Starting Dose of Mounjaro (Tirzepatide)
The starting dose of Mounjaro (tirzepatide) is 2.5 mg administered subcutaneously once weekly. 1
Dosing Schedule and Titration
- Tirzepatide therapy begins with 2.5 mg weekly subcutaneous injections for the first 4 weeks 1
- After 4 weeks at the initial dose, tirzepatide should be increased to 5 mg once weekly 1
- Further dose escalations can occur based on clinical response and tolerability:
Administration Considerations
- Tirzepatide is administered as a subcutaneous injection once weekly 1
- The injection can be given at any time of day, regardless of meals 1
- No dose adjustments are required for patients with renal impairment 1
Side Effect Management
- The gradual dose escalation schedule is designed to minimize gastrointestinal side effects, which are the most common adverse events 2
- Common side effects include:
- Nausea (10-31%, dose-dependent)
- Diarrhea (7-23%)
- Vomiting (2-12%)
- Constipation (3-5%)
- Abdominal pain (3-5%) 1
Clinical Considerations
- Starting at the 2.5 mg dose and following the recommended titration schedule is crucial to improve gastrointestinal tolerability 2
- Tirzepatide has dual agonistic activity on GIP and GLP-1 receptors, which contributes to its efficacy for both glycemic control and weight management 3
- The medication has demonstrated superior weight loss compared to semaglutide in clinical trials (20.2% vs 13.7% at maximum doses) 4
Important Precautions
- Monitor for signs of pancreatitis and discontinue if suspected 1
- Use caution in patients with kidney disease when initiating or increasing the dose due to potential risk of acute kidney injury 1
- Tirzepatide carries a black box warning regarding the risk of thyroid C-cell tumors in rodents (human relevance not determined) 1
- Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia type 2 1