Tirzepatide
Brand: Mounjaro, Zepbound
Boxed warning
Thyroid C-cell tumors in rodents; contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2.
- Caution
- Pancreatitis, gallbladder disease, and slowed gastric emptying; reduces oral contraceptive absorption for 4 weeks after starting or increasing the dose.
- Storage
- Refrigerate; a pen or vial may be kept at room temperature (up to 86 F) for up to 21 days; protect from light and never freeze.
- Pregnancy
- May cause fetal harm based on animal data; used in pregnancy only if benefit justifies risk (Mounjaro); Zepbound is discontinued once pregnancy is recognized. Oral contraceptives are less reliable for 4 weeks after starting and after each dose increase.
Common side effects
- Nausea and vomiting
- Diarrhea
- Reduced appetite
- Injection-site reaction
Key interactions
- Slows gastric emptying: can alter absorption of oral drugs
- Additive low blood sugar with insulin or sulfonylureas
Counseling points
- Inject once weekly on the same day each week, with or without meals
- Rotate injection sites
- Nausea usually eases as the dose is stepped up
- Report severe, persistent abdominal pain
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