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Can You Take Trulicity and Metformin Together?

Key Takeaways

  • You can take the diabetes medications Trulicity and metformin together with your doctor’s approval. Both medications can improve glycemic control in people with type-2 diabetes, but they work differently. Trulicity increases insulin secretion from the pancreas. Metformin lowers glucose production in the liver, reduces glucose absorption in the stomach, and improves insulin sensitivity. 

  • Both Trulicity and metformin can cause some weight loss. Therefore, taking metformin and Trulicity together may help you lose weight. However, neither of them is an FDA-approved weight loss drug.

  • One of the concerns with taking Trulicity and metformin together is the increased risk of low blood sugar. Trulicity and metformin taken together can also cause side effects such as abdominal pain, nausea, diarrhea, and heartburn. 

Type-2 diabetes mellitus is a chronic condition that causes high levels of blood sugar, which can lead to other health complications, such as kidney disease and nerve pain while increasing the risk of cardiovascular disease and major cardiovascular events in the long run. Trulicity and metformin are two diabetic medications commonly used to control high blood sugar levels. Please continue reading to find out whether you can take the prescription drugs Trulicity and metformin together.

Can metformin be used with Trulicity?

The short answer is yes, you can take the diabetes medications Trulicity and metformin together. For many people, metformin alone cannot improve blood sugar levels. Therefore, healthcare providers would recommend adding other medications in combination with metformin. There are risks associated with taking these two medications together, and your doctor would recommend it if the risks outweigh the benefits. 

Trulicity (generic dulaglutide) belongs to a drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. Metformin belongs to a group of drugs called biguanides. 

Both medications improve glycemic control in diabetic patients, but they work differently. Trulicity increases insulin secretion from the pancreas. While metformin does not affect insulin production, it improves insulin sensitivity, lowers glucose production in the liver, and reduces glucose absorption in the stomach and intestines. 

Which is better: metformin or Trulicity?

Traditionally, metformin has always been and still is the first-line medication for people with type-2 diabetes. Nowadays, while there are newer diabetic medications, healthcare providers still typically prescribe metformin when someone is diagnosed with type-2 diabetes unless metformin is considered a contraindication.  

Healthcare providers typically use Trulicity or other diabetes medications in addition to metformin if the body’s blood sugar levels are not controlled on metformin alone. 

Keep in mind that metformin is usually the first medication given to someone who is newly diagnosed with diabetes. This is not the case with Trulicity. 

Many people prefer metformin since it is an oral medication (taken by mouth), whereas Trulicity is an injection pen. You have to learn to inject Trulicity with the single dose pens in your upper arm or thigh. However, Trulicity is a weekly dose, whereas metformin is a daily dose.

One major advantage of Trulicity is it can reduce the risk of major cardiovascular events such as heart attacks and stroke in people who have heart diseases or are at risk for heart diseases. 

The choice of diabetes medication depends on various factors, including your medical history, response to diabetes medications, drug interactions, personal preference, and cost factors (metformin is an affordable generic medication, whereas the list price of Trulicity is over $900 without health insurance). Even with health insurance coverage, Trulicity prescriptions require prior authorizations for most people. 

What are the risks of taking metformin and Trulicity together?

Taking Trulicity and metformin together may cause side effects such as abdominal pain, nausea, diarrhea, and heartburn. It may help to eat smaller meals and bland foods, especially at the beginning of this combination therapy.

Anti-diabetic medications can also cause more serious side effects, such as severe allergic reactions. Call your healthcare provider at once or seek immediate medical attention if you develop signs and symptoms of an allergic reaction (skin rash, hives, itching, swelling, or difficulty breathing or swallowing).

Taking Trulicity and metformin together can increase the risk of hypoglycemia (low blood sugar). Talk to your healthcare professional about how often you should check blood sugar levels and what to do if you develop low blood sugar. Your doctor may adjust the dose based on your blood glucose levels and medical history.

Additional risks associated with taking Trulicity are an increased risk of thyroid tumors. Tell your doctor if you have a personal or family history of thyroid cancer before starting this medicine. Metformin can increase the risk of a serious condition called lactic acidosis (too much lactic acid in the body). Give your doctor a complete list of your medications before starting diabetes treatment to prevent drug interactions. Also, tell your doctor if you have medical conditions such as severe stomach problems or kidney problems

Does Trulicity and metformin cause weight loss?

Both Trulicity and metformin can cause some weight loss. Taking metformin and Trulicity together may help you lose weight through different mechanisms. Keep in mind that neither is an FDA-approved weight loss drug. 

If a healthy diet and exercise have not helped you lose weight, you should talk to your healthcare provider about an FDA-approved medication for weight management, such as semaglutide (Wegovy) or tirzepatide (Zepbound).

What should I avoid while taking Trulicity?

  • Do not eat foods like sugary snacks or refined carbohydrates in excess. Trulicity and other diabetes medications work along with lifestyle changes such as a healthy diet and exercise. 

  • Avoid drinking alcohol while on Trulicity. If you drink alcohol, it can increase your risk of low blood sugar.

  • Do not use the same injection site again. This will help prevent skin injury.

  • Do not change the Trulicity dosage (weekly dose) or dosage frequency without talking to your healthcare professional.

  • Do not skip doses. In case of a missed dose, take it as soon as you remember unless it is less than 3 days until your next dose.

What medications cannot be taken with Trulicity?

Tell your doctor if you take insulin or other medications, injectable or oral, that can lower blood sugar levels. Your healthcare provider may change the dose of your medications and/or monitor you carefully for adverse effects. Examples of medication classes that can lower your blood sugar:

  • Insulin

  • Sulfonylureas 

  • Glinides 

Other medications that can interact with Trulicity are thiazide diuretics and an antibiotic class called fluoroquinolones. 

Trulicity helps you feel fuller longer by slowing down gastric emptying. While this may be beneficial for blood sugar control and weight management, slowing down gastric emptying may interfere with the absorption of certain oral medications, especially seizure medications and blood thinners. Therefore, it is important to inform your doctor of all the medications you are taking to prevent harmful adverse effects.

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  1. https://medlineplus.gov/druginfo/meds/a614047.html

  2. https://medlineplus.gov/druginfo/meds/a696005.html#: