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Manufacturer recommendations for missed doses of GLP-1 receptor agonist-based therapy

Manufacturer recommendations for missed doses of GLP-1 receptor agonist-based therapy
Agent Recommended dosing interval Manufacturer recommendations for missed doses
Short-acting agents
Exenatide Twice daily
  • Skip missed dose and resume at the next scheduled dose.
Lixisenatide Once daily
  • If a dose is missed, administer within 1 hour prior to next meal.
Long-acting agents
Dulaglutide Once weekly
  • Administer as soon as possible if there are ≥3 days (72 hours) until next scheduled dose.
  • If <3 days before next scheduled dose, skip the missed dose and administer on the next scheduled day.
Exenatide extended release Once weekly
  • Administer as soon as possible if there are ≥3 days (72 hours) until the next scheduled dose.
  • If <3 days before next scheduled dose, skip the missed dose and administer on the next scheduled day.
Liraglutide Once daily
  • If dose is missed, resume with the next scheduled dose.
Semaglutide (injectable) Once weekly
  • Administer as soon as possible within 5 days after the missed dose.
  • If >5 days have passed, skip the dose and administer on the next scheduled day.
Semaglutide (oral) Once daily
  • If dose is missed, resume with the next scheduled dose.
Tirzepatide Once weekly
  • Administer as soon as possible within 4 days (96 hours) after the missed dose.
  • If >4 days have passed, skip the dose and administer on the next scheduled day.
GLP-1: glucagon-like peptide 1.
From: American Diabetes Association. Whitley HP, Trujillo JM, Neumiller JJ. Special report: Potential strategies for addressing GLP-1 and dual GLP-1/GIP receptor agonist shortages. Clin Diabetes 2023; 41:467. Copyright and all rights reserved. Material from this publication has been used with the permission of American Diabetes Association.
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