Can I stop taking Soliqua (lixisenatide and insulin glargine) and start taking Mounjaro (tirzepatide) immediately?

Switching from Soliqua to Mounjaro: Transition Protocol

You can safely stop Soliqua and start Mounjaro immediately without a tapering period, but should monitor blood glucose closely during the transition. 1

Rationale for Direct Transition

• Soliqua contains lixisenatide (a GLP-1 receptor agonist) and insulin glargine, while Mounjaro (tirzepatide) is a dual GIP/GLP-1 receptor agonist with different pharmacokinetics 1, 2
• Tirzepatide has a long half-life of approximately 5 days, allowing for once-weekly dosing, compared to the daily dosing required for Soliqua 1
• Clinical evidence supports transitioning between injectable diabetes medications without tapering periods when moving from one class to another 1

Transition Protocol

1. Day of transition:

   • Take your last dose of Soliqua
   • Start Mounjaro at the initial recommended dose of 2.5 mg weekly 3, 4

2. Dose titration:

   • Maintain the 2.5 mg dose for 4 weeks
   • Then increase by 2.5 mg every 4 weeks until reaching the target dose (5 mg, 10 mg, or 15 mg) 5, 6

3. Blood glucose monitoring:

   • Check blood glucose levels more frequently during the first 1-2 weeks of transition (before meals and at bedtime) 7
   • Pay particular attention to fasting morning glucose levels 8

Important Considerations

• Hypoglycemia risk: The risk of hypoglycemia is significantly lower with Mounjaro compared to insulin-containing regimens like Soliqua (0.4 events per patient-year with tirzepatide vs. 4.4 events per patient-year with insulin) 6
• Gastrointestinal side effects: Be prepared for potential GI symptoms with Mounjaro, including nausea (14-26%), diarrhea (11-15%), and vomiting (5-13%), which are typically mild to moderate 5, 6
• Efficacy expectations: Expect improved glycemic control and potential weight loss with Mounjaro compared to insulin-based regimens 5, 6

Special Precautions

• Gastric emptying effects: Both medications affect gastric emptying, but tirzepatide may have more pronounced effects, so be aware of potential changes in medication absorption if taking other oral medications 1
• Perioperative considerations: If planning surgery, be aware that GLP-1 receptor agonists like Mounjaro should be discontinued 3-7 days before elective procedures due to effects on gastric emptying 1
• Contact provider if: You experience severe or persistent nausea/vomiting, signs of hypoglycemia, or if blood glucose readings are consistently outside target range 1, 7

Follow-up Recommendations

• Schedule follow-up with your healthcare provider within 2-4 weeks after transition to assess response and adjust treatment if needed 8
• Bring blood glucose logs to your appointment to help identify patterns and guide any necessary adjustments 8