Active Ingredient: Dulaglutide
Dulaglutide is indicated in adults with type 2 diabetes mellitus to improve glycaemic control as:
Monotherapy: When diet and exercise alone do not provide adequate glycaemic control in patients for whom the use of metformin is considered inappropriate due to intolerance or contraindications.
Add-on therapy: In combination with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control.
For this indication, competent medicine agencies globally authorize below treatments:
Subcutaneous
0.75 - 1.5 mg
From 0.75 To 1.5 mg once every 7 day(s)
The recommended dose is 0.75 mg once weekly.
The recommended dose is 1.5 mg once weekly.
For potentially vulnerable populations, such as patients ≥75 years, 0.75 mg once weekly can be considered as a starting dose.
When dulaglutide is added to existing metformin and/or pioglitazone therapy, the current dose of metformin and/or pioglitazone can be continued. When dulaglutide is added to existing metformin and/or sodium-glucose co-transporter 2 inhibitor (SGLT2i) therapy, the current dose of metformin and/or SGLT2i can be continued. When it is added to existing therapy of a sulphonylurea or insulin, a reduction in the dose of sulphonylurea or insulin may be considered to reduce the risk of hypoglycaemia.
The use of dulaglutide does not require blood glucose self-monitoring. Blood glucose self-monitoring is necessary to adjust the dose of sulphonylurea or insulin, particularly when dulaglutide therapy is started and insulin is reduced. A stepwise approach to insulin dose reduction is recommended.
Dulaglutide is to be injected subcutaneously in the abdomen, thigh or upper arm. It should not be administered intravenously or intramuscularly.
The dose can be administered at any time of day, with or without meals.
If a dose is missed, it should be administered as soon as possible if there are at least 3 days (72 hours) until the next scheduled dose. If less than 3 days (72 hours) remain before the next scheduled dose, the missed dose should be skipped and the next dose should be administered on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing schedule.
The day of weekly administration can be changed if necessary, as long as the last dose was administered 3 or more days (72 hours) before.
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