Mounjaro (tirzepatide)

Mounjaro (tirzepatide) is an innovative injection designed to help adults manage type 2 diabetes by effectively lowering blood sugar (glucose) and A1C levels. Administered just once a week, Mounjaro works best when combined with a healthy diet and regular exercise.

In clinical trials, patients using a 15 mg dose of Mounjaro for weight loss experienced a remarkable mean reduction of 20.9% in body weight over 72 weeks, compared to just 3.1% for those on placebo. The weight loss version, known as Zepbound, contains the same active ingredient, tirzepatide. While Mounjaro is FDA-approved for managing type 2 diabetes, Zepbound has received FDA approval specifically for aiding weight loss.

Pioneering in its category, Mounjaro is the first treatment acting as both a GIP and GLP-1 receptor agonist. It targets the glucose-dependent insulinotropic polypeptide (GIP) receptors and glucagon-like peptide-1 (GLP-1) receptors to regulate blood sugar levels efficiently.

Mounjaro helps to lower blood sugar by:

• Stimulating the pancreas to produce more insulin.
• Reducing the amount of sugar produced by the liver.
• Slowing down the digestive process, which in turn helps you feel full for longer periods.

This is achieved by activating the GIP and GLP-1 receptors, which are natural hormones that play a crucial role in blood sugar regulation.

Approved by the FDA on May 13, 2022, Mounjaro offers a significant advancement in the treatment of type 2 diabetes when used alongside diet and exercise. However, it's not suitable for individuals with type 1 diabetes, and its effects on those with a history of pancreatitis remain unknown.

For those aged 45 to 75, Mounjaro represents a beacon of hope in managing type 2 diabetes more effectively, improving not just health metrics but also overall quality of life.

Mounjaro is supplied as single-dose vial for subcutaneous use with the following strengths:

• 2.5 mg/0.5 mL single-dose vial
• 5 mg/0.5 mL single-dose vial
• 7.5 mg/0.5 mL single-dose vial
• 10 mg/0.5 mL single-dose vial
• 12.5 mg/0.5 mL single-dose vial
• 15 mg/0.5 mL single-dose vial

For Adults Managing Type 2 Diabetes:

• Starting Dose: Begin with a 2.5 mg injection under the skin (subcutaneously) once per week.
• After the First Four Weeks: Increase your dosage to 5 mg under the skin weekly.
• If More Control is Needed: You can further increase your dosage in 2.5 mg increments, but only after you've been on the current dose for at least four weeks.
• Maximum Allowable Dose: Do not exceed 15 mg subcutaneously per week.

Important Notes:
The initial 2.5 mg dose is solely for starting the treatment and isn't meant for long-term blood sugar management.

If necessary, you can adjust the day of your weekly injection, provided there’s a minimum gap of 3 days (72 hours) between doses. This guidance ensures you start your diabetes management journey safely, with room for adjustments to best suit your body's needs.

Mounjaro aids in weight management by curbing your appetite and slowing the journey of food through your digestive system, a process known as gastric emptying. This dual action helps you feel satiated longer, thereby reducing your overall food intake. Intriguingly, scientific studies suggest that this effect might also be linked to neurological processes in the brain. Many individuals between 45 and 75 have found success with Mounjaro, finding it a valuable tool in their path to healthier living.

Before starting this medication, it's crucial to evaluate whether it is suitable for you. Do not use this medicine if you:

Are Allergic: If you have any known allergies to tirzepatide or any other ingredients in this medication, it's best to avoid it.

Have Certain Cancer Histories: Those with a personal or family history of medullary thyroid carcinoma (a specific type of thyroid cancer) or multiple endocrine neoplasia type 2 (which involves tumors in the glands) should steer clear of this medicine. Inform your healthcare provider if you have experienced any of the following conditions:

Pancreatic Issues: Previous problems with your pancreas could be a red flag.

Kidney Disease: A history of kidney disease should be communicated to your doctor.

Severe Digestive Problems: Conditions such as gastroparesis, which involves difficulty in food digestion or delayed stomach emptying, need to be disclosed.

Diabetic Retinopathy: If you've had complications related to diabetes that affect your eyes, it’s essential to let your doctor know. Ensuring these factors are considered can help you and your healthcare provider make the best decision regarding the use of this medication.

Pregnancy: If you are pregnant, planning to become pregnant, or find out that you are expecting while taking this medication, it is crucial to inform your healthcare provider immediately. The effects of this medication on an unborn child are currently unknown.

Please be aware that this medication can reduce the effectiveness of birth control pills. Consult your doctor regarding alternative contraceptive methods such as injections, implants, skin patches, vaginal rings, condoms, diaphragms, cervical caps, or contraceptive sponges. You may need to use additional birth control measures for the first 4 weeks after beginning this medication and for 4 weeks after any dosage increase if you are on birth control pills.

Breastfeeding: Before using this medication, it's important to discuss breastfeeding with your healthcare provider if you are currently nursing or plan to do so. We don't yet know if tirzepatide is excreted in breast milk. Your healthcare provider can help you determine the safest and most suitable feeding options for your baby while you are on this medication.

If you experience any signs of thyroid issues, like a lump or swelling in your neck, hoarseness, difficulty swallowing, or shortness of breath, it's crucial to contact your doctor right away. Research involving rats has shown that tirzepatide and similar medications have led to the development of thyroid tumors, including thyroid cancer. However, it's still unclear whether Mounjaro will result in thyroid tumors or a specific type of thyroid cancer known as medullary thyroid carcinoma (MTC) in humans.

Avoid using this medicine if you or your family have a history of medullary thyroid carcinoma (MTC) or if you have a condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) Stay diligent with your medical appointments and any necessary lab tests. Your doctor may schedule specific tests to monitor how your body is reacting to this treatment.

Common Side Effects
When taking Mounjaro, some patients experience a range of side effects. The most frequent include nausea, diarrhea, reduced appetite, vomiting, constipation, indigestion, and abdominal pain, affecting about 5% or more of users.

Serious Side Effects
While these are common side effects, there are more serious reactions that require immediate medical attention. If you experience any of the following, stop using the medication and seek emergency help:

• Allergic Reactions: Symptoms such as hives, difficulty breathing, light-headedness, or swelling of the face, lips, tongue, or throat.
• Pancreatitis: Severe upper stomach pain spreading to your back, accompanied by nausea and vomiting.

When to Call Your Doctor
In addition to the above, contact your healthcare provider immediately if you notice:

• Severe Stomach Issues: Intense stomach discomfort or pain.
• Vision Changes: Blurred or fuzzy vision.
• Thyroid Tumors: Symptoms include swelling or a lump in the neck, difficulty swallowing, a hoarse voice, or shortness of breath.
• Gallbladder Problems: Signs such as chalky-colored stools, stomach pain after eating, nausea, heartburn, bloating, and severe upper stomach pain radiating to your back.
• Low Blood Sugar: Symptoms include headache, hunger, weakness, sweating, confusion, irritability, dizziness, rapid heartbeat, or feeling jittery.
• Kidney Problems: Little or no urination, swelling in feet or ankles, fatigue, or shortness of breath.

This list is not a complete list of possible Mounjaro side effects, other side effects may occur. Always consult your doctor for medical advice regarding side effects. Staying informed and vigilant about potential side effects can help ensure that your experience with Mounjaro is as safe as possible.

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