Mounjaro dosage – 5 useful dose tips you need to know

MOUNJARO DOSAGE HIGHLIGHTS

1. Mounjaro dosage is generally recommended to start with 2.5 mg once a week.
2. After 4 weeks, doctors may increase the dose to 5 mg if the desired results are not achieved.
3. It is administered by subcutaneous injection.
4. Missed dose should be taken within 96 hours (4 days)
5. The maximum recommended dosage is 15 mg subcutaneously.

MOUNJARO DOSAGE –

Mounjaro Dosage Forms –

Mounjaro dosage forms are 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg per 0.5 mL in a single-dose pen.

The recommended starting dose is 2.5 mg. This dose is for treatment initiation and not for glycemic control.

After 4 weeks, doctors generally increase the dose to 5 mg for the next week.

Dose should be adjusted by the doctor after continuous patient glycemic monitoring to achieve the desired results.

Mounjaro missed dose-

The patient should inject the missed dose within 96 hours (4 days) of the missed dose.

If 4 days have passed, then skip the missed dose and inject your medicine on the next regularly scheduled day.

Mounjaro injection sites-

Inject Mounjaro subcutaneously in the abdomen, thigh, or upper arm.

It can be injected with or without food and at any time of day.

Rotate the injection site with each dose.

Never mix Mounjaro and insulin. Mounjaro and insulin can be used in the same body region, but should not be adjacent to each other.

Inspect Mounjaro visually before injecting, and it should be colorless to slightly yellow. Do not use Mounjaro if particulate matter or discoloration is seen.

Mounjaro

What is Mounjaro (Tirzepatide)?

Mounjaro or Tirzepatide is a GIP receptor and GLP-1 receptor agonist. It enhances the first and second phase insulin secretion and reduces glucagon levels.

It reduces the fasting and postprandial blood sugar concentration.

It is a 39 amino acid modified peptide with a C20 fatty diacid moiety that enables albumin binding and prolongs the half-life.

It selectively binds to and activates both GIP and GLP-1 receptors.

It is a clear, colorless to slightly yellow, sterile, preservative-free solution for subcutaneous use.

It comes in a 0.5 ml solution single-dose pen.

How Tirzepatide Works?

It lowers fasting and postprandial glucose concentration, decreases food intake, and reduces body weight in patients with type 2 diabetes mellitus.

Insulin sensitivity –

This medicine increases insulin sensitivity, thus helping in controlling sugar levels in diabetic patients.

Glucagon secretion –

It reduces fasting and postprandial glucagon concentration. When glucagon concentration is decreased then glucose production in liver is reduced too which helps to maintain blood sugar levels.

Gastric Emptying –

It delays gastric emptying, and this delay is largest after the first dose, and the effect slowly diminishes with the next dose.

This delay in gastric emptying results in reduced hunger and slowly leads to weight loss in type 2 diabetic patients.

How to Store –

1. Store your pen in the refrigerator between 36°F to 46°F.
2. You may store your pen at room temperature up to 86°F (30°C) for up to 21 days.
3. Do not freeze your pen, and if it is frozen, then throw away your pen and use a new pen.
4. Store your pen in the original carton to protect your pen from light.
5. Keep the medicine away from the children.

Mounjaro warning and precautions –

Risk of Thyroid C-cell tumors-

In both sexes of rats, a dose-dependent and treatment duration-dependent increase in the incidence of Thyroid C-cell tumors (adenoma and carcinoma) was seen.

This medicine is contraindicated in patients with a personal or family history of MTC (medullary thyroid carcinoma) or in patients with MEN 2 ( multiple endocrine neoplasia type 2).

Pancreatitis

Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists.

After initiation of the treatment, observe the patient carefully for signs and symptoms of pancreatitis, such as persistent severe abdominal pain, sometimes radiating to the back, which may or may not be accompanied by vomiting.

If pancreatitis is suspected, then this medicine should be stopped and the patient should be treated appropriately for pancreatitis.

Hypoglycemia when used with insulin or insulin secretagogues-

Patients using this medicine in combination with insulin secretagogues (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia.

Doctors should adjust the medicine and insulin dose to prevent hypoglycemia.

Other warning and precautions –

1. Hypersensitivity reaction- These reactions have been reported, such as eczema and urticaria. Anaphylaxis and angioedema have been reported with GLP-1 receptor agonists.
2. Severe Gastrointestinal Disease – Nausea, vomiting, Diarrhoea, and Flatulence can be observed in some patients, especially during the start of the treatment.
3. Acute Kidney Injury- Sometimes severe dehydration, especially if not treated, can lead to acute Kidney injury.
4. Diabetic Retinopathy – Rapid improvement of glucose control has been associated with temporary worsening of diabetic retinopathy.
5. Acute Gall bladder disease- Acute events of Gall bladder disease, cholelithiasis or cholecystitis have been reported in patients with GLP-1 receptor agonist. It is important to keep monitoring the patient to detect the problem as early as possible.

Can anybody take Mounjaro?

1) Pregnancy –

Available data are insufficient to evaluate the use of this medicine in pregnant women. Based on available data from animal reproduction studies, there may be a risk to the fetus from exposure to this medicine during pregnancy.

It should be used in pregnancy only if the potential benefits justify the potential risk to the fetus.

Poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, spontaneous abortion, preeclampsia, preterm delivery, and delivery complications.

Fetuses can suffer from major birth defects, stillbirth, and macrosomia-related morbidity in uncontrolled diabetic pregnant women.

2) Lactation-

There are no data on the presence of Mounjaro in animal or human milk, the effect on breastfed infant or the effect on milk production.

Use of this medicine during lactation should justify the potential benefits to the mother’s diabetic condition over the risk of lactation.

3) Oral Hormonal contraceptives-

This medicine may reduce the efficacy of oral hormonal contraceptives due to delayed gastric emptying, especially after the first dose of tirzepatide.

Patients can be advised by the doctor to switch from oral hormonal contraceptives to non-oral contraceptive methods or barrier methods of contraception for 4 weeks after the initiation of the medicine and 4 weeks after the dose escalation.

4) Pediatric Use-

The safety and efficacy of this medicine have not been established in patients younger than 18 years of age.

5) Other conditions –

1. Geriatric use- No overall difference in safety or efficacy in younger and geriatric patients was detected, but greater sensitivity to this medicine in older patients can not be ruled out.
2. Renal impairment – No dose adjustment is required, but monitoring of renal function is important.
3. Hepatic impairment – No dose adjustment is required.

What to know before taking Mounjaro –

Do not use this medicine if –

1. You or any of your family members have ever had a type of thyroid cancer called Medullary thyroid carcinoma, or if you have an endocrine system condition called Multiple endocrine neoplasia syndrome type 2 (MEN2).
2. You had a serious allergic reaction to this medicine.

Before using this medicine, inform your doctor about-

1. Kidney or pancreas problem, or had a kidney or pancreas-related disease.
2. Severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food.
3. History of Diabetic retinopathy.
4. Pregnancy or planning to get pregnant.
5. Taking oral hormonal contraceptive pills.
6. Breastfeeding or planning to breastfeed.
7. Insulin or any sulfonylurea, as it could lead to hypoglycemia if the dose is not properly adjusted.