What is the recommended protocol for switching from Ozempic (semaglutide) to Mounjaro (tirzepatide)?

From the Guidelines

When switching from Ozempic (semaglutide) to Mounjaro (tirzepatide), patients should discontinue Ozempic and start Mounjaro at the initial dose of 2.5 mg or 5 mg once weekly, as no dose change is necessary according to the pharmacokinetics of both medications 1. The transition from Ozempic to Mounjaro should be done after the final dose of Ozempic, with no overlap between medications, to avoid potential additive effects.

• Key considerations during the transition include:
  • Monitoring for gastrointestinal side effects such as nausea, vomiting, and diarrhea, which can be managed with adequate hydration and smaller, more frequent meals.
  • Blood glucose monitoring to adjust for potential fluctuations in glycemic control.
• The mechanism of action of Mounjaro, which works through both GLP-1 and GIP receptors, differs from Ozempic, which acts only on GLP-1 receptors, supporting the need for careful dose initiation and monitoring 1.
• According to the most recent evidence, the pharmacokinetics of tirzepatide (Mounjaro) and semaglutide (Ozempic) suggest that no dose adjustment is necessary when switching from one medication to the other, with both having a similar administration route and elimination half-life 1.
• The dose of Mounjaro can be increased based on clinical response and tolerance, up to the maximum approved dose of 15 mg weekly, with increments of 2.5 mg every 4 weeks if necessary and tolerated.

From the Research

Switching from Ozempic to Mounjaro

There is limited information available on the specific protocol for switching from Ozempic (semaglutide) to Mounjaro (tirzepatide). However, based on the available studies, here are some key points to consider:

• Efficacy and Safety: Studies have shown that tirzepatide is more effective than semaglutide in reducing HbA1c and body weight in patients with type 2 diabetes 2, 3, 4.
• Dosing and Administration: Tirzepatide is administered subcutaneously once weekly, similar to semaglutide. The recommended doses of tirzepatide are 5 mg, 10 mg, and 15 mg once weekly 2, 3, 4.
• Switching Protocol: There is no established protocol for switching from semaglutide to tirzepatide. However, based on the available studies, it is likely that patients can be switched from semaglutide to tirzepatide without a washout period. The dose of tirzepatide can be titrated based on the patient's response to treatment and tolerability 2, 3, 4.
• Monitoring and Follow-up: Patients switching from semaglutide to tirzepatide should be closely monitored for changes in blood glucose control, weight, and adverse events such as gastrointestinal symptoms 2, 3, 4.

Key Considerations

• Gastrointestinal Adverse Events: Both semaglutide and tirzepatide can cause gastrointestinal adverse events such as nausea, diarrhea, and vomiting. Patients should be advised to report any adverse events to their healthcare provider 2, 3, 4.
• Hypoglycemia: Tirzepatide can cause hypoglycemia, especially when used in combination with other glucose-lowering medications. Patients should be advised to monitor their blood glucose levels regularly and report any symptoms of hypoglycemia to their healthcare provider 2, 3, 4.
• Weight Loss: Tirzepatide can cause significant weight loss, which may be beneficial for patients with obesity or overweight. However, patients should be advised to follow a healthy diet and exercise regimen to maintain weight loss over time 5.

Some key points to consider when switching from Ozempic to Mounjaro include:

• The patient's current dose of semaglutide and their response to treatment
• The patient's medical history, including any history of gastrointestinal disease or hypoglycemia
• The patient's current medications, including any other glucose-lowering medications or medications that may interact with tirzepatide
• The patient's lifestyle, including their diet and exercise habits.