Common Registration Assessment, Part 1

Dulaglutide weekly pen doses and step-up schedule for the GPhC assessment

Three original practice questions, with the working shown. Read the stated prescription or plan before calculating.

Published 8 November 2026. Independent revision material, not GPhC questions, not for patient care.

A young woman holding an injection pen indoors
Photo from Pexels, used under the Pexels licence. It is a stock image and does not show the exercise.

The manufacturer's UK product information for Trulicity (dulaglutide) solution for injection in pre-filled pens states that the recommended dose for monotherapy is 0.75 mg once weekly, and that the recommended dose for add-on therapy is 1.5 mg once weekly.

The same information states that, if needed, the 1.5 mg dose can be increased after at least 4 weeks to 3 mg once weekly, that the 3 mg dose can be increased after at least 4 weeks to 4.5 mg once weekly, and that the maximum dose is 4.5 mg once weekly.

For children aged 10 years and above, it states a starting dose of 0.75 mg once weekly, which can be increased to 1.5 mg once weekly after at least 4 weeks, with a maximum dose of 1.5 mg once weekly.

Each question fixes the values needed for its arithmetic. Write the unit beside every step and distinguish a single dose from a weekly schedule or a supply period. All prescriptions and patients here are fictional; these are revision materials, not for patient care.

The method

  1. Identify the stated weekly dose in mg and the minimum 4 weeks at each step.
  2. Count one pen for each week at the stated dose.
  3. Add the stated weeks for each step to find when a dose level is reached.
  4. Keep mg per week, pens and weeks separate; convert only when the question asks.

Three practice questions

Work each one on paper first, then open the answer. All patients and prescriptions are fictional.

Question 1

A fictional adult starts dulaglutide 1.5 mg once weekly in week 1 as add-on therapy, then steps up at the earliest allowed point each time: 3 mg after at least 4 weeks, then 4.5 mg after at least 4 more weeks. In which week is 4.5 mg first injected?

Show the answer

Answer: Week 9

Working: Weeks 1 to 4: 1.5 mg weekly. Weeks 5 to 8: 3 mg weekly. The first 4.5 mg injection falls in week 9.

Question 2

A fictional patient uses one single-use dulaglutide pen each week. How many pens are needed for 8 weeks of treatment?

Show the answer

Answer: 8 pens

Working: One pen each week x 8 weeks = 8 pens.

Question 3

A fictional 12 year old starts dulaglutide at 0.75 mg once weekly. What is the maximum weekly dose the label allows for this age group?

Show the answer

Answer: 1.5 mg once weekly

Working: For patients aged 10 years and above the label allows an increase to 1.5 mg once weekly after at least 4 weeks, and states the maximum dose is 1.5 mg once weekly.

eMC SmPC: TRULICITY 1.5 mg solution for injection in pre-filled pen

https://www.medicines.org.uk/emc/product/3634/smpc

Where marks are lost

  • Stepping up before the minimum 4 weeks at a dose, so 4.5 mg appears in week 7 instead of week 9.
  • Counting one pen per dose level instead of one pen per week.
  • Applying the adult 4.5 mg maximum to a patient aged 10 years and above, whose stated maximum is 1.5 mg once weekly.

Frequently asked questions

Are these official assessment questions?

No. They are original revision exercises, not official GPhC questions and not for patient care.

Does this calculation decide a real dulaglutide schedule?

No. Follow the stated schedule in the exercise. Real escalation depends on response, with at least 4 weeks at each dose and different limits for children.

How should I check the answer?

Count the weeks at each dose level first, then map one pen to each week.

Sources

The questions above are original and use fictional patients and prescriptions. PreRegExamPrep is not affiliated with or endorsed by the General Pharmaceutical Council.

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More calculation topics

See also the formula sheet, the eight sample questions and the approved calculator page.