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What is Tirzepatide?
- Tirzepatide (Mounjaro) is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist used to improve blood sugar control in diabetes, in addition to diet and exercise.
What are the uses of Mounjaro?
- Tirzepatide (Mounjaro) is an injectable prescription medicine that is used along with diet and exercise to improve blood sugar in adults with type 2 diabetes mellitus.
Limitations of use:
- It is not known if Mounjaro can be used in people who have had pancreatitis.
- It is not for use in people with type 1 diabetes.
How does this medicine work?
- Tirzepatide is a GIP receptor and GLP-1 receptor agonist.
- It is a 39-amino-acid modified peptide with a C20 fatty diacid moiety that enables albumin binding and prolongs the half-life.
- Tirzepatide selectively binds to and activates both the GIP and GLP-1 receptors, the targets for native GIP and GLP-1.
- Tirzepatide enhances first- and second-phase insulin secretion, and reduces glucagon levels, both in a glucosedependent manner.
Who Should Not Use this medicine ?
This medicine cannot be used in patients who:
- have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- have had a serious allergic reaction to tirzepatide or any of the ingredients in Mounjaro.
What drug interactions can this medicine cause?
- Mounjaro may affect the way some medicines work, and some medicines may affect the way Mounjaro works. Before using Mounjaro, tell your healthcare provider if you are taking other medicines to treat diabetes including insulin or sulfonylureas which could increase your risk of low blood sugar.
- Mounjaro delays gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications.
Is this medicine FDA approved?
- Tirzepatide was approved for medical use in the United States in May 2022.
How should this medicine be used?
- The recommended starting dosage is 2.5 mg injected subcutaneously once weekly.
- After 4 weeks, increase to 5 mg injected subcutaneously once weekly.
- If additional glycemic control is needed, increase the dosage in 2.5 mg increments after at least 4 weeks on the current dose.
- The maximum dosage is 15 mg subcutaneously once weekly.
- Mounjaro is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm.
- Use Mounjaro 1 time each week, at any time of the day.
- You may change the day of the week you use Mounjaro as long as the time between the 2 doses is at least 3 days (72 hours).
- If you miss a dose of Mounjaro, take the missed dose as soon as possible within 4 days (96 hours) after the missed dose. If more than 4 days have passed, skip the missed dose and take your next dose on the regularly scheduled day. Do not take 2 doses of Mounjaro within 3 days of each other.
- Mounjaro may be taken with or without food.
- Do not mix insulin and Mounjaro together in the same injection.
- You may give an injection of Mounjaro and insulin in the same body area (such as your stomach area), but not right next to each other.
- Change (rotate) your injection site with each weekly injection. Do not use the same site for each injection.
What are the dosage forms and brand names of this medicine?
This medicine is available in fallowing doasage form:
- As Injection: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg per 0.5 mL in single-dose pen
This medicine is available in fallowing brand namesː
What side effects can this medication cause?
The most common side effects of this medicine include:
Mounjaro may cause serious side effects, including:
- Possible thyroid tumors, including cancer
- serious allergic reactions
- kidney failure
- severe stomach problems
- changes in vision
- gallbladder problems
What special precautions should I follow?
- Tirzepatide causes thyroid C-cell tumors in rats. Mounjaro is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.
- Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists. s. Discontinue promptly if pancreatitis is suspected.
- Patients receiving Mounjaro in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Reducing dose of insulin secretagogue or insulin may be necessary.
- Hypersensitivity reactions have been reported with Mounjaro. Discontinue Mounjaro if suspected.
- Mounjaro has been associated with gastrointestinal adverse reactions, which include nausea, vomiting, and diarrhea. Monitor renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions.
- Use of Mounjaro has been associated with gastrointestinal adverse reactions, sometimes severe. Mounjaro has not been studied in patients with severe gastrointestinal disease and is not recommended in these patients.
- Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Mounjaro has not been studied in patients with non proliferative diabetic retinopathy requiring acute therapy, proliferative diabetic retinopathy, or diabetic macular edema. Monitor patients with a history of diabetic retinopathy for progression.
- Acute events of gallbladder disease such as cholelithiasis or cholecystitis have been reported in GLP-1 receptor agonist. If cholelithiasis is suspected, gallbladder studies and clinical followup are indicated.
What to do in case of emergency/overdose?
Management of overdosage:
- In the event of an overdosage, contact Poison Control for latest recommendations.
- Appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms.
- A period of observation and treatment for these symptoms may be necessary, taking into account the half-life of tirzepatide of approximately 5 days.
Can this medicine be used in pregnancy?
- Available data with Mounjaro use in pregnant women are insufficient to evaluate for a drug-related risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes.
- Based on animal reproduction studies, there may be risks to the fetus from exposure to tirzepatide during pregnancy.
- Mounjaro should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Can this medicine be used in children?
- It is not known if Mounjaro is safe and effective for use in children under 18 years of age.
What are the active and inactive ingredients in this medicine?
- Active ingredient: tirzepatide
- Inactive ingredients: sodium chloride, sodium phosphate dibasic heptahydrate, and water for injection. Hydrochloric acid solution and/or sodium hydroxide solution may have been added to adjust the pH.
Who manufactures and distributes this medicine?
- Marketed by: Lilly USA, LLC Indianapolis, IN, USA
- Mounjaro is a trademark of Eli Lilly and Company.
What should I know about storage and disposal of this medication?
- Store Mounjaro in the refrigerator between 36⁰F to 46⁰F (2⁰C to 8⁰C).
- Store Mounjaro in the original carton until use to protect it from light.
- If needed, each single-dose pen can be stored at room temperature up to 86⁰F (30⁰C) for up to 21 days.
- Do not freeze Mounjaro.
- Do not use Mounjaro if frozen.
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