Trulicity Dosage/Direction for Use

Posology: Adults: Monotherapy: The recommended dose is 0.75 mg once weekly.
Add‑on therapy: The recommended dose is 1.5 mg once weekly.
If needed, the 1.5 mg dose can be increased after at least 4 weeks to 3 mg once weekly; the 3 mg dose can be increased after at least 4 weeks to 4.5 mg once weekly.
The maximum dose is 4.5 mg once weekly.
Paediatrics: The starting dose for paediatric patients 10 years and above is 0.75 mg once weekly.
If needed, the dose can be increased to 1.5 mg once weekly after at least 4 weeks. The maximum dose is 1.5 mg once weekly.
Combination therapy: When Trulicity is added to existing metformin and/or pioglitazone therapy, the current dose of metformin and/or pioglitazone can be continued. When Trulicity 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 (see Precautions and Adverse Reactions).
The use of Trulicity does not require blood glucose self-monitoring. Blood glucose self-monitoring is necessary to adjust the dose of sulphonylurea or insulin, particularly when Trulicity therapy is started and insulin is reduced. A stepwise approach to insulin dose reduction is recommended.
Missed doses: 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.
Special population: Elderly: No dose adjustment is required based on age (see Pharmacology: Pharmacokinetics under Actions).
Renal impairment: No dose adjustment is required in patients with mild, moderate or severe renal impairment (eGFR <90 to ≥15 mL/min/1.73 m²).
There is very limited experience in patients with end stage renal disease (<15 ml/min/1.73 m²), therefore Trulicity cannot be recommended in this population (see Pharmacology: Pharmacodynamics and Pharmacokinetics under Actions).
Hepatic impairment: No dose adjustment is required in patients with hepatic impairment.
Paediatric population: The safety and efficacy of dulaglutide in children aged less than 10 years have not been established and no data are available (see Pharmacology: Pharmacodynamics and Pharmacokinetics under Actions).
Method of administration: Trulicity 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.
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.