The generic name for Trulicity is dulaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist used to manage type 2 diabetes mellitus. Whilst Trulicity is the brand name given by manufacturer Eli Lilly, dulaglutide refers to the active pharmaceutical ingredient itself. In the UK, biological medicines like dulaglutide should be prescribed by brand name in line with MHRA guidance for safety monitoring. Understanding this distinction helps patients navigate prescriptions and communicate effectively with healthcare professionals about their diabetes treatment options.

What Is the Generic Name for Trulicity?

Trulicity is the brand name for the medication dulaglutide, a prescription medicine used primarily to manage type 2 diabetes mellitus. Understanding the distinction between brand and generic names is important for patients navigating their treatment options and prescriptions.

The generic name—dulaglutide—refers to the active pharmaceutical ingredient itself, whilst Trulicity is the proprietary name given by the manufacturer, Eli Lilly and Company. When healthcare professionals discuss your medication, they may use either term, though in the UK, biological medicines like dulaglutide should be prescribed by brand name for safety monitoring and pharmacovigilance purposes, in line with MHRA guidance.

Dulaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. This class also includes other medicines such as semaglutide (Ozempic), liraglutide (Victoza) and others. All GLP-1 receptor agonists work through similar mechanisms, though they differ in their dosing schedules, formulations, and specific clinical profiles.

It's worth noting that dulaglutide is a biological medicine—a complex protein manufactured using living cells—rather than a traditional chemical drug. This distinction becomes particularly relevant when considering generic alternatives, as biological medicines require a different regulatory pathway for generic versions, known as biosimilars. Understanding this terminology helps patients make informed decisions about their diabetes management and communicate effectively with their healthcare team about treatment options.

Understanding Dulaglutide: How It Works

Dulaglutide works by mimicking the action of a naturally occurring hormone called glucagon-like peptide-1 (GLP-1), which plays a crucial role in regulating blood glucose levels. This incretin hormone is normally released by the intestines in response to food intake, but its effects are short-lived in the body.

The medication exerts its therapeutic effects through several complementary mechanisms:

• Stimulates insulin secretion: Dulaglutide enhances the release of insulin from pancreatic beta cells, but only when blood glucose levels are elevated. This glucose-dependent action reduces the risk of hypoglycaemia (dangerously low blood sugar) when used alone, though the risk increases if combined with insulin or sulfonylureas, which may require dose adjustments of these medications.

• Suppresses glucagon release: It inhibits the secretion of glucagon, a hormone that raises blood glucose levels by promoting glucose production in the liver. This dual action on insulin and glucagon helps maintain better glycaemic control.

• Slows gastric emptying: Dulaglutide delays the rate at which food leaves the stomach, leading to a more gradual rise in post-meal blood glucose levels and promoting a feeling of fullness. This effect may lessen over time and can affect the absorption of some oral medicines.

• May support weight management: Many patients experience modest weight loss whilst taking dulaglutide, which can be beneficial as obesity is a significant risk factor in type 2 diabetes.

Dulaglutide is administered as a once-weekly subcutaneous injection using a pre-filled pen device. The standard doses are 0.75 mg or 1.5 mg weekly, with higher doses (3 mg and 4.5 mg) available for patients requiring additional glycaemic control. The once-weekly dosing schedule is possible because dulaglutide has been engineered to have a longer half-life than natural GLP-1, providing sustained therapeutic effects throughout the week.

Patients should be aware of important safety considerations, including the risk of pancreatitis (seek urgent medical attention for severe abdominal pain), potential gallbladder disease, and the importance of maintaining hydration to prevent kidney problems.

Is a Generic Version of Trulicity Available in the UK?

As of early 2023, there is no generic version or biosimilar of dulaglutide (Trulicity) available in the UK. The medication remains under patent protection, which grants the original manufacturer exclusive rights to produce and market the drug. This patent protection typically prevents other pharmaceutical companies from manufacturing and selling generic or biosimilar versions until the patent expires.

For biological medicines like dulaglutide, the pathway to generic alternatives differs from traditional chemical drugs. Rather than exact generic copies, biological medicines can have biosimilars—highly similar versions that demonstrate comparable safety, quality, and efficacy to the original product. However, biosimilars require extensive clinical testing and regulatory approval from the Medicines and Healthcare products Regulatory Agency (MHRA) in Great Britain, with European Medicines Agency (EMA) decisions remaining relevant to Northern Ireland under current arrangements.

The patent landscape for dulaglutide is complex, with various patents covering different aspects of the medication, including its formulation, manufacturing process, and delivery device. These patents may expire at different times, potentially delaying the entry of biosimilar products into the UK market.

Patients should be aware that even when biosimilars become available, they may not be automatically interchangeable with the original branded product. UK guidance from the MHRA and NHS England recommends that any switch between a biological medicine and its biosimilar should be undertaken only under appropriate clinical supervision, with informed patient consent and brand name prescribing. This cautious approach ensures patient safety and maintains treatment continuity.

