Tirzepatide Dosing Guidelines

Effective Date: January 2025

Important Notice: This guide is for informational purposes only. Always talk to your doctor before starting or changing any medication.

1. What is Tirzepatide?

Tirzepatide is a medication used to help manage type 2 diabetes and support weight loss in adults who are overweight or have obesity along with other health issues like high blood pressure or high cholesterol.

2. When is Tirzepatide Used?

• Type 2 Diabetes:
• • Helps control blood sugar levels.
  • Can be used alone or with other diabetes medications.
• Weight Loss:
• • For adults with a Body Mass Index (BMI) of 30 or higher (obesity).
  • For those with a BMI of 27 or higher (overweight) plus at least one weight-related health problem (like high blood pressure or diabetes).

3. How to Take Tirzepatide

A. For Type 2 Diabetes

Starting Dose:

• 2.5 mg injected under the skin once a week.
• • Note: This initial dose helps your body get used to the medication and doesn’t control blood sugar.

Increasing the Dose:

• After 4 weeks, increase to 5 mg once a week.
• After another 4 weeks, you might increase to 7.5 mg once a week if needed and if you’re handling it well.

Regular Dose:

• 7.5 mg once a week.
• If you need better blood sugar control and tolerate 7.5 mg, your doctor might increase it to 10 mg once a week.
• The dose can be further increased to a maximum of 15 mg once a week based on your needs and how well you tolerate the medication.

How to Take It:

• Take it on the same day every week, with or without food.
• Don’t take more than one dose in a week.
• Change the injection spot each week (belly, thigh, or upper arm) to avoid skin issues.

B. For Weight Loss

Starting Dose:

• 2.5 mg injected under the skin once a week for the first 4 weeks.

Increasing the Dose:

• After 4 weeks, increase to 5 mg once a week for the next 4 weeks.
• After another 4 weeks, increase to 7.5 mg once a week.
• You can keep increasing by 2.5 mg every 4 weeks if needed, up to 15 mg once a week.

Regular Dose:

• 15 mg once a week, following the same schedule for increases.

How to Take It:

• Take it on the same day every week, with or without food.
• Change the injection spot each week (belly, thigh, or upper arm).

4. Special Considerations

• Kidney Problems:
• • Usually no need to change the dose.
  • Be careful if you have severe kidney issues.
• Liver Problems:
• • Use carefully if you have moderate or severe liver issues.
• Older Adults:
• • No dose changes needed, but watch for side effects.
• Children:
• • Not approved for use in kids as of October 2023. Check with your doctor for updates.

5. Who Should Not Take Tirzepatide & Safety Tips

• Do Not Take If:
• • You or your family have a history of a certain thyroid cancer (medullary thyroid carcinoma).
  • You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • You’re allergic to tirzepatide or any ingredients in the medicine.
• Use Carefully If:
• • You’ve had pancreatitis (inflammation of the pancreas).
  • You have eye problems related to diabetes.
  • You have a history of thyroid tumors.

6. Possible Side Effects

Common Side Effects:

• Upset stomach (nausea, vomiting, diarrhea, constipation)
• Feeling less hungry
• Indigestion
• Tiredness
• Redness or irritation where you injected

Rare but Serious Side Effects:

• Pancreatitis (severe stomach pain)
• Eye problems related to diabetes getting worse
• Tumors in the thyroid gland

7. What to Monitor

• For Diabetes:
• • Check your blood sugar levels regularly.
  • Have your HbA1c (a measure of blood sugar control) checked every 3 months.
  • Watch for signs of low blood sugar, especially if you’re also taking insulin or other diabetes meds.
• For Weight Loss:
• • Keep track of your weight loss.
  • Check for any nutritional deficiencies.
  • Watch for any side effects regularly.

8. Storing Tirzepatide

• Keep unopened pens in the fridge.
• Once you start using a pen, you can keep it at room temperature or in the fridge, but use it within the time specified on the label.
• Protect it from light and don’t freeze it.

9. Patient Education

Helping you understand how to use tirzepatide properly is key to your success. Here’s what you need to know:

A. How to Inject Tirzepatide Correctly

• Before You Start:
• • Check the pen for any damage or discoloration.
  • Make sure the medicine looks clear. Don’t use it if it’s cloudy or has particles.
• Steps to Inject:
• 1. Wash your hands with soap and water.
  2. Take off the pen cap and make sure the dose is correct.
  3. Clean the area where you’ll inject (belly, thigh, or upper arm) with an alcohol wipe and let it dry.
  4. Pinch your skin lightly and insert the needle at a 45- to 90-degree angle.
  5. Press and hold the injection button until the dose counter goes back to zero.
  6. Pull out the needle and throw it away safely in a sharps container.
• Changing Injection Spots:
• • Use a different spot each week to avoid skin problems.
  • Don’t inject where you have scars, moles, or a lot of hair.

B. Why It’s Important to Stick to Your Schedule

• Be Consistent:
• • Take tirzepatide on the same day each week to keep the medicine working well.
• Set Reminders:
• • Use a weekly reminder or link your injection to something you do every week to help you remember.
• If You Miss a Dose:
• • Take it as soon as you remember within 5 days after the missed dose.
  • If more than 5 days have passed, skip the missed dose and go back to your regular schedule.
  • Don’t take two doses close together.

C. Understanding Side Effects and When to Get Help

• Common Side Effects:
• • You might feel nauseous, throw up, have diarrhea or constipation, or not feel as hungry.
  • These usually get better as your body gets used to the medicine.
• Handling Side Effects:
• • Eat smaller, more frequent meals.
  • Drink plenty of water to help with stomach issues.
• Serious Side Effects:
• • Pancreatitis: Severe belly pain that might spread to your back, vomiting, and high pancreatic enzymes.
  • Eye Problems: Worsening vision, eye pain, or other vision changes.
  • Thyroid Issues: A lump in your neck, trouble swallowing, or shortness of breath.
  • Allergic Reactions: Rash, itching, swelling, severe dizziness, or trouble breathing.
• What to Do:
• • Get medical help right away if you experience any serious side effects.

D. Making Lifestyle Changes to Boost Results

• Healthy Eating:
• • Eat a balanced diet with lots of vegetables, fruits, lean proteins, and whole grains.
  • Cut back on sugary drinks, fatty foods, and processed snacks.
• Stay Active:
• • Aim for at least 150 minutes of moderate exercise each week, like walking, swimming, or biking.
  • Do strength training exercises at least twice a week.
• Behavior Tips:
• • Keep a food and activity diary to track your progress.
  • Consider working with a dietitian or fitness expert for a personalized plan.
• Support for Weight Loss:
• • Join support groups or counseling to help with the emotional and psychological parts of losing weight.

E. Keep Up with Doctor Visits

• Regular Check-Ups:
• • Go to your scheduled appointments to check how well the treatment is working and adjust the dose if needed.
• Blood Tests:
• • Have regular blood tests, including HbA1c and kidney function tests, to monitor your health and the effects of the medication.
• Stay in Touch:
• • Let your doctor know if you have any concerns or problems with your medication.

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