Weight Management Protocol
DulaglutideComplete Dosing & Administration Guide
Once-weekly GLP-1 receptor agonist Fc-fusion protein (Trulicity) that reduces HbA1c by 1.5–1.9%, promotes 3–4.6 kg weight loss, and demonstrated cardiovascular event reduction in the REWIND trial — available in convenient pre-filled autoinjector with no reconstitution required
Dose Range
0.75-4.5mg
Frequency
Once weekly
Route
Subcutaneous injection
Cycle Length
Ongoing/indefinite
Dosing
How much
do I take?
Starting Dose
0.75 mg subcutaneous once weekly
Initiate at 0.75 mg weekly to assess gastrointestinal tolerability. Inject in abdomen, thigh, or upper arm on the same day each week — timing can be changed as long as the last dose was at least 3 days prior. No reconstitution required; use the pre-filled autoinjector pen. If combining with insulin or sulfonylureas, consider reducing their dose to minimize hypoglycemia.
Standard Dose
1.5 mg subcutaneous once weekly
Standard maintenance dose for most type 2 diabetes patients. Increase from 0.75 mg after at least 4 weeks if additional glycemic control is needed. This dose provides HbA1c reduction of approximately 1.5% and weight loss of 3.0 kg. The ready-to-use autoinjector pen simplifies administration. No dose adjustment needed for renal or hepatic impairment.
Advanced Dose
3.0–4.5 mg subcutaneous once weekly
Higher doses approved in 2020 for patients requiring additional glycemic control. AWARD-11 demonstrated 4.5 mg superiority over 1.5 mg: HbA1c -1.77% vs -1.54% and weight loss -4.6 kg vs -3.0 kg. Titrate from 1.5 mg to 3.0 mg and then to 4.5 mg at minimum 4-week intervals. GI side effects are dose-dependent but generally tolerable with gradual escalation.
Timing
Best time to take
Administer Dulaglutide at the same time each day (or on the same day each week for weekly injections). Many users prefer morning or evening administration. Pick a time you'll remember consistently.
With food?
Dulaglutide injections can be given regardless of meal timing. However, if GI effects occur, administering on an empty stomach or with a light meal may help reduce discomfort.
If stacking
Dulaglutide should be used as directed by your healthcare provider. If combining with other medications or supplements, discuss potential interactions with your provider. Avoid combining with compounds that have overlapping mechanisms unless specifically guided by a medical professional.
Adjusting Your Dose
Increase if
- +You've tolerated the current dose for the recommended period without significant side effects
- +Therapeutic goals haven't been met at the current dose level
- +Your healthcare provider recommends dose escalation based on your response
- +Lab work or clinical assessments support a higher dose
Decrease if
- -Side effects are bothersome or impacting daily life despite management strategies
- -You experience any signs of an adverse reaction
- -Lab results indicate the need for dose reduction
- -Your healthcare provider recommends a lower dose based on your response
Signs of right dose
- ✓Therapeutic goals being met with minimal side effects
- ✓Stable and consistent response to treatment
- ✓Lab values or clinical markers trending in the right direction
- ✓Good tolerance with manageable or absent side effects
Dosing Calculator
Calculate Your Exact Dose
Step 1: Peptide Weight
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Administration
How do I
use it?
