From the FDA Drug Label
- 1 Dosage The recommended starting dosage of MOUNJARO is 2.5 mg injected subcutaneously once weekly. Follow the dosage escalation below to reduce the risk of gastrointestinal adverse reactions [see Warnings and Precautions (5.6) and Adverse Reactions (6.1)]. The 2. 5 mg dosage is for treatment initiation and is not intended for glycemic control. After 4 weeks, increase the dosage to 5 mg injected subcutaneously once weekly.
The FDA drug label does not answer the question.
From the Research
Risks of Escalating Tirzepatide Dose
The decision to escalate the dose of tirzepatide, a dual GIP and GLP-1 receptor agonist, at week 3 instead of week 5 may pose several risks, including:
- Increased incidence of gastrointestinal adverse events (GI AEs) such as nausea, vomiting, diarrhea, and constipation, which are dose-dependent 1
- Higher rates of drug discontinuation due to adverse events, particularly with the 15 mg dose 1
- Potential for increased risk of hypoglycemia, although the incidence of severe hypoglycemia is extremely low 1
- Unknown long-term effects of earlier dose escalation on cardiovascular outcomes, although tirzepatide has been shown to reduce the risk of cardiovascular events in some studies 2, 3
Adverse Event Profile
The adverse event profile of tirzepatide is characterized by:
- Gastrointestinal AEs, which are the most commonly reported adverse events and are dose-dependent 1
- Nausea and diarrhea, which are the most frequent gastrointestinal AEs 1
- Drug discontinuation due to adverse events, which is highest with the 15 mg dose 1
- Low incidence of severe hypoglycemia, fatal adverse events, acute pancreatitis, cholelithiasis, and cholecystitis 1
Clinical Trial Data
Clinical trial data suggest that tirzepatide is effective in reducing HbA1c and body weight, and improving insulin sensitivity and lipid metabolism 2, 4, 5