Dulaglutide dosing — approved titration schedule

Dulaglutide is a long-acting GLP-1 receptor agonist given as a once-weekly subcutaneous injection. Like others in its class, it is titrated: you start low and step up so the body adapts and gastrointestinal side effects stay manageable.

The approved titration steps up once weekly:

• Start: 0.75 mg once weekly.
• Increase to 1.5 mg once weekly for additional glycemic control.
• If more effect is needed and it is tolerated, increase to 3 mg, then 4.5 mg, after at least 4 weeks at each step.
• Maximum: 4.5 mg once weekly.

Many people stay at whichever step gives a good response rather than pushing to the maximum.

Starting higher would cause more nausea, vomiting, and other GI effects. Stepping up gives the gut time to adapt, which is why 0.75 mg is the starter step and increases are spaced at least about a month apart. If a step is not tolerated, staying longer at the lower dose is common.

Dulaglutide is injected under the skin (abdomen, thigh, or upper arm) once weekly, on the same day each week. Its long half-life — from linking the GLP-1 analog to an antibody fragment — is what allows once-weekly dosing.

• The approved product comes as pre-filled, single-dose pens, so the amount is fixed and verified.
• Unregulated "research" material lacks that fixed, verified dosing and should not be treated as equivalent to the approved pen.

Dulaglutide affects blood glucose and interacts with other medicines and conditions. A prescriber screens for contraindications (such as a personal or family history of medullary thyroid carcinoma or MEN 2), monitors response, and adjusts the step-up. The schedule above is the map; a clinician and the approved labeling are how you use it safely.