Dulaglutide
TRULICITY
Pronunciation: doo-la-GLOO-tide (TROO-li-si-tee)
“Truly a Doula”
What it isGLP-1 receptor agonist; type 2 diabetes.
Why this oneIts single-use autoinjector and cardiovascular evidence make it a simple weekly option, but it is less weight-potent than semaglutide or tirzepatide.
What limits itGI intolerance limits uptake, and delayed gastric emptying matters before anesthesia.
FDA-approved for
- type 2 diabetes (2014)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Type 2 diabetes mellitus | Adults | 0.75 mg SC once weekly | 1.5 mg once weekly | 4.5 mg once weekly |
| Type 2 diabetes mellitus | Pediatric ≥10 yr | 0.75 mg SC once weekly | 1.5 mg once weekly | 1.5 mg once weekly |
Titration Increase dose after at least 4 weeks on current dosage
Renal No adjustment needed (including ESRD)
Hepatic Use with caution (limited experience)
Once weekly; day of administration may be changed if last dose was ≥3 days prior
Instructions
- Inject SC in abdomen, thigh, or upper arm; rotate sites
- Any time of day, with or without food
- If a dose is missed and ≥3 days remain until the next dose, take it as soon as possible
Available strengths
- inj 0.75, 1.5, 3, 4.5 mg/.5 mL
Contraindications
- Personal or family history of medullary thyroid carcinoma, or MEN 2
Cautions
- Acute pancreatitis
- Hypoglycemia with insulin secretagogues or insulin
- Hypersensitivity reactions (anaphylaxis, angioedema)
- Acute kidney injury from volume depletion
- Severe GI reactions; not recommended in severe gastroparesis
- Diabetic retinopathy complications
- Acute gallbladder disease
- Pulmonary aspiration during general anesthesia/deep sedation
Adverse reactions
- Nausea
- Diarrhea
- Vomiting
- Abdominal pain
- Decreased appetite
Pregnancy Use only if potential benefit justifies risk; animal studies showed fetal harm.
Lactation No data; consider developmental/health benefits of breastfeeding vs risk.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 0.75 mg/.5 mL | inj | per unit | — | $487.57/mL | not offered |
| 1.5 mg/.5 mL | inj | per unit | — | $487.54/mL | not offered |
| 3 mg/.5 mL | inj | per unit | — | $487.50/mL | not offered |
| 4.5 mg/.5 mL | inj | per unit | — | $487.42/mL | not offered |
Generic entry2037 est. (biosimilar)
⚠ BOXED WARNING
- Thyroid C-cell tumors in rodents
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.
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