Reconstitution
What you need
- •Dulaglutide vial (lyophilized powder or solution)
- •Bacteriostatic water or sterile sodium chloride for reconstitution
- •Alcohol swabs for cleaning vial tops and injection sites
- •Appropriately sized syringes with fine-gauge needles (27-30 gauge)
- •Sharps disposal container
Injection
Route
Subcutaneous injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training
Best sites
- •Abdomen (stomach area)—at least 2 inches from the belly button, most popular choice for self-injection
- •Front of thighs—middle to upper portion of the outer leg
- •Back of upper arm—outer area (may need assistance from another person)
Technique
- 1.Wash your hands thoroughly with soap and water before handling supplies
- 2.Clean the injection site with an alcohol swab and let it air dry completely
- 3.Pinch a fold of skin at the chosen injection site
- 4.Insert the needle at a 45-90 degree angle (depending on needle length and body composition)
- 5.Inject the medication slowly and steadily over 5-10 seconds
- 6.Release the skin fold and remove the needle, applying gentle pressure with a clean swab
- 7.Rotate injection sites to prevent tissue irritation or lipodystrophy
- 8.Dispose of the needle safely in a sharps container—never recap or reuse needles
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
Dulaglutide is an FDA-approved GLP-1 receptor agonist carrying a black box warning for thyroid C-cell tumor risk, based on rodent data showing increased medullary thyroid cancer (MTC) in rat models. This risk is contraindicated in patients with personal or family history of MTC or multiple endocrine neoplasia type 2. Nausea occurs in 20-40% of patients, particularly dose-dependent and most severe at initiation; gastrointestinal side effects (vomiting, diarrhea) are common. Pancreatitis has been reported in 0.1-0.2% of patients—discontinue immediately if severe abdominal pain develops. Rapid weight loss can trigger gallstone formation. Dehydration risk is significant, especially with concurrent SGLT2 inhibitors. Injection site reactions are mild but frequent.
Dulaglutide was studied through Phase 3 randomized controlled trials for type 2 diabetes (AWARD program) with thousands of patients, providing robust safety data. The FDA black box warning reflects preclinical evidence in animal models combined with post-market surveillance over 10+ years. Comparative efficacy and safety trials with other GLP-1 agonists (semaglutide, liraglutide) provide substantial evidence base for risk-benefit analysis.
Common Side Effects
Experienced by some users
Nausea
Occurs in 13.4–16.4% of patients depending on dose. Generally mild to moderate, most pronounced during the first weeks and dose escalation. Lower incidence than many other GLP-1 RAs.
Management: Gradual dose titration over 4-week intervals. Eat smaller, more frequent meals. Most patients develop tolerance within 4–6 weeks. Nausea rates with dulaglutide are among the lowest in the GLP-1 RA class.
Diarrhea and abdominal pain
Common GI effects of GLP-1 receptor activation affecting the gastrointestinal tract. Usually mild to moderate and self-limiting.
Management: Stay hydrated. Dietary adjustments as needed. Generally improves with continued therapy.
Vomiting
Reported in 5.6–9.3% of patients, dose-dependent. More common during dose escalation periods.
Management: Ensure gradual dose titration. Temporarily hold at current dose if persistent. Consider anti-emetics short-term if needed.
Decreased appetite
Reduced appetite is a pharmacological effect of central GLP-1 receptor activation and contributes to the weight loss benefit of dulaglutide.
Management: Generally considered a therapeutic benefit. Ensure adequate nutrition is maintained despite reduced appetite.
Less Common
- •Injection site reactions and fatigue
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe or worsening side effects that don't improve with dose adjustment or supportive care
- ×Signs of an allergic reaction—rash, hives, swelling, or difficulty breathing
- ×Your healthcare provider recommends discontinuation based on your clinical response
- ×Development of any new medical condition that may be contraindicated with Dulaglutide
- ×Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
- ×Abnormal lab results or clinical markers that suggest adverse effects
Dulaglutide should only be started, adjusted, or discontinued under medical supervision. This information is for educational purposes only and does not replace professional medical advice. Never stop a prescribed treatment without consulting your healthcare provider first, as abrupt discontinuation may have consequences.
Interactions
With other peptides
- ✓May be used together under medical guidance.
- ✓May be used together under medical guidance.
- ✓May be used together under medical guidance.
With medications
- !Other GLP-1 receptor agonists (liraglutide, semaglutide, exenatide) — redundant mechanism with increased adverse effects and no additional benefit - Use with caution—discuss with your healthcare provider.
- !DPP-4 inhibitors — overlapping incretin pathway mechanism without additional glycemic benefit - Use with caution—discuss with your healthcare provider.
- !Sulfonylureas or insulin at full dose — increased hypoglycemia risk; dose reduction of insulin secretagogues required when initiating dulaglutide - Use with caution—discuss with your healthcare provider.
With supplements
- ✓Multivitamins - Generally safe to take alongside Dulaglutide. Space doses apart if taking oral formulations to ensure optimal absorption.
- ✓Electrolyte supplements - Helpful if experiencing any GI side effects that could lead to dehydration. Safe to combine.
Want the Full Picture?
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