Dulaglutide: It is probably safe to continue dulaglutide in a patient who is already taking it and tolerating it well. Consider the adverse effects of chemotherapy (eg, nausea, vomiting, diarrhoea) and recognise that dulaglutide can make these worse, with the potential for acute renal injury if a patient becomes very dehydrated. Therefore, consider withholding the dulaglutide if it is associated with gastrointestinal adverse effects pre-chemotherapy.
Empagliflozin: Be very cautious continuing empagliflozin in someone about to start chemotherapy. Consider the potential adverse effects and the risks of renal injury or diabetic ketoacidosis. If the patient tolerates empagliflozin well enough during the first cycle of chemotherapy, it will likely be fine to keep it going.
It may be best not to start new treatment with dulaglutide or empagliflozin in a patient about to undergo chemotherapy.