Approved & therapeutic
Dulaglutide
Trulicity
Dulaglutide is a long-acting GLP-1 receptor agonist approved in the US for glycemic control in type 2 diabetes and for reducing major adverse cardiovascular events in adults with type 2 diabetes who have established cardiovascular disease or multiple risk factors. It is given once weekly and carries a boxed warning for thyroid C-cell tumors observed in rodents.
- Status
- Dulaglutide is approved by the U.S. FDA and has official prescribing information.
- Evidence
- Approved labeling. Official prescribing information exists, based on clinical trials in people.
- Half-life
- Approximately 5 days.
- How it's taken
- Subcutaneous injection once weekly, on the same day each week, at any time of day with or without food, into the abdomen, thigh or upper arm with site rotation.
- Mechanism
- Incretin (GLP-1 / GIP / glucagon / amylin)
- Pathways
- GLP-1
How Dulaglutide works
Dulaglutide consists of two GLP-1 analog chains fused to a modified human IgG4 Fc fragment, which slows clearance and supports weekly dosing. Receptor activation increases glucose-dependent insulin secretion, suppresses inappropriately elevated glucagon secretion, and slows gastric emptying.
What research has looked at
- Improved HbA1c and fasting glucose as an adjunct to diet and exercise in adults and in children aged 10 and over with type 2 diabetes.
- In the REWIND cardiovascular outcomes trial (9,901 participants, median 5.4 years of follow-up), dulaglutide reduced the primary composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke versus placebo (hazard ratio 0.88, 95 percent CI 0.79 to 0.99, p=0.026) in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors. Only 31 percent of participants had established cardiovascular disease at baseline; the remainder were enrolled on risk factors alone.
- Modest weight reduction has been reported in type 2 diabetes trials, though weight loss is not an approved indication for dulaglutide.
Evidence level: Approved labeling. Official prescribing information exists, based on clinical trials in people. These are areas studied or reported, not promised effects.
Reported side effects and risks
- Boxed warning: dulaglutide causes dose-related and treatment-duration-dependent thyroid C-cell tumors (adenomas and carcinomas) in rats; whether it causes medullary thyroid carcinoma in humans is unknown.
- Contraindicated in people with a personal or family history of medullary thyroid carcinoma and in Multiple Endocrine Neoplasia syndrome type 2, and after a prior serious hypersensitivity reaction to dulaglutide or to any of the product components.
- Acute pancreatitis, including fatal and non-fatal hemorrhagic and necrotizing pancreatitis, has been reported.
- Hypersensitivity reactions including anaphylaxis and angioedema, and hypoglycemia when combined with insulin or insulin secretagogues.
- Acute kidney injury and worsening of chronic renal failure, sometimes requiring dialysis, usually in the setting of volume depletion from gastrointestinal reactions; acute gallbladder disease has also been reported.
- Pulmonary aspiration during general anesthesia or deep sedation: dulaglutide delays gastric emptying, and there have been rare postmarketing reports of pulmonary aspiration in patients undergoing elective procedures who had residual gastric contents despite reported adherence to preoperative fasting. Tell every anesthesia and procedural team you are taking it before any planned surgery or procedure.
- Most common reactions are nausea, diarrhea, vomiting, abdominal pain and decreased appetite; severe gastrointestinal disease and diabetic retinopathy complications are labeled precautions.
- Supply caveat: dulaglutide injection has been on the FDA drug shortage list since August 2022, with the higher strengths most affected.
Sources
- PubMed research on Dulaglutide · NIH · National Library of Medicine
- DrugBank record for Dulaglutide · DrugBank
- Active clinical trials for Dulaglutide · U.S. National Library of Medicine
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Related compounds
Dulaglutide FAQ
What is Dulaglutide?
Dulaglutide is a long-acting GLP-1 receptor agonist approved in the US for glycemic control in type 2 diabetes and for reducing major adverse cardiovascular events in adults with type 2 diabetes who have established cardiovascular disease or multiple risk factors. It is given once weekly and carries a boxed warning for thyroid C-cell tumors observed in rodents.
How does Dulaglutide work?
Dulaglutide consists of two GLP-1 analog chains fused to a modified human IgG4 Fc fragment, which slows clearance and supports weekly dosing. Receptor activation increases glucose-dependent insulin secretion, suppresses inappropriately elevated glucagon secretion, and slows gastric emptying.
Is Dulaglutide FDA approved?
Yes. Dulaglutide is approved by the U.S. FDA and has official prescribing information. Evidence level: approved labeling. Official prescribing information exists, based on clinical trials in people.
What is the half-life of Dulaglutide?
Reported half-life: Approximately 5 days.
How is Dulaglutide taken?
Subcutaneous injection once weekly, on the same day each week, at any time of day with or without food, into the abdomen, thigh or upper arm with site rotation.
What side effects have been reported with Dulaglutide?
Reported in the sources: Boxed warning: dulaglutide causes dose-related and treatment-duration-dependent thyroid C-cell tumors (adenomas and carcinomas) in rats; whether it causes medullary thyroid carcinoma in humans is unknown; Contraindicated in people with a personal or family history of medullary thyroid carcinoma and in Multiple Endocrine Neoplasia syndrome type 2, and after a prior serious hypersensitivity reaction to dulaglutide or to any of the product components; Acute pancreatitis, including fatal and non-fatal hemorrhagic and necrotizing pancreatitis, has been reported; Hypersensitivity reactions including anaphylaxis and angioedema, and hypoglycemia when combined with insulin or insulin secretagogues; Acute kidney injury and worsening of chronic renal failure, sometimes requiring dialysis, usually in the setting of volume depletion from gastrointestinal reactions; acute gallbladder disease has also been reported; Pulmonary aspiration during general anesthesia or deep sedation: dulaglutide delays gastric emptying, and there have been rare postmarketing reports of pulmonary aspiration in patients undergoing elective procedures who had residual gastric contents despite reported adherence to preoperative fasting. Tell every anesthesia and procedural team you are taking it before any planned surgery or procedure; Most common reactions are nausea, diarrhea, vomiting, abdominal pain and decreased appetite; severe gastrointestinal disease and diabetic retinopathy complications are labeled precautions; Supply caveat: dulaglutide injection has been on the FDA drug shortage list since August 2022, with the higher strengths most affected.
Educational summary compiled from the sources listed above. Not medical advice. Peptide Vault does not sell, source or recommend any compound. Talk to a qualified clinician before starting or changing anything.