Purpose | Dosage | Frequency |
---|---|---|
Type 2 Diabetes | 2.5 mg weekly 5-10 mg weekly 15 mg weekly |
Once weekly |
Weight Loss | 2.5 mg weekly 5-10 mg weekly 15 mg weekly |
Once weekly |
Tirzepatide is a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. Key points:
Synthetic peptide comprising 39 amino acids
Conjugated to a C20 fatty diacid moiety
Marketed as Mounjaro (for diabetes) and Zepbound (for weight loss)
Approved by FDA in May 2022 for type 2 diabetes and November 2023 for weight loss
Unique "twincretin" mechanism of action
Stimulates first- and second-phase insulin secretion
Reduces glucagon levels in a glucose-dependent manner
Delays gastric emptying
Lowers fasting and postprandial glucose concentrations
Decreases food intake
Reduces body weight
Increases insulin sensitivity
Significant reduction in HbA1c levels (maximum reduction of 2.46%)
Substantial improvements in fasting and postprandial glucose levels
Substantial weight loss (up to 22.5% of body weight in clinical trials)
Improvements in waist circumference and body composition
Reduction in blood pressure
Improvements in lipid profiles
Potential cardiovascular benefits under investigation in ongoing trials
Ongoing research into potential benefits for liver health
Starting dose: 2.5 mg once weekly
Increase to 5 mg once weekly after 4 weeks
Further increases in 2.5 mg increments every 4 weeks as needed
Maximum dose: 15 mg once weekly
Same dosing schedule as for type 2 diabetes
Remove pen from refrigerator 30 minutes before injection
Choose injection site (abdomen, thigh, or upper arm)
Clean injection site with alcohol swab
Remove pen cap and inject as directed
Dispose of used pen in a sharps container
May be used with metformin, SGLT2 inhibitors, and other diabetes medications
Caution advised when used with sulfonylureas or insulin due to hypoglycemia risk
May affect absorption of oral medications due to delayed gastric emptying
Tirzepatide is a prescription medication and should only be obtained through licensed pharmacies with a valid prescription.
Most common side effects are gastrointestinal (nausea, vomiting, diarrhea)
Risk of hypoglycemia, especially when combined with other diabetes medications
Contraindicated in patients with personal or family history of medullary thyroid carcinoma
Caution advised in patients with a history of pancreatitis
FDA-approved for type 2 diabetes and weight loss in the United States
Approved in the European Union, Canada, and other countries
Prescription-only medication
Store in refrigerator (2°C to 8°C or 36°F to 46°F)
Can be stored at room temperature for up to 21 days
Protect from light
Do not freeze
Many patients see improvements in blood glucose within 2-4 weeks, with maximum weight loss typically occurring after 6-12 months of treatment.
Tirzepatide is not approved for use in type 1 diabetes.
Tirzepatide is not recommended during pregnancy due to insufficient safety data.
Tirzepatide represents a significant advancement in the treatment of type 2 diabetes and obesity. Its unique dual-action mechanism offers superior glycemic control and weight loss compared to many existing therapies. The recommended dosing strategy, starting at 2.5 mg weekly and gradually increasing, helps minimize side effects while maximizing benefits. As with any medication, tirzepatide should be used under the guidance of a healthcare professional, with careful consideration of individual patient factors and potential risks.
Frías JP, et al. (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med, 385(6), 503-515.
Rosenstock J, et al. (2021). Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet, 398(10295), 143-155.
Sattar N, et al. (2021). Tirzepatide cardiovascular event risk assessment: a pre-specified meta-analysis. Nat Med, 28(3), 591-598.
Jastreboff AM, et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med, 387(3), 205-216.
Min T, Bain SC. (2021). The Role of Tirzepatide, Dual GIP and GLP-1 Receptor Agonist, in the Management of Type 2 Diabetes: The SURPASS Clinical Trials. Diabetes Ther, 12(1), 143-157.
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