From the Guidelines
To write a prescription for Mounjaro (tirzepatide) 2.5 milligrams (mg) weekly, the prescription should be written as: "Tirzepatide 2.5mg subcutaneously once weekly".
Important Considerations
- The starting dose of tirzepatide is 2.5 mg weekly subcutaneously, as indicated in the study 1.
- Dosing and Administration: Tirzepatide is dosed subcutaneously once weekly, as stated in the study 1.
- Benefits and Monitoring: Improved waist circumference, glucose-dependent difference, and hemoglobin A1c are benefits of tirzepatide, and hydration is recommended if taking insulin or sulfonylurea, as mentioned in the study 1.
- Contraindications: Personal or family history of medullary thyroid carcinoma, or MEN type 2 are contraindications for tirzepatide, as indicated in the study 1.
- Common Side Effects: Nausea, diarrhea, vomiting, constipation, alopecia, and abdominal pain are common side effects of tirzepatide, as reported in the study 1.
- Safety Concerns: Pancreatitis, kidney disease, and cholelithiasis are possible safety concerns and considerations for tirzepatide, as mentioned in the study 1.
Key Points to Consider When Prescribing
- Black Box Warning: Risk of thyroid C-cell tumors in rodents; human relevance not determined, as stated in the study 1.
- Pregnancy and Contraception: Advise those using oral hormonal contraception to use or add a non-oral contraception method for 4 weeks after initiation and dose escalations, as recommended in the study 1.
- Drug Interactions: Monitor effects of oral medications with narrow therapeutic index (warfarin) or whose efficacy is dependent on threshold concentration, as mentioned in the study 1.
From the FDA Drug Label
The recommended starting dosage of MOUNJARO is 2.5 mg injected subcutaneously once weekly. Administer MOUNJARO once weekly, any time of day, with or without meals. Inject MOUNJARO subcutaneously in the abdomen, thigh, or upper arm. Rotate injection sites with each dose.
To write a prescription for Mounjaro (tirzepatide) 2.5 milligrams (mg) weekly, the prescription should be written as: Mounjaro 2.5 mg subcutaneously once weekly. The patient should be instructed to rotate injection sites and administer the dose at the same time each week, with or without meals, in the abdomen, thigh, or upper arm 2.
From the Research
Prescription Guidelines for Mounjaro (Tirzepatide)
To write a prescription for Mounjaro (tirzepatide) 2.5 milligrams (mg) weekly, consider the following:
- The typical starting dose of tirzepatide is 2.5 mg weekly, which can be escalated by 2.5 mg every 4 weeks until the assigned dose is achieved 3.
- The dose escalation schedule is as follows:
- Week 1-4: 2.5 mg weekly
- Week 5-8: 5 mg weekly
- Week 9-12: 10 mg weekly (if tolerated)
- Week 13 and beyond: 15 mg weekly (if tolerated) 3
- The prescription should include the patient's name, date, medication name (Mounjaro), dose (2.5 mg), frequency (weekly), and route of administration (subcutaneous injection).
- It is essential to monitor the patient's response to the medication and adjust the dose as needed to minimize adverse effects.
Important Considerations
- Tirzepatide is a dual GIP/GLP-1 receptor co-agonist, which has been shown to be effective in reducing HbA1c and body weight in patients with type 2 diabetes 4, 5.
- The most common adverse events associated with tirzepatide are gastrointestinal, including nausea, vomiting, diarrhea, and constipation 4, 5, 3.
- Patients should be educated on the proper use of the medication, including injection technique and dose escalation schedule.
Clinical Trials and Studies
- Several clinical trials have demonstrated the efficacy and safety of tirzepatide in patients with type 2 diabetes, including the SURPASS-1 to 5 trials 4 and the SURPASS-2 trial 5.
- Additionally, tirzepatide has been shown to be effective in reducing body weight in patients with obesity, as demonstrated in the SURMOUNT-1 trial 6.