Dulaglutide

Dulaglutide is best known as Trulicity, an FDA-approved weekly GLP-1 medicine for type 2 diabetes — a lab-made peptide that copies a natural gut hormone involved in fullness and blood-sugar control. It comes in a fixed-dose, pre-filled pen, and unlike some other GLP-1 medicines it uses an antibody-fragment (Fc) fusion to extend its half-life so it only needs to be injected once a week.

Dulaglutide (Trulicity) is a weekly GLP-1 injection FDA-approved for type 2 diabetes. In the AWARD trial program it lowered blood sugar (HbA1c) in adults with type 2 diabetes, and a cardiovascular outcomes trial (REWIND) supported a label expansion to reduce major adverse cardiovascular events. It produces moderate weight loss — less than semaglutide or tirzepatide. The research attributes these weight and blood-sugar changes largely to reduced appetite and food intake (greater satiety via the gut-hormone pathway these agents act on), an appetite and energy-intake mechanism measured across the trials.

FDA-approved — Trulicity (BLA 125469, Eli Lilly), approved September 18, 2014 for glycemic control in adults with type 2 diabetes; expanded February 21, 2020 to reduce major adverse cardiovascular events in adults with T2D and established CV disease or multiple CV risk factors; pediatric T2D (ages ≥10) approved 2022. Not DEA-scheduled. Not listed in the WADA 2026 Prohibited List (the entire GLP-1 class is currently absent — same as liraglutide/semaglutide/tirzepatide; confirm against current edition before competition).

Dulaglutide is a prescription-only medication and carries a class boxed warning related to thyroid C-cell tumors. It is not on the WADA Prohibited List. VialWise is a research and educational reference, not medical advice — consult a licensed professional.

⚠️ For research and educational purposes only. Dulaglutide is FDA-approved as a prescription drug (Trulicity). Information in this entry is informational, not medical advice. Always confirm dose calculations with the in-app calculator and consult appropriate professional guidance before any protocol decisions.

⚠️ No reconstitution — fixed-dose pre-filled device. Unlike lyophilized research peptides, dulaglutide ships ready-to-inject at fixed doses. There is no vial to reconstitute and no dose to draw. The Vialwise reconstitution math does not apply to dulaglutide.

⚠️ Dulaglutide is not interchangeable with other GLP-1 agonists. It shares the GLP-1 receptor mechanism with semaglutide, liraglutide, exenatide, and tirzepatide, but differs in structure (IgG4-Fc fusion vs fatty-acid acylation), half-life (~5 days), and dosing device. Do not stack it on top of another GLP-1/GIP agonist — the compounded incretin effect is unpredictable. See [semaglutide.md](./semaglutide.md), [liraglutide.md](./liraglutide.md), [tirzepatide.md](./tirzepatide.md).

Dulaglutide is a once-weekly, FDA-approved GLP-1 receptor agonist marketed by Eli Lilly as Trulicity, approved in 2014 for type 2 diabetes. It is mechanistically a member of the same incretin class as semaglutide and liraglutide, but uses a structurally distinct half-life-extension strategy.

Mechanism. Dulaglutide consists of two identical GLP-1(7-37) analog chains, each covalently linked to a fragment of a modified human IgG4 antibody (Fc fusion). Native GLP-1 is degraded within ~2 minutes by DPP-4; the GLP-1 analog portion of dulaglutide is engineered to resist DPP-4, and the large Fc fusion slows renal clearance — together extending the half-life to ~5 days. The downstream pharmacology is the GLP-1 class effect: glucose-dependent insulin secretion, glucagon suppression, slowed gastric emptying, and central appetite reduction. The key structural contrast with semaglutide and liraglutide is that those use a fatty-acid acylation (albumin binding) for half-life extension, whereas dulaglutide uses an Fc fusion — a different molecular strategy reaching a similar once-weekly endpoint.

Clinical development. Trulicity was approved by the FDA on September 18, 2014 for glycemic control in adults with T2D, based on the AWARD phase 3 program (AWARD-1 through AWARD-11), which demonstrated A1c reduction across monotherapy and combination settings. The REWIND cardiovascular outcomes trial (n=9,901, median 5.4 years) supported a 2020 label expansion for cardiovascular risk reduction. Higher doses were added in 2020 based on the AWARD-11 dose-escalation trial. Pediatric T2D approval (ages ≥10) followed in 2022.

