Dulaglutide: Brands, Price & Uses in Bangladesh

Dulaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated for use in adults and, in select cases, children as described below.

Established / FDA-approved indications

• Glycemic control in type 2 diabetes mellitus (adults and pediatric patients 10 years and older): As an adjunct to diet and exercise to improve blood glucose control in adults and children 10 years of age and older with type 2 diabetes.
• Cardiovascular risk reduction (adults): To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors.

Not indicated for

• Type 1 diabetes mellitus.
• Treatment of diabetic ketoacidosis.
• Weight management as a labeled indication (Dulaglutide is not approved for chronic weight management; any weight-loss effect is a secondary observation of its diabetes indication).

Type 2 diabetes mellitus (glycemic control) - Adults

Cardiovascular risk reduction - Adults

Dosing follows the same once-weekly regimen (0.75 mg to 4.5 mg per week) titrated for tolerability and glycemic response.

Pediatric patients (10 years and older)

Starting dose 0.75 mg once weekly; may be increased in a stepwise manner (to 1.5 mg, then higher doses if needed and tolerated) following the same general titration principles used in adults, under close physician supervision. Safety and efficacy in children under 10 years of age have not been established.

Renal/hepatic impairment

No dose adjustment is required based on renal or hepatic impairment; however, caution is advised in patients with renal impairment because gastrointestinal adverse reactions leading to dehydration may worsen kidney function (see Precautions).

Administration instructions

• Inject subcutaneously in the abdomen, thigh, or upper arm.
• May be administered at any time of day, with or without food.
• Administer once weekly on the same day each week; the day can be changed if the last dose was given at least 3 days before.
• If a dose is missed and there are at least 3 days until the next scheduled dose, administer as soon as possible; if less than 3 days remain, skip the missed dose and resume on the regular schedule.
• Do not mix with insulin in the same injection; if co-administered with insulin, use separate injection sites.

Very common / common

• Nausea, vomiting, diarrhea, abdominal pain, decreased appetite (most frequent, often dose-related and tend to diminish over time).
• Injection site reactions (redness, itching, swelling).
• Fatigue, dyspepsia.

Less common but clinically important

• Hypoglycemia (mainly when combined with insulin or sulfonylureas).
• Hypersensitivity reactions, including anaphylaxis and angioedema (rare).
• Acute pancreatitis and acute kidney injury - see Precautions and Warnings.