Dulaglutide

also known as: Trulicity, LY2189265

A weekly GLP-1 agonist for type 2 diabetes, delivered as a GLP-1/IgG4 fusion protein in a single-use auto-injector.

A recombinant fusion protein consisting of two GLP-1 analog chains linked to a modified human IgG4 Fc fragment, producing a ~5-day half-life suitable for weekly dosing.

Mechanism of action

GLP-1 receptor agonism via the two GLP-1 analog chains. Fc fusion provides both the extended half-life (FcRn-mediated recycling) and reduced immunogenicity. Clinical effects mirror other GLP-1 agonists: glucose-dependent insulin release, glucagon suppression, delayed gastric emptying, and central appetite modulation. Weight loss is typically more modest than with semaglutide or tirzepatide.

Primary uses

Type 2 diabetes mellitus
Cardiovascular risk reduction in T2DM (REWIND trial)

Typical dosing

0.75–4.5 mg weekly (subcutaneous)

Initiated at 0.75 mg weekly, titrated to 1.5 mg, then optionally 3.0 or 4.5 mg for additional glycemic control.

Regulatory status

FDA-approved as Trulicity in 2014 for type 2 diabetes mellitus; cardiovascular risk reduction indication added 2020. Manufactured by Eli Lilly.

References

[fda-pi] Trulicity (dulaglutide) Prescribing Information. Eli Lilly.
[clinical-trial] Gerstein HC, et al. "Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND)." Lancet, 2019;394:121-130.

Related peptides

Semaglutide

A once-weekly GLP-1 receptor agonist FDA-approved for type 2 diabetes and chronic weight management.

Liraglutide

The first once-daily GLP-1 analog to be FDA-approved for both type 2 diabetes (Victoza) and chronic weight management (Saxenda).

Exenatide

The first GLP-1 receptor agonist to reach market (2005), available in both twice-daily and weekly extended-release formulations.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.