From the Research
Tirzepatide (Zepbound) for type 2 diabetes is typically initiated at 2.5 mg subcutaneously once weekly for the first 4 weeks, then increased to 5 mg weekly. The dose can be gradually increased in 2.5 mg increments every 4 weeks as needed and tolerated, up to a maximum dose of 15 mg once weekly, as supported by the study 1. Patients should inject the medication on the same day each week, and can change the day if needed as long as the last dose was administered at least 3 days (72 hours) prior. The medication should be administered in the abdomen, thigh, or upper arm. Some key points to consider when dosing tirzepatide include:
- Dose escalation should be guided by glycemic response and gastrointestinal tolerability, as nausea, vomiting, and diarrhea are common side effects, particularly during dose increases, as seen in the study 2.
- The gradual titration schedule helps minimize these gastrointestinal side effects.
- Tirzepatide works as a dual GIP/GLP-1 receptor agonist, which enhances insulin secretion, reduces glucagon levels, slows gastric emptying, and promotes satiety, making it effective for both glycemic control and weight management in type 2 diabetes, as shown in the study 3.
- The most recent study 4 suggests that tirzepatide has a positive impact on urine albumin-to-creatinine ratio (UACR) without detrimental effects on estimated glomerular filtration rate (eGFR) in subjects with type 2 diabetes and obesity without type 2 diabetes, with a reassuring renal safety profile. However, it's essential to consider the individual patient's response and adjust the dose accordingly, as recommended in the study 5. Overall, the recommended dosing regimen for tirzepatide (Zepbound) in patients with type 2 diabetes should prioritize minimizing adverse effects while reducing glycemia and weight, as suggested by the study 1.