Dulaglutide protocol

FDA titration

Weeks 1–4

15u

0.75 mg · Once weekly

Starting dose (FDA Trulicity).

Weeks 5–8

30u

1.5 mg · Once weekly

Step up if tolerated.

Weeks 9–12

60u

3.0 mg · Once weekly

Week 13+

90u

4.5 mg · Once weekly

Max labeled dose.

Phase	How often	Dose	Units	Notes
Weeks 1–4	Once weekly	0.75 mg	15u	Starting dose (FDA Trulicity).
Weeks 5–8	Once weekly	1.5 mg	30u	Step up if tolerated.
Weeks 9–12	Once weekly	3.0 mg	60u
Week 13+	Once weekly	4.5 mg	90u	Max labeled dose.

Units column is for 5 mg/mL.

Cycle & timing

Cycle: Escalate every 4 weeks as tolerated to the 4.5 mg max. Continuous use is standard for the indication.

Timing: Same day each week, any time, with or without food.

Where: SubQ, abdomen/thigh/upper arm. Rotate.

What to expect

Lower blood sugar and appetite within weeks; moderate weight loss over months.

How much to buy

For 12-wk titration to 4.5 mg/wk:

10

× 5mg vials

5

× 10mg vials

Men & women

Men: In men, excess fat lowers testosterone; GLP-1 raises total testosterone, SHBG and gonadotropins as weight drops, and improves sperm and erectile function; and preserves fertility, unlike TRT (which suppresses sperm).

Women: Women lose more than men at the same dose but report more GI (start lower). In PCOS they improve cycles, lower free testosterone and raise ovulation; a real unplanned-pregnancy risk. Stop before conceiving.

Dilution calculator

Set to the guide's typical mix for Dulaglutide. Change anything to see where to draw.

Vial size

BAC water added

Dose you want

Draw to

15u

Volume

0.15 mL

Strength

5 mg/mL

Doses per vial

6

Assumes a U-100 insulin syringe (100 units = 1 mL). Double-check against the compound's page before you draw.

Recommended mixes

Vial	Water	Strength
5 mg	1 mL	5 mg/mL
10 mg	2 mL	5 mg/mL

5 mg: 1 unit = 0.05 mg

10 mg: 1 unit = 0.05 mg

Storage

PowderFreeze-dried: -4°F.
MixedReconstituted: 36–46°F, up to 30 days. (Commercial Trulicity is pre-filled, refrigerated.)

Don't use if: Personal/family history of medullary thyroid carcinoma or MEN2 (boxed warning) · Prior pancreatitis · Pregnancy and lactation · Type 1 diabetes / diabetic ketoacidosis

Stop if you notice

Severe persistent abdominal pain (pancreatitis)
Persistent vomiting / dehydration
Signs of gallbladder disease (RUQ pain, jaundice)
Pregnancy

Side effects

Nausea, diarrhea, vomiting, reduced appetite, injection-site reactions. GI effects dose-dependent.

Drug interactions

Insulin / sulfonylureas: reduce dose to avoid hypoglycemia. Delayed gastric emptying alters oral drug absorption. Other GLP-1 agents: do not combine.

Labs

Fasting glucose / HbA1c (baseline + periodic). Renal function with significant GI losses. Lipase if pancreatitis suspected. Out of range? Rising glucose/HbA1c = blood sugar creeping toward diabetes (recheck, tighten diet); a falling eGFR = kidney strain, usually dehydration (hydrate, hold the dose).

What these labs mean →

Warnings

Thyroid C-cell tumors in rodents (boxed warning). Gallbladder disease with rapid weight loss. Hypoglycemia when combined with insulin/sulfonylureas. Diabetic retinopathy complications with rapid glucose improvement. Acute kidney injury from dehydration (vomiting/diarrhea).

Patient education

FDA-approved GLP-1, same class precautions as semaglutide. Titrate every 4 weeks; most nausea is early and improves. Hydrate and maintain protein intake. Stop and seek care for severe abdominal pain or persistent vomiting.

These apply on top of the universal safety rules.

Pairs well with

Lipo-C / L-Carnitine

metabolic support. Do not combine with other GLP-1 / incretin agents

LC120 L-Carnitine

Avoid with

Personal/family history of medullary thyroid carcinoma or MEN2

Prior pancreatitis

Pregnancy

Other GLP-1s

Can Dulaglutide + LC120 share a syringe?

Keep in separate syringes. GLP-1s run on their own weekly (or daily) schedule. Give them their own pin.

What it does

FDA: approved as Trulicity for type-2 diabetes; weight loss is moderate vs semaglutide/tirzepatide.

Dulaglutide is a long-acting GLP-1 receptor agonist (an antibody-Fc fusion). It enhances glucose-dependent insulin secretion, slows gastric emptying, and reduces appetite. FDA-approved (Trulicity) for type-2 diabetes; produces moderate weight loss. Once-weekly.

References

rxlist dailymed researchdosing peptidedosages GLP-1 sex differences Jensterle 2020

From the guide, page 31.