Tirzepatide is emerging as a significant player in the treatment of obesity and overweight, offering a promising avenue for individuals seeking to manage their weight and improve related health conditions. This article delves into the details of tirzepatide, its mechanism of action, clinical trial results, usage guidelines, and important safety considerations.
Understanding Tirzepatide
Tirzepatide is a medication that has been approved by the Food and Drug Administration (FDA) under the brand name Zepbound for chronic weight management in adults with obesity (body mass index of 30 kg/m2 or greater) or overweight (body mass index of 27 kg/m2 or greater) who also have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol. It is intended to be used in conjunction with a reduced-calorie diet and increased physical activity. Tirzepatide is also FDA-approved under the brand name Mounjaro for the treatment of type 2 diabetes in adult patients, when used together with diet and exercise.
How Tirzepatide Works
Tirzepatide works by activating receptors for two hormones secreted by the intestine: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones play a crucial role in regulating appetite and food intake.
Normally, when we eat, natural hormones called GIP and GLP-1 are released by the gut. These hormones increase insulin release, suppress appetite, slow gastric emptying, and increase the feeling of fullness. Tirzepatide mimics these natural hormones, leading to:
- Decreased appetite: By interacting with areas in the brain that harbor GLP-1 receptors, tirzepatide signals satiety, helping individuals eat less.
- Slower gastric emptying: Tirzepatide slows down the movement of food from the stomach into the small intestine, which may make you feel full more quickly and for a longer period.
Clinical Trial Results: The SURMOUNT Studies
The effectiveness of tirzepatide for chronic weight management has been demonstrated in several randomized, double-blind, placebo-controlled trials. One notable study is the SURMOUNT-1 trial, which compared different doses of tirzepatide to a placebo.
Read also: Comprehensive guide: Tirzepatide and Semaglutide for weight management
In the SURMOUNT-1 clinical trial, patients on tirzepatide (Zepbound) 15mg weekly lost 23.6 kg (52.0 lb) on average after 72 weeks. For patients on the tirzepatide 10mg weekly dose, the average weight loss was 22.2 kg (48.9 lb), and for the tirzepatide 5mg weekly dose, patients lost 16.1 kg (35.5 lb) after 72 weeks. Patients who used a placebo lost 2.4 kg (5.3 lb) over the 72 weeks.
The SURMOUNT-4 trial investigated the long-term effects of tirzepatide. Participants took a maximum tolerated dose of tirzepatide for 36 weeks, which yielded the expected weight reduction of 20.9 percent with improvements in blood pressure, blood sugar metrics and lipid levels. Then participants were randomly assigned to either continue with the tirzepatide for an additional year (52 weeks) or to switch to a placebo. Those who continued on tirzepatide lost an additional 5.5 percent versus the placebo group which regained 14 percent of their weight.
These studies underscore the potential of tirzepatide to produce significant and sustained weight loss when combined with lifestyle modifications.
Dosage and Administration
Zepbound is administered once a week by subcutaneous (under the skin) injection. Your healthcare provider will show you how to do this and then you can administer the injection at home yourself or have a caregiver administer it for you. Your healthcare provider will tell you the correct dose of Zepbound to use.
The dosage must be increased over four to 20 weeks to achieve the target dosages of 5 milligram (mg), 10 mg or 15 mg once weekly.
Read also: Weight Loss Patterns with Tirzepatide 2.5 mg
If you miss a dose of tirzepatide, take the missed dose as soon as you remember it, if within 4 days after the missed dose. However, if it has been more than 4 days since your last dose, then skip the missed dose and continue your regular dosing schedule.
Important Safety Information
Before starting tirzepatide, it is crucial to discuss your medical history and any existing conditions with your doctor. Tirzepatide has several warnings and precautions that patients should be aware of:
- Thyroid C-cell tumors: Zepbound causes thyroid C-cell tumors in rats. It is unknown whether Zepbound causes such tumors, including medullary thyroid cancer, in humans. Tell your doctor if you have a personal or family history of thyroid cancer or a condition called Multiple Endocrine Neoplasia (MEN) syndrome.
- Pancreatitis: Inflammation of the pancreas (pancreatitis) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
- Gallbladder problems: Check with your doctor right away if you have gaseous stomach pain, indigestion, recurrent fever, severe nausea or vomiting, stomach fullness, or yellow eyes or skin. These may be symptoms of gallbladder problems (eg, cholelithiasis, cholecystitis).
- Hypoglycemia: This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use tirzepatide with other medicines, including insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.
- Kidney problems: This medicine may cause dehydration which can lead to acute kidney injury. Check with your doctor right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.
- Diabetic retinopathy: This medicine may cause diabetic retinopathy. Check with your doctor if you have blurred vision or any other changes in vision.
- Gastrointestinal issues: This medicine may cause severe stomach and bowel problems. Check with your doctor right away if you have stomach problems that are severe or will not go away.
- Mental health: This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed.
It is also important to inform your doctor about all medications, vitamins, and herbal supplements you are taking, as tirzepatide can interact with other drugs.
Potential Side Effects
As with any medication, tirzepatide can cause side effects. The most common side effects are related to the gastrointestinal system, such as nausea, vomiting, diarrhea, and constipation. These side effects are usually mild and temporary, and they often resolve with time.
Other potential side effects include:
Read also: Comprehensive Analysis: Tirzepatide and Semaglutide
- Abdominal pain
- Indigestion
- Fatigue
- Increased heart rate
If you experience any severe or persistent side effects, it is important to contact your doctor right away.
Special Considerations
- Pregnancy: Using this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away. If you are using birth control pills, your doctor may recommend another type of birth control for 4 weeks after you start using this medicine and after each increase in your dose.
- Alcohol: Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
- Other medicines: Do not take other medicines during the time you are using tirzepatide unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
Cost and Availability
The cost of tirzepatide (Zepbound brand) will depend on your insurance plan and which pharmacy you use.
It is also important to note that tirzepatide may not be available from a compounding pharmacy at this time. It has been removed from the FDA drug shortage list as of October 2, 2024.
Tirzepatide vs. Semaglutide
Both tirzepatide and semaglutide are prescription medicines used with diet and exercise to treat people with type 2 diabetes or to help people lose and maintain weight loss. Tirzepatide is a dual GIP and GLP-1 receptor agonist, while semaglutide is a GLP-1 receptor agonist.
The SURMOUNT-5 clinical trial compared tirzepatide with semaglutide for the treatment of obesity.
Lifestyle Modifications
Tirzepatide is most effective when used in conjunction with lifestyle modifications, such as a reduced-calorie diet and increased physical activity. It is important to work with your healthcare provider to develop a comprehensive weight management plan that includes these elements.
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