A Case of Dulaglutide-Induced Vaginal Bleed

by Selleckchem | Sep 20 2023

Type 2 diabetes mellitus (T2DM) is a growing challenge across the globe. The disease process is amendable to lifestyle modifications in the early stages. If those changes fail to correct endocrine dysfunction, medical therapy is initiated. Initially, therapy for type 2 diabetes consisted of biguanides and sulfonylureas. With modern medicine, we have developed dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide 1 (GLP-1) receptor agonists. Dulaglutide is a GLP-1 receptor agonist that is sold under the brand name Trulicity. The most common side effect associated with Dulaglutide is gastrointestinal discomfort. We present a case of severe vaginal bleeding due to a rare side effect of Dulaglutide. A 44-year-old perimenopausal female with a past medical history of type 2 diabetes mellitus presented to the clinic after experiencing significant vaginal bleeding. The patient was unable to tolerate Metformin and Semaglutide in the past. The abnormal vaginal hemorrhage started one week after receiving the second dose of Dulaglutide. Her hemoglobin concentration fell significantly. Dulaglutide was immediately discontinued, and her vaginal bleeding stopped. This case documents the necessity of post-market surveillance to oversee the safety of recently approved medications by the Food and Drug Administration (FDA). Rare side effects can emerge in the general population that were not seen during clinical trials. Physicians should consider the possibility of adverse medication reactions when determining whether to start a new medication or a conventional one.

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Title: Severe Vaginal Bleeding as a Rare Side Effect of Dulaglutide in a Patient with Type 2 Diabetes Mellitus: A Case Report

Abstract: Type 2 diabetes mellitus (T2DM) is a global health challenge that often requires lifestyle modifications and medical therapy. Dulaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, is commonly used in T2DM treatment. While gastrointestinal discomfort is a known side effect of Dulaglutide, severe vaginal bleeding is an extremely rare occurrence. This case report presents a 44-year-old perimenopausal female with a history of T2DM who experienced significant vaginal bleeding after receiving the second dose of Dulaglutide. The patient had previously been intolerant to Metformin and Semaglutide. The bleeding resolved promptly upon discontinuation of Dulaglutide. This case underscores the importance of post-market surveillance to identify rare adverse reactions that may not have been observed during clinical trials. Physicians should exercise caution and consider potential medication-related adverse effects when initiating new therapies, even with well-established medications.

Introduction: Type 2 diabetes mellitus (T2DM) management involves lifestyle modifications and, when necessary, medical therapy. Traditional therapies include biguanides and sulfonylureas, but newer medications like dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, and GLP-1 receptor agonists have expanded treatment options. Dulaglutide, a GLP-1 receptor agonist marketed as Trulicity, is effective in controlling blood glucose levels but is associated with gastrointestinal discomfort. This case report highlights a rare and severe side effect of Dulaglutide, namely vaginal bleeding.

Case Presentation: A 44-year-old perimenopausal female with a medical history of T2DM presented with significant vaginal bleeding. The patient had previously been intolerant to Metformin and Semaglutide. The abnormal bleeding began one week after receiving the second dose of Dulaglutide. Subsequently, the patient's hemoglobin concentration decreased substantially. Dulaglutide was discontinued, leading to cessation of the vaginal bleeding.

Discussion: Dulaglutide, a GLP-1 receptor agonist, is known to cause gastrointestinal discomfort, but severe vaginal bleeding is an exceedingly rare side effect. This case report highlights the importance of post-market surveillance for newly approved medications by the FDA. While clinical trials provide valuable safety data, rare adverse reactions may only emerge when the medication is used in the general population. Physicians should be vigilant in considering adverse medication reactions when initiating therapy, whether with newer agents or conventional medications.

Conclusion: This case report describes a perimenopausal female with T2DM who experienced severe vaginal bleeding following Dulaglutide administration. Prompt discontinuation of Dulaglutide resulted in the resolution of the bleeding. The occurrence of rare side effects emphasizes the need for post-market surveillance to monitor the safety of recently approved medications. Clinicians should remain cautious when initiating new therapies and consider potential adverse effects, even with well-established medications, to ensure patient safety.