Role of Tirzepatide®(Tirzacto) in Treatment
- Significant reduction in HbA1c and fasting blood glucose in patients with type 2 diabetes
- Meaningful weight reduction in overweight or obese individuals
- Improvement of cardiovascular and metabolic parameters such as blood pressure and blood cholesterol following weight loss
- Reduction in obstructive sleep apnea events
Unique Advantages of Tirzacto
- Effective glycemic control in patients with uncontrolled HbA1c as a first-line injectable therapy (provided that endogenous insulin production is not impaired)
- Significant weight reduction in obese individuals without increasing the risk of hypoglycemia
- The first and only approved medication for the treatment of obstructive sleep apnea in obese individuals
- Positive effects on HDL cholesterol, total cholesterol, and systolic blood pressure
- Improved patient adherence due to once-weekly administration
This medication was first developed under the brand name Mounjaro by Eli Lilly and Company in the United States.
Indications
- Significant reduction of blood glucose in patients with type 2 diabetes
- Significant weight reduction in individuals with obesity
- Improvement in obstructive sleep apnea treatment
Mechanism of Action
Tirzacto is a dual GLP-1 and GIP receptor agonist. By simultaneously enhancing insulin secretion, increasing satiety, and slowing gastric emptying, it helps reduce both body weight and blood glucose levels.
Dosage and Administration
Tirzepatide treatment is initiated at a dose of 2.5 mg once weekly for 4 weeks. Thereafter, the dose is gradually increased based on therapeutic response and patient tolerability to 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg once weekly. Each dose level is generally maintained for at least 4 weeks; however, the duration may be extended at the physician’s discretion. The maximum recommended dose of tirzepatide is 15 mg once weekly.
In general, the use of Tirzacto during pregnancy and breastfeeding is not recommended. Consultation with a specialist physician is advised.
If a dose of Tirzacto is missed, it should be administered as soon as remembered within 96 hours (4 days). If more than 4 days have passed, the missed dose should be skipped and the next dose administered on the regularly scheduled day.
Warnings
- If a patient plans to undergo surgery while using Tirzacto, the physician should be informed. Because Tirzacto delays gastric emptying, it may increase the risk of pulmonary aspiration during surgery. Therefore, the medication should be discontinued 48 hours before surgery.
- Patients with a history of gallstones or pancreatitis should inform their physician before using tirzepatide.
- In patients with a history of diabetic retinopathy, tirzepatide should be used with caution. Patients should be monitored for worsening or progression of diabetes-related ocular complications. In addition, this medication has not been fully studied in patients with proliferative diabetic retinopathy, diabetic retinopathy requiring urgent treatment, or diabetic macular edema.
Contraindications
This medication is contraindicated in individuals with a personal or family history of a specific type of thyroid cancer known as medullary thyroid carcinoma (MTC), or in patients with the genetic condition MEN2.
Drug Interactions
- Patients using oral hormonal contraceptives should use an alternative non-oral contraceptive method for 4 weeks after initiating Tirzacto and for 4 weeks after each dose escalation.
- If tirzepatide is used concurrently with sulfonylureas or insulin, these medications should be dose-adjusted by a physician due to the risk of hypoglycemia.
- By slowing gastric emptying, tirzepatide may alter the absorption of certain oral medications, especially drugs with a narrow therapeutic index such as Warfarin. Therefore, dose adjustment of these medications should be performed by a physician.
Adverse Effects
Tirzepatide may cause common side effects such as nausea, vomiting, diarrhea, constipation, dyspepsia, and abdominal pain.
Less common adverse effects include pancreatitis and acute kidney injury.
Packaging and Dosage Form
Each Tirzacto package contains 4 prefilled injection pens intended for single-use subcutaneous injection.
Storage Conditions for Tirzacto
- Tirzacto should be stored refrigerated at 2–8°C. If necessary, the pens may be kept at room temperature (up to 30°C) for a maximum of 21 days.
The medication should be stored in its original packaging, protected from direct light and freezing.
