Dosage guide
Trulicity dose escalation schedule
Week-by-week titration for Trulicity (dulaglutide) — starting dose, step-up schedule, maintenance, maximum, and what to do if you miss a dose.
Starting dose
0.75 mg once weekly
Maintenance
0.75–4.5 mg subcutaneous once weekly
Maximum dose
4.5 mg/week
Dose form & administration
- Dose form
- Single-dose auto-injector pen (no titration calc needed)
- Dosing frequency
- Once weekly, same day each week, any time of day, with or without food
Titration timeline
FDA-labeled step-up schedule. Most clinicians follow this exactly, but may pause at a step for an additional 4 weeks if side effects are intolerable.
- 1
Weeks 1–4+
0.75 mg/week
Starting dose — may also be the maintenance dose.
- 2
Step up after ≥4 weeks
1.5 mg/week
If additional A1c reduction needed.
- 3
Step up after ≥4 weeks
3.0 mg/week
- 4
Step up after ≥4 weeks
4.5 mg/week
Maximum dose.
If a step-up is poorly tolerated
Hold the current dose for additional 4 weeks if the step-up is poorly tolerated. Many patients achieve target A1c at 0.75 or 1.5 mg without needing 4.5 mg.
Missed-dose protocol
Max skip window
3 days
If less than 3 days since the missed dose, inject it as soon as remembered. If more than 3 days, skip it and resume the regular weekly schedule.
When to contact your prescriber
- Multiple consecutive missed doses.
- Severe GI symptoms during dose escalation.
- Signs of pancreatitis or gallbladder disease.
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