From the Guidelines
Tirzepatide is dosed subcutaneously once weekly, with a typical starting dose of 2.5 mg, which can be gradually increased in 2.5 mg increments every 4 weeks up to a maximum of 15 mg once weekly, based on glycemic control and tolerability, as supported by the most recent study 1. To use tirzepatide:
- Start with 2.5 mg weekly for 4 weeks
- Increase to 5 mg weekly for at least 4 weeks
- If needed, increase by 2.5 mg every 4 weeks up to 15 mg weekly Inject subcutaneously in the abdomen, thigh, or upper arm. Rotate injection sites with each dose. Administer on the same day each week, at any time of day, with or without meals. This gradual dose escalation helps minimize gastrointestinal side effects like nausea and vomiting. Tirzepatide works by activating GLP-1 and GIP receptors, improving insulin secretion, reducing glucagon, and slowing gastric emptying, which collectively improves blood glucose control in type 2 diabetes, with significant weight loss benefits as reported in a recent meta-analysis 1. Key considerations for tirzepatide use include:
- Potential for gastrointestinal side effects, which can be mitigated with slower dose titration and dietary modifications
- Impact on drug absorption, particularly for orally administered medications
- Contraindication in individuals with a history of pancreatitis or at high risk for pancreatitis
- Potential benefits for weight loss and glycemic control, as demonstrated in clinical trials 1.
From the Research
Dosing for Tirzepatide
The dosing for Tirzepatide, a dual GIP and GLP-1 receptor agonist, is as follows:
- Once-weekly subcutaneous injection of 5 mg, 10 mg, or 15 mg 2, 3, 4
- The dose is escalated by 2.5 mg every 4 weeks until the assigned dose is reached 4
- Tirzepatide is available as single-dose prefilled pens and single-dose vials 5
Key Findings
- The efficacy and safety of tirzepatide were assessed in phase 3 clinical trials (SURPASS 1-5) 2
- Tirzepatide has been shown to achieve better glycemic control and weight loss compared to other diabetic medications 2, 4
- The most common adverse events with tirzepatide were gastrointestinal, and most were mild to moderate in severity 2, 3, 4, 6
Study Results
- In the SURMOUNT-1 trial, tirzepatide provided substantial and sustained reductions in body weight in persons with obesity over a 72-week period 3
- In the SURPASS-3 trial, tirzepatide was superior to titrated insulin degludec in reducing HbA1c and body weight at week 52 4
- In the SURMOUNT-1 trial, 3 years of treatment with tirzepatide resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo 6