Tirzepatide belongs to a group of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptides (GIP). It is used alone or with other medications to improve blood glucose (sugar) levels for people with type 2 diabetes. It works by helping your body make more insulin and control blood glucose levels.

Diabetes medications such as tirzepatide are used when diet, exercise, weight reduction, and medications such as metformin, glyburide, or insulin have not been found to lower blood sugar levels well enough on their own. It works by helping your body make more insulin and control blood glucose levels.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all the forms or approved for all the conditions discussed here. As well, some forms of this medication may not be used for all the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended starting dose of this medication is 2.5 mg injected subcutaneously (under the skin) in the thigh, abdomen, or upper arm once a week. After 4 weeks, the dose increases to 5 mg injected once a week. Depending on how well this medication works for you, your doctor may increase your weekly dose to a maximum of 15 mg once a week.

This medication is clear and colourless to slightly yellow, and should not contain particles. Do not use it if the solution appears cloudy or coloured.

It may be injected at any time of day, without regard to meals.

This medication is available as a single use vial. Review the information provided with the vial for instructions on how to administer the medication. If you are not sure how to use this medication, talk to your doctor, pharmacist, or diabetes nurse. Do not attempt to prepare or inject this medication on your own until you completely understand how to mix and inject a dose.

Use a different injection site for each dose. You should avoid injecting this medication into an area of skin that is sore, red, infected, or otherwise damaged. If you are having difficulty giving yourself injections, talk to your health care provider.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose and it has been 4 days (96 hours) or less since the missed dose, inject the dose as soon as possible and continue with your regular schedule. If it is more than 96 hours since your last dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you need to change the day of the week that you take this medication, leave at least 3 days between doses.

Store this medication in the refrigerator, protect it from light, and do not allow it to freeze. Keep this and all other medications out of the reach of children. It may be stored at room temperature for up to 21 days, if necessary. Vials are for single use only. Discard any medication remaining in the vial after using a dose.

Each single dose vial containing 0.5 mL of clear-and-colourless-to-slightly-yellow solution that is particle free, contains 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg of tirzepatide. Nonmedicinal ingredients: hydrochloric acid, sodium chloride, sodium hydroxide solution, sodium phosphate dibasic heptahydrate, and water for injection.

Do not take this medication if you:

• are allergic to tirzepatide or any ingredients of the medication
• are pregnant
• are breast-feeding
• have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body)
• have a personal or family history of thyroid cancer

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary, or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• belching (burping)
• bruising, pain, or irritation at the injection site
• constipation
• decreased appetite
• diarrhea
• fatigue
• gas
• heartburn
• nausea
• stomach bloating
• stomach pain
• vomiting
• weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• increased heart rate
• symptoms of gallbladder problems (e.g., severe abdominal pain, yellowed skin, high fever with chills)
• symptoms of kidney failure (e.g., dark yellow, strong-smelling urine, extreme thirst, dizziness, or light headedness)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe low blood sugar (e.g., disorientation, loss of consciousness, seizures)

• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea, and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Heart problems: This medication may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease or an abnormal heart rhythm (e.g., heart block or fast heart rate), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood sugar (hypoglycemia): This medication may cause low blood sugar when it is used with sulfonylureas (e.g., glyburide, gliclazide) or insulin. If you are taking any of these types of medications, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling of the tongue or lips, contact your doctor. Your doctor may need to adjust the dose of your medication(s).

Pancreatitis (inflammation of the pancreas): Tirzepatide may cause pancreatitis that can be serious or life-threatening. If you experience symptoms of pancreatitis such as severe and persistent abdominal pain that may move to your back and may be accompanied by vomiting, stop taking this medication and contact your doctor or get immediate medical attention.

If you have previously had pancreatitis, gallstones, or alcohol use problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Risk of thyroid cancer: In rare cases, people have developed thyroid cancer while using medications similar to tirzepatide. People with a personal or family history of thyroid cancer or people who have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body) should not use this medication. If you develop difficulty swallowing or breathing, hoarseness or notice a mass developing in your neck, contact your doctor as soon as possible.

Vision: Diabetic retinopathy is a complication of diabetes that results from uncontrolled blood glucose levels. When blood glucose levels are brought under control quickly, symptoms of retinopathy may become worse for a short period of time. If you experience vision changes with the use of tirzepatide, talk to your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Perople who may become pregnant should use a barrier method of birth control. Tirzepatide should be stopped at least 1 month before a planned pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if tirzepatide passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.