Regulatory status. FDA-approved prescription drug (BLA 125469). Not DEA-scheduled. Not listed in the WADA 2026 Prohibited List — the entire GLP-1 / GIP / glucagon agonist class is currently absent from the list (same negative-listing pattern documented in the liraglutide, semaglutide, and PT-141 entries).

Comparison within the GLP-1 family. Dulaglutide produces moderate weight loss (less than semaglutide or tirzepatide) and robust A1c reduction, with strong cardiovascular outcomes evidence (REWIND). It is positioned as a well-established once-weekly T2D agent. Researchers prioritizing magnitude of weight loss more often select semaglutide (Wegovy) or tirzepatide; dulaglutide's strengths are its long track record, once-weekly convenience, and CV outcomes data. See [semaglutide.md](./semaglutide.md), [tirzepatide.md](./tirzepatide.md), [retatrutide.md](./retatrutide.md).

Commonly reported

• Nausea — most common, especially early; usually transient
• Diarrhea, vomiting, abdominal pain
• Decreased appetite, dyspepsia
• Fatigue
• Injection-site reactions
• Hypoglycemia (mainly when combined with insulin/sulfonylureas)

Serious

• Acute pancreatitis (severe abdominal pain radiating to the back)
• Gallbladder disease (right-upper-quadrant pain, jaundice)
• Acute kidney injury (often secondary to dehydration from GI effects)
• Severe hypersensitivity / anaphylaxis
• Signs of medullary thyroid carcinoma (neck mass, hoarseness, dysphagia, dyspnea)
• Diabetic retinopathy worsening in predisposed patients

Personal or family history of medullary thyroid carcinoma (MTC) or MEN2 — FDA boxed warning across the GLP-1 class (rodent thyroid C-cell tumor findings).

History of pancreatitis — caution; weigh benefit/risk.

Severe GI disease / gastroparesis — dulaglutide further slows gastric emptying.

Hypersensitivity to dulaglutide or any component.

Pregnancy/lactation — limited data; given the ~5-day half-life, discontinuation well before a planned pregnancy is the labeled consideration. Not for use in pregnancy unless benefit justifies risk.

Regulatory (US): prescription-only; not DEA-scheduled.

Regulatory (sport): Not listed in WADA 2026; confirm current edition before competition.

GLP-1 receptor agonist

A compound that switches on the GLP-1 receptor, the same target a natural gut hormone uses to signal fullness and help regulate blood sugar.

Subcutaneous

An injection into the fatty layer just under the skin, rather than into a muscle or vein.

Half-life

Roughly how long the body takes to clear half of a dose. A long half-life is why some compounds can be taken only once a week.

Titration

Starting at a low dose and increasing it gradually.

1. Eli Lilly. Trulicity (dulaglutide) injection prescribing information. US Food and Drug Administration, BLA 125469. Original approval September 18, 2014; higher-dose and pediatric updates 2020–2022.
2. Dulaglutide pharmacokinetics — ~5-day (~120 h) elimination half-life, confirming once-weekly dosing.
3. Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riesmeyer JS, Riddle MC, Rydén L, Xavier D, et al. (REWIND Investigators). (2019). Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet, 394(10193):121–130.(PMID 31189511)
4. Frias JP, Bonora E, Nevarez Ruiz L, Li YG, Yu Z, et al. (2021). Efficacy and Safety of Dulaglutide and Versus Dulaglutide in Metformin-Treated Patients With Type 2 Diabetes in a Randomized Controlled Trial (AWARD-11). Diabetes Care, 44(3):765–773.(PMID 33397768)
5. World Anti-Doping Agency. The 2026 Prohibited List, International Standard (effective 1 January 2026). Dulaglutide and the entire GLP-1 / GIP / glucagon agonist class are not listed.

• Testosterone — discussed together in this entry's stacks section
• Amycretin — same mechanism class
• CagriSema — same mechanism class
• Exenatide — same mechanism class
• Liraglutide — same mechanism class
• Mazdutide — same mechanism class