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  4. Should Trulicity® (dulaglutide) therapy be modified for surgical procedures or hospitalization?
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Trulicity ® (dulaglutide)

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Should Trulicity® (dulaglutide) therapy be modified for surgical procedures or hospitalization?

The use of dulaglutide in patients undergoing surgical procedures or hospitalization has not been evaluated. For additional considerations please see below.

UK_cFAQ_GLP089_HOSPITAL_AND_SURGERY_MANAGEMENT
UK_cFAQ_GLP089_HOSPITAL_AND_SURGERY_MANAGEMENTen-GB

Relevant considerations from the summary of product characteristics

Cases of pulmonary aspiration have been reported in patients receiving GLP-1 receptor agonists undergoing general anaesthesia or deep sedation. Also, dulaglutide delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products.1

For complete information about relevant considerations, please refer to the Trulicity Summary of Product Characteristics, in particular the sections

  • 4.2 Posology and method of administration
  • 4.4 Special warnings and precautions for use
  • 4.5 Interaction with other medicinal products and other forms of interaction
  • 4.8 Undesirable effects
  • 5.2 Pharmacokinetic properties

There is limited experience with the use of concomitant medications in clinical trials with dulaglutide doses of 3 mg and 4.5 mg.2

Aspiration in association with general anaesthesia or deep sedation

Cases of pulmonary aspiration have been reported in patients receiving GLP-1 receptor agonists undergoing general anaesthesia or deep sedation. Therefore, the increased risk of residual gastric content due to delayed gastric emptying should be considered prior to performing procedures with general anaesthesia or deep sedation.1

On 28-Jan-2025, the MHRA issued a drug safety update on the potential risk of pulmonary aspiration during general anaesthesia or deep sedation that can be accessed at https://www.gov.uk/drug-safety-update/glp-1-and-dual-gip-slash-glp-1-receptor-agonists-potential-risk-of-pulmonary-aspiration-during-general-anaesthesia-or-deep-sedation. 

This update includes reference to a UK consensus statement produced by expert members of a Working Party established by the Association of Anaesthetists, on elective peri-operative management of adults taking glucagon-like peptide-1 receptor agonists, glucose-dependent insulinotropic peptide agonists and sodium-glucose cotransporter-2 inhibitors.3

References

1Trulicity [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

2Data on file, Eli Lilly and Company and/or one of its subsidiaries.

3El-Boghdadly K, Dhesi J, Fabb P, et al. Elective peri-operative management of adults taking glucagon-like peptide-1 receptor agonists, glucose-dependent insulinotropic peptide agonists and sodium-glucose cotransporter-2 inhibitors: a multidisciplinary consensus statement. Anaesthesia 2025. https://doi.org/10.1111/anae.16541

Links to references and third-party websites are provided solely for your convenience and to facilitate easy access to the sources cited.

Date of Last Review: 11 July 2024

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