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.
Dulaglutide prescription history
Animated chart of estimated U.S. prescriptions per year, Diabetes meds (1923–2026). Dulaglutide enters in 2014 (estimated).
FDA-approved for
- type 2 diabetes (2014)
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.
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)
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Self-check
- How often is dulaglutide used?
Weekly. - Why does dulaglutide matter before anesthesia?
Delayed gastric emptying.