What it's for (Indications)
- Dulaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is primarily indicated for the treatment of type 2 diabetes mellitus in adults and pediatric patients aged 10 years and older.
- It is prescribed as an adjunct to diet and exercise to improve glycemic control.
- This medication can be utilized as monotherapy when metformin is deemed inappropriate or poorly tolerated, or it can be combined with other antihyperglycemic agents, including metformin, sulfonylureas, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and basal insulin, to achieve optimal blood glucose management.
- Beyond glycemic control, dulaglutide is also indicated to reduce the risk of major adverse cardiovascular events (MACE), which encompass cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke, in adults with type 2 diabetes who have established cardiovascular disease or possess multiple cardiovascular risk factors.
- This dual therapeutic benefit underscores its role in comprehensive diabetes management, addressing both metabolic dysregulation and critical cardiovascular protection.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Dulaglutide is administered subcutaneously once weekly, at any time of day, with or without food. For Adults: The recommended starting dose is 0.75 mg once weekly. After 4 weeks, the dose may be increased to 1.5 mg once weekly for additional glycemic control. If further glycemic control is needed, the dose can be increased in 1.5 mg increments after at least 4 weeks on the current dosage, up to a maximum recommended dosage of 4.5 mg once weekly. For Pediatrics: The recommended starting dose is 0.75 mg once weekly. If additional glycemic control is needed, the dose may be increased to a maximum of 1.5 mg once weekly after at least 4 weeks on the 0.75 mg dosage. Missed Dose: If a dose is missed, administer it as soon as possible, provided there are at least 3 days (72 hours) until the next scheduled dose. |
Safety & Warnings
Common Side Effects
- The most commonly reported adverse reactions associated with dulaglutide are predominantly gastrointestinal in nature.
- These frequently include nausea, vomiting, diarrhea, abdominal pain, decreased appetite, and constipation.
- These gastrointestinal effects are typically mild to moderate in severity, tend to be more prevalent during the initiation phase of treatment, and often diminish in frequency and intensity with continued use over time.
- Hypoglycemia is another potential side effect, particularly when dulaglutide is co-administered with insulin secretagogues (e.
- g.
- , sulfonylureas) or insulin; consequently, a dose reduction of the concomitant insulin or sulfonylurea may be necessary to mitigate this risk.
- Other common side effects include localized injection site reactions such as pain, erythema, or pruritus, which are generally mild and transient.
- Less common but more serious adverse events reported in clinical trials and post-marketing surveillance include acute pancreatitis, gallbladder-related disorders (e.
- g.
- , cholelithiasis, cholecystitis), and acute kidney injury or worsening of chronic renal failure, which may sometimes arise secondary to severe gastrointestinal fluid loss and dehydration.
- Rare but severe hypersensitivity reactions, including anaphylaxis and angioedema, have also been observed.
- Patients should be advised to promptly report any persistent, severe, or unusual symptoms to their healthcare provider for appropriate medical evaluation and management.
Serious Warnings
- Black Box Warning: WARNING: RISK OF THYROID C-CELL TUMORS. Dulaglutide has been shown to cause a dose-related and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors (adenomas and carcinomas) in male and female rats after lifetime exposure. It is currently unknown whether dulaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of dulaglutide-induced rodent thyroid C-cell tumors has not been determined.
- Caution is advised when using dulaglutide, especially during pregnancy (consult a doctor).
- Precautions include potential risk of thyroid C-cell tumors, acute pancreatitis, hypoglycemia (particularly with concomitant use of insulin secretagogues or insulin), serious hypersensitivity reactions, acute kidney injury (due to volume depletion), severe gastrointestinal adverse reactions, diabetic retinopathy complications in patients with a history of diabetic retinopathy, acute gallbladder disease, and pulmonary aspiration during general anesthesia or deep sedation.
- Patients with existing thyroid C-cell tumors, pancreatitis, hypoglycemia, hypersensitivity, or kidney impairment require careful consideration.
How it Works (Mechanism of Action)
Dulaglutide is a human GLP-1 receptor agonist with 90% amino acid sequence homology to endogenous human GLP-1 (7-37). It activates the GLP-1 receptor, a membrane-bound cell-surface receptor in pancreatic beta cells, leading to increased intracellular cyclic AMP (cAMP) and glucose-dependent insulin release. It also decreases glucagon secretion and slows gastric emptying.
Commercial Brands (Alternatives)
No other brands found for this formula.