MOUNJARO 12,5 mg KWIKPEN

Indications

• Type 2 diabetes mellitus
• Obesity (as part of a comprehensive weight management program)

Dosage

Children: Refer to the BNF for Children for pediatric dosing recommendations.

Adults: Refer to current clinical guidelines for specific dosing recommendations. Generally, dosing is initiated at a low dose and titrated based on individual response and tolerability.

Mechanism of action

Tirzepatide acts as an agonist at both GIP and GLP-1 receptors. By activating these receptors, it stimulates insulin secretion from pancreatic beta cells in a glucose-dependent manner, reduces glucagon secretion from alpha cells, slows gastric emptying, and promotes satiety, ultimately leading to a reduction in blood glucose levels and body weight.

Pharmacodynamics

The pharmacodynamic effects of tirzepatide include increased insulin sensitivity, decreased hepatic glucose production, and improved glycemic control. It also leads to a significant reduction in body weight, which is beneficial for patients with type 2 diabetes who are often overweight or obese. The dual action of targeting both GIP and GLP-1 pathways provides complementary effects on glucose metabolism and appetite regulation.

Pharmacokinetics

Tirzepatide has a long half-life, allowing for once-weekly dosing. It is administered via subcutaneous injection and demonstrates a peak plasma concentration approximately 24 to 48 hours post-injection. The drug is primarily metabolized by proteolytic degradation, and its elimination half-life allows for stable and sustained levels in the bloodstream. The pharmacokinetics can be influenced by factors such as renal function, but specific adjustments for renal impairment are not typically required.

Contra-indications

• History of hypersensitivity to tirzepatide or any of its components
• Personal or family history of medullary thyroid carcinoma
• Multiple endocrine neoplasia syndrome type 2

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain
• Decreased appetite
• Injection site reactions
• Pancreatitis

Interactions

• Potentially increased risk of hypoglycemia when used with insulin or insulin secretagogues
• May affect the absorption of oral medications due to changes in gastric emptying
• Caution advised when used with other agents that affect gastrointestinal motility

Precautions

• Monitor for signs of pancreatitis
• Caution in patients with a history of gastrointestinal disease
• Not recommended for use in patients with severe renal impairment
• Assess for risk of hypoglycemia, especially in combination with other antidiabetic medications

Pregnancy

There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known if tirzepatide is excreted in human milk. Caution should be exercised when administered to a nursing woman.

Storage

Store in a refrigerator (2°C to 8°C). Do not freeze. Once in use, tirzepatide can be stored at room temperature (up to 30°C) for up to 21 days.

Formulations

• Subcutaneous injection solution