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Tirzepatide

What is the FDA-approved use of tirzepatide?

Tirzepatide is FDA-approved for chronic weight management in adults with obesity (BMI of 30 kg/m2 or greater) or overweight (BMI of 27 kg/m2 or greater) with at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol. It is intended for use alongside a reduced-calorie diet and increased physical activity.

 

Mechanism of Action 

Tirzepatide activates receptors for intestinal hormones—glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)—leading to a decrease in appetite and food intake. This action regulates insulin production, reducing blood glucose levels, while the heightened GLP-1 and GIP levels influence the brain to diminish hunger and promote a sense of fullness.

 

Who should not use tirzepatide?

Do not use tirzepatide if you have a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2. Do not use tirzepatide if you have a history of severe allergic reactions to tirzepatide or any of its ingredients.

 

Boxed warning for serious effects:

Tirzepatide causes thyroid C-cell tumors in rats. It is unknown whether it causes similar tumors, including medullary thyroid cancer, in humans. Avoid tirzepatide use in patients with a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2.

 

What should I tell a provider before starting tirzepatide?

Ensure you disclose your entire medical history to your healthcare provider.  Be aware that withholding or providing inaccurate health and medical history to obtain treatment can have serious consequences, potentially including death.

  • Comorbidities:
    • Personal or family history of pancreas inflammation (pancreatitis) or severe gastrointestinal disease.
    • •Known hypersensitivity to tirzepatide
  • Pregnancy and special populations:
    • Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue tirzepatide.
    • Females and Males of Reproductive Potential: Discontinue tirzepatide at least 2 months before a planned pregnancy because of the long half-life of tirzepatide
  • Drug-interactions:
    • Tirzepatide delays gastric emptying. May impact absorption of concomitantly administered oral medications. Use with caution.

How should I use tirzepatide?

Administer tirzepatide by injection under the skin once weekly. The dosage must be increased over four to 20 weeks to achieve target dosages of 5 mg, 10 mg, or 15 mg once weekly. The maximum dosage is 15 mg once weekly.

What side effects should I be aware of?

Common side effects include nausea, diarrhea, vomiting, constipation, abdominal discomfort and pain, injection site reactions, fatigue, hypersensitivity reactions (typically fever and rash), burping, hair loss, and gastroesophageal reflux disease.

It is important to talk to your healthcare provider about any potential risks and benefits of taking tirzepatide, and to report any side effects or concerns promptly.

The above does not encompass all potential side effects, medication interactions, or studies related to tirzepatide. Unreported or yet undiscovered side effects might exist.

 

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