Dulaglutide

Dulaglutide is a human GLP-1 receptor agonist with 90% amino acid sequence homology to endogenous human GLP-1 (7-37). It activates GLP-1 receptors on pancreatic beta cells, increasing intracellular cAMP leading to glucose-dependent insulin release. It also decreases glucagon secretion and slows gastric emptying. The recommended initiating dose is 0.75 mg once weekly, may be increased to 1.5 mg once weekly. Administered subcutaneously in the abdomen, thigh, or upper arm. Common side effects include nausea, diarrhea, vomiting, abdominal pain, and decreased appetite. Contraindicated in patients with personal/family history of medullary thyroid carcinoma or MEN type 2.

• Glycemic control in type 2 diabetes mellitus
• Reduction of major adverse cardiovascular events in type 2 diabetes with established cardiovascular disease or multiple cardiovascular risk factors

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 on pancreatic beta cells, increasing intracellular cAMP leading to glucose-dependent insulin release. It also decreases glucagon secretion and slows gastric emptying.

Dulaglutide increases intracellular cAMP in beta cells leading to glucose-dependent insulin release, decreases glucagon secretion, and slows gastric emptying.

Adult Dose: Initiating dose: 0.75 mg once weekly. May be increased to 1.5 mg once weekly for additional glycemic control. Maximum dose: 1.5 mg once weekly.

Administered subcutaneously once weekly any time of day, with or without food, in the abdomen, thigh, or upper arm.

Subcutaneous injection in the abdomen, thigh, or upper arm administered by a doctor or nurse. Training required for self-administration.

If a dose is missed, administer as soon as possible if at least 3 days (72 hours) remain until the next scheduled dose. If less than 3 days remain, skip the missed dose and administer the next dose on the regularly scheduled day.

Common Side Effects (≥5%):

• Nausea
• Diarrhea
• Vomiting
• Abdominal pain
• Decreased appetite

• Pancreatitis: Discontinue promptly if suspected. Do not restart if confirmed.
• Hypoglycemia: Consider lowering dose of sulfonylurea or insulin when used with Dulaglutide.
• Hypersensitivity Reactions: Discontinue and seek medical advice for serious reactions.
• Acute Kidney Injury: Monitor renal function in patients with renal impairment reporting severe GI reactions.
• Severe Gastrointestinal Disease: Not recommended in patients with severe GI disease.
• Diabetic Retinopathy: Monitor patients with history of diabetic retinopathy.

• Personal or family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2
• Prior serious hypersensitivity reaction to Dulaglutide or any product components

Dulaglutide slows gastric emptying and may reduce the rate of absorption of concomitantly administered oral medications. Monitor drug levels of oral medications with a narrow therapeutic index.

It is not known whether it is safe to consume alcohol with Dulaglutide. Please consult your doctor.

Should not be used during pregnancy. Only if potential benefit justifies potential risk to fetus.

No data on presence of dulaglutide in human milk. Decision to discontinue nursing or drug should be made.

Safety and effectiveness in pediatric patients not established. Not recommended for use in patients younger than 18 years.

Limited information available regarding dose adjustment for elderly patients.

Renal impairment: No dosage adjustment recommended. Monitor renal function in patients with renal impairment reporting severe GI reactions.

Hepatic impairment: Limited clinical experience in mild, moderate, or severe hepatic impairment. Use with caution.

Overdoses have been reported primarily with mild or moderate gastrointestinal events (nausea, vomiting) and non-severe hypoglycemia. Provide supportive care and plasma glucose monitoring.

Store in refrigerator at 2°C-8°C. If needed, each single-dose pen can be kept at room temperature not exceeding 30°C for up to 14 days. Do not freeze.

Dulaglutide