What patient education is required for initiating Mounjaro (tirzepatide) therapy, including proper administration, side effects, and lifestyle modifications?

Patient Education on Mounjaro (Tirzepatide): Side Effects and Administration

Patients starting Mounjaro (tirzepatide) should be educated on proper administration techniques, common side effects, and lifestyle modifications to maximize effectiveness and minimize adverse events.

Administration Instructions

• Mounjaro is administered as a once-weekly subcutaneous injection using single-dose prefilled pens 1
• The starting dose is typically 2.5 mg weekly, with gradual titration to higher doses (up to 15 mg) based on glycemic control and tolerability 2
• Patients should be taught proper injection technique, including:
  • Rotating injection sites to prevent lipohypertrophy
  • Proper disposal of used needles
  • Storage requirements (protection from light and heat) 3
• Missed doses should be administered as soon as possible if within 4 days; otherwise, wait until the next scheduled dose 1

Common Side Effects

• Gastrointestinal effects are the most common side effects and include:
  • Nausea (31% of patients)
  • Diarrhea (23% of patients)
  • Vomiting (12% of patients)
  • Constipation (5% of patients)
  • Abdominal pain (5% of patients) 2
• These side effects are typically mild to moderate and tend to decrease over time with continued use 1
• Other potential side effects include:
  • Decreased appetite
  • Alopecia/hair loss (6% of patients) 2
  • Fatigue
  • Headache 1

Serious Side Effects Requiring Medical Attention

• Patients should be educated to seek immediate medical attention for:
  • Severe abdominal pain that may radiate to the back, with or without vomiting (potential pancreatitis) 4
  • Signs of hypoglycemia, especially if taking insulin or sulfonylureas concurrently 2
  • Severe allergic reactions
  • Persistent severe gastrointestinal symptoms 1, 4

Precautions and Contraindications

• Mounjaro is contraindicated in patients with:
  • Personal or family history of medullary thyroid carcinoma
  • Multiple Endocrine Neoplasia syndrome type 2 2
• Caution should be exercised in patients with:
  • History of pancreatitis
  • Gallbladder disease (as tirzepatide may increase risk of gallstone formation)
  • Severe gastrointestinal disease 4
• Patients should be informed about potential delayed gastric emptying, which may affect the absorption of oral medications 2

Lifestyle Modifications and Monitoring

• Patients should be encouraged to:
  • Follow a healthy diet and increase physical activity levels to maximize benefits 5, 6
  • Monitor blood glucose regularly if diabetic
  • Stay well-hydrated, especially if experiencing gastrointestinal side effects 2
  • Attend regular follow-up appointments for monitoring of effectiveness and side effects
• Weight loss expectations should be discussed (potential for 15-20% weight reduction with the highest dose) 2

Special Considerations

• For patients undergoing surgery:
  • Inform all healthcare providers about Mounjaro use
  • May need to temporarily discontinue before procedures due to effects on gastric emptying 2
• Drug interactions should be discussed, particularly with medications that require specific timing relative to meals 2
• Cost considerations and insurance coverage should be addressed, as Mounjaro can be expensive 2

Managing Side Effects

• For nausea and vomiting:
  • Eat smaller, more frequent meals
  • Avoid fatty or spicy foods
  • Stay hydrated
  • Take medication as prescribed (gradual dose titration helps minimize these effects) 1
• For constipation:
  • Increase fluid and fiber intake
  • Regular physical activity
  • Consider stool softeners if needed 4

By providing comprehensive education on Mounjaro administration, side effects, and lifestyle modifications, healthcare providers can help patients maximize the benefits of this medication while minimizing adverse effects.