Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
GLP-1 Receptor Agonist Pregnancy: Use not recommended during pregnancy (no/limited human data; animal reproductive toxicity). Should not be used during breast-feeding (excretion in human milk unknown; risk to infant cannot be excluded).

Dulaglutide

Brand names: Trulicity

Dulaglutide is a once-weekly injectable GLP-1 receptor agonist for type 2 diabetes, providing glucose lowering, weight loss and cardiovascular benefit.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Monotherapy: 0.75 mg once weekly. Add-on therapy: 1.5 mg once weekly.
Route: Subcutaneous injection (abdomen, thigh or upper arm); not intravenous or intramuscular
Frequency: Once weekly, any time of day, with or without meals
Max: 4.5 mg once weekly
Titration (add-on): the 1.5 mg dose can be increased after at least 4 weeks to 3 mg once weekly; the 3 mg dose can be increased after at least 4 weeks to 4.5 mg once weekly. When added to metformin and/or pioglitazone and/or an SGLT2 inhibitor, continue those doses; when added to a sulphonylurea or insulin, consider reducing the sulphonylurea/insulin dose to reduce hypoglycaemia risk (stepwise insulin reduction recommended). Missed dose: give as soon as possible if at least 3 days (72 h) remain before the next dose; otherwise skip. Should not be used in type 1 diabetes or diabetic ketoacidosis; not a substitute for insulin.

Dose adjustments

Renal

No dose adjustment for mild, moderate or severe renal impairment (eGFR 90 to >=15 mL/min/1.73m2). Very limited experience in end-stage renal disease (<15 mL/min/1.73m2) — not recommended. Hepatic impairment: no dose adjustment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Adult Dosage ( 2.1 ) Recommended starting dosage is 0.75 mg injected subcutaneously once weekly. Increase dosage to 1.5 mg once weekly for additional glycemic control. If additional glycemic control is needed, increase dosage in 1.5 mg increments after at least 4 weeks on the current dosage. Maximum recommended dosage is 4.5 mg injected subcutaneously once weekly. Pediatric Dosage ( 2.2 ) Recommended starting dosage is 0.75 mg injected subcutaneously once weekly. If additional glycemic control is needed, increase dosage to the maximum recommended dosage of 1.5 mg once weekly after at least 4 weeks on the 0.75 mg dosage. Recommendations Regarding Missed Dose ( 2.3 ) If a dose is missed, …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-08-05. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients

Side effects

  • Very common: nausea, diarrhoea, vomiting, abdominal pain; hypoglycaemia (in combination with insulin, glimepiride, metformin, or metformin plus glimepiride)
  • Common: decreased appetite, dyspepsia, constipation, flatulence, abdominal distension, gastro-oesophageal reflux disease, eructation; fatigue; injection-site reactions
  • Uncommon: acute pancreatitis, delayed gastric emptying; cholelithiasis, cholecystitis; dehydration; sinus tachycardia, first-degree AV block
  • Immune: hypersensitivity; (post-marketing) anaphylactic reaction, angioedema
  • Rare: non-mechanical intestinal obstruction

Clinical monograph

How it works

It mimics GLP-1 — stimulating glucose-dependent insulin secretion, suppressing glucagon, slowing gastric emptying and reducing appetite.

Prescribing in practice

  • Gastrointestinal effects (nausea, vomiting, diarrhoea) are common — titrate the dose and they usually settle.
  • It is not for type 1 diabetes or diabetic ketoacidosis; pancreatitis is a rare but important risk (stop if suspected).
  • It is contraindicated in a personal/family history of medullary thyroid carcinoma or MEN 2.

Monitoring

Monitor glycaemic response, weight and gastrointestinal tolerance.

Counselling the patient

  • It is a once-weekly injection; nausea usually improves with time.
  • Report severe or persistent abdominal pain (possible pancreatitis).

Evidence & guidelines

Improves glycaemia and weight with cardiovascular benefit (NICE NG28; REWIND).

Reference: REWIND Trial (Gerstein et al, Lancet 2019); NICE NG28; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways