GLP-1 Agonist·Endocrinology - Insulins & Injectables

Dulaglutide

Type 2 Diabetes, reduction of major cardiovascular events

Authority requiredPBSGLP-1TrulicityS4+1

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At a glance

Max Dose

1.5 mg/week

Half-life

5 Days

Device

AUTO-INJECTOR

Caution: Pancreatitis

RISK

Cautions

Avoid / Cautions

Personal/family history of Medullary Thyroid Carcinoma or MEN 2. History of pancreatitis. Pregnancy Category D.

Where it stands

Rapid Summary

Overview

Once-weekly GLP-1 receptor agonist. Highly prized for its incredibly simple, hidden-needle auto-injector device. Excellent cardiovascular benefits.

Clinical Focus

Provides identical benefits to Ozempic, but often preferred by patients with severe needle phobia.

Bottom Line

Dulaglutide is a once-weekly GLP-1 agonist for type 2 diabetes with cardiovascular benefit, but causes GI side effects and is contraindicated in personal/family history of medullary thyroid carcinoma.

Formulation & Access

Brand Names

Trulicity

Parenteral

Single-use, pre-filled auto-injector pens (1.5 mg/0.5 mL). The needle is hidden and automatically retracts.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Type 2 Diabetes, reduction of major cardiovascular events.

Clinical Place

Direct competitor to Semaglutide. Highly effective for T2DM with established cardiovascular disease.

Quick reference

Class & Role

GLP-1 Agonist — Once-weekly GLP-1 receptor agonist.

Route / Formulation

Single-use, pre-filled auto-injector pens (1.5 mg/0.5 mL). The needle is hidden and automatically retracts. (Trulicity)

Usual Dose & Max

SC 1.5 mg ONCE WEEKLY. (Can be taken at any time of day, with or without meals). Max 1.5 mg/week.

Key Indication Doses

Type 2 Diabetes: SC 1.5 mg ONCE WEEKLY. (Can be taken at any time of day, with or without meals). Renal Impairment: No dose adjustment required in mild/moderate CKD. Avoid in end-stage renal disease (eGFR < 15).

Best Uses

Key Risks

Gastrointestinal: Nausea, vomiting, diarrhea, dyspepsia. CRITICAL — Acute pancreatitis. Endocrine: Theoretical risk of Medullary Thyroid Carcinoma. Cardiovascular: Mild increase in resting heart rate.

Key Interactions

Delayed gastric emptying can slightly delay the absorption of concomitant oral medications.

Monitoring

Counsel the patient to place the pen flat against the skin, unlock it, and press the button. They will hear a click, wait 5-10 seconds, hear a second click, and it is done. They never see the needle. Routine HbA1c, U&E, and Weight.

Clinical Pearl

Because the needle is 100% invisible and the dose is pre-measured (no dial to turn like Ozempic), Dulaglutide has the highest patient compliance rate among the injectable diabetes drugs, particularly in the elderly or needle-phobic.

Access

Authority requiredTrulicity

Brand: Trulicity
PBS status: Authority required

From this page

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