Medically reviewed by Drugs.com. Last updated on Aug 7, 2018.
Applies to the following strengths: 0.75 mg/0.5 mL; 1.5 mg/0.5 mL
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Type 2
Initial dose: 0.75 mg subcutaneously once a week
-May increase to 1.5 mg subcutaneously once a week for additional glycemic control
Maintenance dose: 0.75 to 1.5 mg subcutaneously once a week
Maximum dose: 1.5 mg/week
-If used in combination with insulin or an insulin secretagogue, a lower dose of insulin or the insulin secretagogue should be considered to reduce the risk of hypoglycemia.
-This drug is not recommended as a first-line therapy due to uncertain relevance of rodent C-cell tumor findings.
Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Renal Dose Adjustments
No adjustment recommended
For patients with renal impairment who experience severe adverse gastrointestinal reactions during therapy, closely monitor renal function.
Liver Dose Adjustments
Caution is recommended as it has not been studied in subjects with hepatic impairment
Elderly: A greater sensitivity of some older adults cannot be ruled out; use with caution
US BOXED WARNING: Risk of Thyroid C-Cell Tumors
-In male and female rats, this drug causes a dose-related and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors (adenomas and carcinomas) after lifetime exposure. It is unknown whether this drug causes thyroid C-cell tumor, including medullary thyroid carcinoma (MTC) in humans as human relevance of dulaglutide-induced rodent thyroid C-cell tumors has not been determined.
-This drug is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Routine serum calcitonin or thyroid ultrasound monitoring is of uncertain value for early detection. Patients should be counseled regarding the risk factors and symptoms of thyroid tumors (e.g., mass in the neck, dysphagia, dyspnea, persistent hoarseness).
-Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
-Personal or family history of medullary thyroid carcinoma (MTC)
-Prior serious hypersensitivity reaction to this drug or product excipients
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
-Administer subcutaneously in the abdomen, thigh, or upper arm once a week at any time of day, with or without food.
-This pen, syringe, or needles should not be shared with another person due to risk of infection(s).
-Patients should be trained on proper injection technique and instructed to rotate injection site each week.
-If concurrently using insulin, administer as separate injections; may inject in same body region, but not adjacent to each other.
-If a dose is missed, administer as soon as possible if there are at least 3 days until the next scheduled dose; if less than 3 days, skip the missed dose. In both cases, resume weekly dosing on scheduled day.
-Scheduled day of weekly administration can be changed if the last dose was administered 3 or more days earlier.
-Refrigerate at 2C to 8C (36F to 46F); do not use if drug has been frozen.
-Single-dose pen or prefilled syringe can be kept at room temperature for 14 days.
-Protect from light.
Reconstitution/preparation techniques: The manufacturer product information should be consulted.
-This drug is not recommended as first-line therapy because of uncertain relevance of rodent C-cell tumor findings to humans.
-Use in patients with a history of pancreatitis or severe gastrointestinal disease has not been studied.
-This drug is not a substitute for insulin; it should not be used to treat patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
-Monitor renal function in patients with renal impairment experiencing severe gastrointestinal reactions.
-Observe for signs and symptoms of pancreatitis.
-Read the US FDA-approved patient labeling (Medication Guide and Instructions for Use).
-Patients should be instructed to report symptoms of thyroid tumors such as a lump in neck, persistent hoarseness, dysphagia, or dyspnea.
-Patients should be aware of the potential for gastrointestinal (GI) reactions; they should be instructed to take measures to ensure adequate fluid intake to avoid dehydration and to seek medical advice for persistent and severe GI events.
-Patients should be instructed to seek medical advice during periods of stress as medical management of diabetes may change.
-Patients should understand that serious hypersensitivity reactions may occur and if they occur, they should seek immediate medical assistance.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about dulaglutide
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- Drug class: incretin mimetics
Other brands: Trulicity