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They work in sequence

Similar cardiovascular outcomes in patients with diabetes and established or high risk for coronary vascular disease treated with dulaglutide with and without baseline metformin

[4] As detectable levels of myoglobinemia and myoglobinuria occur, blood tests and urine tests may show elevated levels of myoglobin

Metformin HCl extended-release Following a single oral dose of 1,000 mg (2 x 500 mg tablets) metformin HCl extended-release after a meal, the time to reach maximum plasma metformin concentration (Tmax) is achieved at approximately 7 to 8 hours

Lofton, MD Winter 2015 Disclaimer: The imagery of medications used in this article does not represent actual medications