For current information about dulaglutide availability and potential biosimilars, patients should consult their GP, diabetes specialist nurse, or pharmacist, who can provide up-to-date guidance on available treatment options within the NHS.

Trulicity vs Generic Alternatives: What You Need to Know

Whilst a direct generic or biosimilar for dulaglutide is not yet available in the UK, patients and healthcare professionals may consider other GLP-1 receptor agonists as therapeutic alternatives. These medications work through similar mechanisms but are distinct products with their own characteristics.

Comparable GLP-1 receptor agonists available on the NHS include:

• Semaglutide (Ozempic): Administered once weekly, semaglutide has demonstrated robust efficacy in glycaemic control and cardiovascular risk reduction. NICE guidance supports its use in specific patient populations.

• Liraglutide (Victoza): This requires once-daily injection but has an established safety profile and cardiovascular benefits supported by clinical trial evidence.

• Lixisenatide (Lyxumia): A once-daily GLP-1 receptor agonist that may be considered as an alternative option.

• Exenatide (Bydureon): Available as a once-weekly formulation, exenatide was one of the earlier GLP-1 receptor agonists introduced to clinical practice.

When considering alternatives to Trulicity, several factors warrant consideration:

Efficacy and safety profiles: Whilst all GLP-1 receptor agonists share a common mechanism, they differ in their potency, cardiovascular outcomes data, and adverse effect profiles. Dulaglutide has demonstrated cardiovascular benefits in the REWIND trial, similar to evidence for some other agents in this class. Clinical trials comparing these agents are limited.

Dosing convenience: The frequency of administration varies—some require daily injections whilst others are weekly. Patient preference and adherence patterns should inform treatment selection.

Cost and NHS availability: NICE technology appraisals determine which GLP-1 receptor agonists are recommended for NHS use and under what circumstances. Local formularies may further influence prescribing patterns based on cost-effectiveness analyses.

Individual patient factors: Considerations include renal function, gastrointestinal tolerability, weight management goals, and cardiovascular risk profile. Your diabetes care team will assess these factors when recommending the most appropriate medication for your circumstances.

It's important to note that while semaglutide and liraglutide are also available under the brand names Wegovy and Saxenda respectively, these formulations are specifically licensed for weight management, not for glycaemic control in type 2 diabetes.

Getting Dulaglutide on the NHS

Dulaglutide is available on the NHS, but prescribing follows specific NICE guidance to ensure appropriate use and cost-effectiveness. The medication is not suitable for everyone with type 2 diabetes, and eligibility depends on several clinical criteria.

According to NICE guidelines (NG28), GLP-1 receptor agonists like dulaglutide are typically considered for adults with type 2 diabetes when:

• Triple therapy is indicated: The patient has inadequate glycaemic control despite treatment with metformin and two other oral glucose-lowering medications.

• BMI criteria are met: The patient has a body mass index (BMI) of 35 kg/m² or higher (adjusted appropriately for people from South Asian and related minority ethnic backgrounds) and specific psychological or medical problems associated with obesity, OR the patient has a BMI lower than 35 kg/m² and insulin therapy would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.

• Continuation criteria: Treatment should only be continued if there is a beneficial metabolic response (HbA1c reduction of at least 11 mmol/mol [1.0%] and weight loss of at least 3% of initial body weight at 6 months).

Local NHS formularies may have additional criteria or variations, so eligibility should be discussed with your healthcare team.

To access dulaglutide through the NHS, patients should:

1. Discuss with your GP or diabetes specialist: Your healthcare team will assess whether dulaglutide is clinically appropriate based on your diabetes control, other medications, BMI, and overall health status.

2. Attend regular monitoring appointments: Once prescribed, you'll need periodic reviews to assess treatment response, manage any adverse effects, and ensure continuation criteria are met.

3. Receive proper training: Healthcare professionals will demonstrate the correct injection technique using the pre-filled pen device and provide ongoing support.

Important safety information:

• If you experience severe, persistent abdominal pain (with or without vomiting), seek urgent medical attention or go to A&E immediately, as this could indicate pancreatitis.

• The risk of hypoglycaemia increases when dulaglutide is used with insulin or sulfonylureas; dose adjustments of these medications may be needed.

• Stay well-hydrated to reduce the risk of kidney problems, especially if you experience diarrhoea or vomiting.

• Report symptoms of gallbladder disease (pain in upper right abdomen, nausea, vomiting) to your doctor.

• Dulaglutide is not indicated for type 1 diabetes or diabetic ketoacidosis.

• Discuss with your doctor if you are pregnant, planning pregnancy, or breastfeeding.

• Report any suspected side effects via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk).

Frequently Asked Questions