From the Research
The initial dose of Zepbound (tirzepatide) for the treatment of type 2 diabetes is 2.5 mg injected subcutaneously once weekly for the first 4 weeks. This starting dose is intentionally lower than the therapeutic dose to allow the body to adjust to the medication and minimize gastrointestinal side effects such as nausea, vomiting, and diarrhea, which are common with this class of medications 1. After the initial 4 weeks at 2.5 mg, the dose should be increased to 5 mg once weekly. Further dose increases can be made in 2.5 mg increments every 4 weeks until the maximum recommended dose of 15 mg once weekly is reached, based on glycemic response and tolerability.
Key Considerations
- Patients should administer Zepbound on the same day each week, but the day can be changed if needed as long as the last dose was given at least 3 days prior.
- The medication should be injected into the abdomen, thigh, or upper arm, and injection sites should be rotated.
- If a dose is missed, patients should administer it as soon as possible within 4 days after the missed dose, then resume their regular weekly schedule.
Rationale
The dosing regimen is based on the most recent and highest quality study available, which demonstrated the efficacy and safety of tirzepatide in patients with type 2 diabetes 1. The study showed that tirzepatide at 5-15 mg per week reduces both HbA1c and body weight by amounts unprecedented for a single agent.
Additional Information
- Tirzepatide is a dual GIP/GLP-1 receptor co-agonist, which has been shown to have a more profound effect on glycemic control and weight reduction compared to selective GLP-1 receptor agonists 1.
- The medication has been found to improve insulin sensitivity and insulin secretory responses to a greater extent than semaglutide, and this was associated with lower prandial insulin and glucagon concentrations 1.