibitors
• Antipsychotics
• Anticonvulsants
• Blood thinners

Trulicity and metformin can interact with other medications. This can change how Trulicity and metformin and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Trulicity and metformin contraindications

You should not use Trulicity if you:

• Are allergic to the active ingredient dulaglutide
• Are allergic to any of the other ingredients in Trulicity
• Have type 1 diabetes (Trulicity is for type 2 diabetes only)
• Have diabetic ketoacidosis – a potentially life-threatening condition caused by diabetes where you break down body fat too quickly
• Have a type of thyroid cancer called medullary thyroid carcinoma, or a family member has or had this
• Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2
• Are under 18 years of age

Talk to your doctor before using Trulicity if you:

• Are taking any of the medications that could interact with Trulicity (see the section above)
• Have or have had any problems with your pancreas
• Have or have had any problems with your liver
• Have or have had any problems with your kidneys
• Have severe stomach or intestinal problems
• Have a history of diabetic retinopathy (a complication of diabetes that affects your eyes)
• Are pregnant or are planning to become pregnant
• Are breastfeeding or are planning to breastfeed

You should not use metformin if you:

• Are allergic to metformin
• Have severe kidney disease
• Have metabolic acidosis or diabetic ketoacidosis
• Are younger than 10 years old
• Are breastfeeding or are planning to breastfeed

Talk to your doctor before using metformin if you:

• Have kidney disease
• Have high ketone levels in your blood or urine
• Have heart disease, or congestive heart failure
• Have liver disease
• Use insulin or other oral diabetes medications
• Have a severe infection
• Have chronic alcoholism
• Are 65 or older
• Are pregnant or are planning to become pregnant

Other drugs for type 2 diabetes

• Bydureon BCise (exenatide)
• Byetta
• Jardiance
• Lantus
• Ozempic
• Victoza
• Adlyxin

If you have any concerns about Trulicity or metformin side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.