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Dulaglutide Dosage

Applies to the following strength(s): 0.75 mg/0.5 mL ; 1.5 mg/0.5 mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Initial dose: 0.75 mg subcutaneously once a week
Maximum dose: May increase to 1.5 mg subcutaneously once a week for additional glycemic control

Comments:
-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.

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.

Precautions

The US FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for Trulicity(TM). It includes a communication plan. For additional information: www.fda.gov/REMS

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).

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Administer subcutaneously in the abdomen, thigh, or upper arm once a week at any time of day, with or without food.
-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.

Storage requirements:
-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.

General:
-This drug is not recommended as first-line therapy.
-Concurrent use of basal insulin has not been studied.

Monitoring:
-Monitor renal function in patients with renal impairment experiencing severe gastrointestinal reactions.
-Observe for signs and symptoms of pancreatitis.

Patient advice:
-Counsel patients to report symptoms of thyroid tumors such as a lump in their neck, persistent hoarseness, dysphagia, or dyspnea.
-Patients should be aware of the potential for gastrointestinal reactions and take measures to ensure adequate fluid intake to avoid dehydration and to seek medical advice for persistent and severe events.
-Patients should be instructed to seek medical advice during periods of stress as medical management of diabetes may change.
-Inform patients that hypersensitivity reactions may occur; patients should be instructed to contact their health care professional.

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