Dulaglutide injection is used as an add-on therapy to diet and exercise to decrease blood glucose levels in adults with type 2 diabetes mellitus.
Dulaglutide is a glucagon-like peptide 1 (GLP-1) agonist used as an additional treatment to diet and exercise to decrease blood glucose in adults with type 2 diabetes mellitus.
Dulaglutide should not be used in patients:
• If there is an allergy to dulaglutide or any other product components
• With a personal or family history of thyroid carcinoma or in patients with type 2 Multiple Endocrine Neoplasia syndrome (a hormonal disorder)
• As the main treatment option for patients inadequately controlled on diet and exercise.
• With pancreatitis , alternate treatment should be considered.
• For the treatment of type 1 diabetes mellitus or severe diabetes like diabetes ketoacidosis
• With pre-existing severe gastrointestinal disease.
Dulaglutide is available as:
Injection: 0.75 mg/0.5 mL solution in a single-dose pen or prefilled syringe
Injection: 1.5 mg/0.5 mL solution in a single-dose pen or prefilled syringe for treating adults with type 2 diabetes
If a dose of dulaglutide is missed, administer within 3 days of a missed dose
Dulaglutide injection should be given subcutaneously in the abdomen, thigh or upper arm once e every week at any time of the day.
The initial dose is 0.75 mg once a week. The dose can be increased to 1.5 mg for further lowering of blood glucose.
• Dulaglutide can cause an increased risk of thyroid cancer s depending on the dose. So, caution is needed in patients with high risk of thyroid cancer.
• Patients should inform the symptoms of thyroid cancer like swelling in the neck, difficulty swallowing, difficulty breathing(dyspnea), changes in the voice. Regular monitoring of serum calcitonin and thyroid ultrasound is recommended.
• Dulaglutide can cause hypoglycemia (very low blood glucose) when used with other drugs like sulfonylurea or insulin. The dose of the sulfonylurea or insulin should be reduced in such case to decrease the risk of hypoglycemia
• In case of an allergic reaction, treat promptly until signs and symptoms resolve.
• Monitor kidney functions in patients with kidney disorders reporting severe gastric related side effects.
Gastrointestinal: Nausea, diarrhea, vomiting, abdominal pain, decreased appetite, acidity
Cardiovascular: Arrhythmia (abnormal rhythm), increased heart rate (tachycardia)
Others: Fatigue, injection-site reactions like injection-site rash, redness
Lab abnormalities: Serum amylase, lipase levels should be monitored.
Dulaglutide should be used during pregnancy only if the benefit justifies the risk to the baby.
The risk-benefit ratio should be considered while using dulaglutide in breastfeeding women.
Dulaglutide is not recommended in patients younger than 18 years.
Dulaglutide is not recommended in patients with gastroparesis (patients with slow stomach emptying).
Patients may experience gastrointestinal symptoms like nausea, vomiting, and hypoglycemia. Appropriate supportive care should be given in this case.
Dulaglutide may slow stomach emptying and may impact the absorption of concomitantly given oral medications.
Dulaglutide should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C). It should not be used beyond the date of expiry.
In need arises, each single-dose pen or prefilled syringe can be kept at room temperature but this should not exceed 30°C for a total of 14 days.
Dulaglutide should not be frozen. It must be protected from light. Storage in the original carton is recommended until the time of administration.
Discard dulaglutide single-dose pen or prefilled syringe after use in a puncture-resistant container.
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