Research Reference
Dulaglutide
Once-weekly GLP-1 receptor agonist for type 2 diabetes
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Dulaglutide (Trulicity) is an FDA-approved once-weekly GLP-1 receptor agonist for type 2 diabetes that also reduces cardiovascular risk in eligible patients.
Dosing Reference
Reconstitution
Add 0.5 mL bacteriostatic water to the 1.5 mg vial. Resulting concentration: 3 mg/mL.
| Dose | Syringe Units | mL Volume | Schedule |
|---|---|---|---|
| 0.75 mg | 25 units | 0.25 mL | SubQ, once weeklyStarting dose (FDA) |
| 1.5 mg | 50 units | 0.5 mL | SubQ, once weeklyStandard maintenance (FDA) |
| 3 mg | 100 units | 1 mL | SubQ, once weeklyHigher dose (FDA) |
| 4.5 mg | 150 units | 1.5 mL | SubQ, once weeklyMax dose (FDA) |
Math assumes U-100 insulin syringes (1 mL = 100 units). Verify your syringe matches before use. Round half-units to the nearest visible mark.
Reconstitution
Dulaglutide (Trulicity) is supplied as a single-dose pre-filled pen at a fixed concentration (0.75, 1.5, 3, or 4.5 mg per pen) and is not reconstituted by the user. Compounded research-peptide forms are not FDA-approved.
For a compounded 3 mg vial reconstituted with 0.5 mL, the concentration is 6 mg/mL; a 1.5 mg dose draws to 25 units (0.25 mL) on a U-100 syringe. Store per manufacturer directions; compounded forms are not FDA-approved.
Cycling Protocol
FDA-approved dulaglutide is once weekly. Start 0.75 mg, increase to 1.5 mg after 2–4 weeks; may increase to 3 mg, then 4.5 mg as needed for glycemic/weight goals. Used as chronic weekly therapy with no fixed cycle end.
Routes of Administration
Subcutaneous injection (only established route): Once weekly into the abdomen, thigh, or upper arm. Any time of day, independent of meals.
No oral, intranasal, or intravenous route is established. Compounded forms are not FDA-approved.
Stacking Protocols
| Stack | Components | Purpose | | --- | --- | --- | | GLP-1 + Lifestyle | Dulaglutide + diet/exercise | Standard FDA-approved T2D protocol | | Combination Therapy | Dulaglutide + metformin / SGLT2i | Studied T2D combinations (under medical supervision) |
Combining multiple GLP-1 agonists is not recommended. Compounded forms are not FDA-approved.
Side Effects & Safety
- Nausea, vomiting, diarrhea, abdominal pain — common, usually transient
- Hypoglycemia — risk, especially with insulin/sulfonylureas
- Pancreatitis — rare; discontinue if suspected
- Gallbladder events — rare
- Black-box warning: thyroid C-cell tumors in rodents; contraindicated in personal/family history of MTC or MEN2
Dulaglutide (Trulicity) is FDA-approved. Compounded research-peptide forms are not FDA-approved.
Research Basis
Dulaglutide is a once-weekly GLP-1 receptor agonist (a fusion of a GLP-1 analog to human IgG4 Fc, extending half-life to ~5 days).
Mechanism: GLP-1 receptor agonism — glucose-dependent insulin secretion, glucagon suppression, slowed gastric emptying, appetite reduction.
Clinical evidence: FDA-approved for type 2 diabetes and to reduce CV risk in T2D with established CV disease or risk factors (REWIND trial). AWARD trials demonstrated glycemic and weight benefit.
FDA-approved for T2D and CV risk reduction. Compounded research-peptide forms are not FDA-approved.