Tizma 10

Indications

Tirzepatide is a once-weekly injection used:

• with diet and exercise to improve blood sugar control in adults with type 2 diabetes;
• with a reduced-calorie diet and more physical activity for weight management in adults with obesity (body mass index, BMI, of 30 or more) or overweight (BMI of 27 or more) with at least one weight-related health problem such as high blood pressure, type 2 diabetes or sleep apnoea.

It is not used for type 1 diabetes.

How It Works

Tirzepatide acts like two natural gut hormones, GIP and GLP-1. It helps the pancreas release insulin when blood sugar is high, lowers glucagon (a hormone that raises blood sugar), slows the emptying of the stomach and reduces appetite, so people feel full sooner and eat less.

Dosage and Administration

Dose as prescribed by the doctor. Treatment usually starts with 2.5 mg once a week for 4 weeks (a starting dose to help the body adjust). The doctor then increases the dose in steps of 2.5 mg, no sooner than every 4 weeks, according to response and side effects. The maximum dose is 15 mg once a week.

• Inject under the skin of the stomach area, thigh or upper arm, on the same day each week, at any time, with or without food. Change the injection spot each week.
• Learn the injection technique from a doctor, nurse or pharmacist before the first dose.
• Missed dose: take it as soon as possible within 4 days (96 hours). If more than 4 days have passed, skip it and take the next dose on the usual day.
• Not for children unless prescribed by a specialist.

Interactions

With Insulin or sulfonylureas (such as Gliclazide or Glimepiride) the risk of low blood sugar rises, and the doctor may lower their dose. Because tirzepatide slows stomach emptying, it can change how some tablets are absorbed. Contraceptive pills may work less well: use a non-pill method or add a barrier method (such as condoms) for 4 weeks after starting and for 4 weeks after each dose increase. If you take Warfarin, your blood tests may need closer checks.

Contraindications

• Personal or family history of medullary thyroid cancer, or multiple endocrine neoplasia type 2 (MEN 2)
• Allergy to tirzepatide or any ingredient of the injection
• Pregnancy

Side Effects

Common, especially when starting or after a dose increase: nausea, diarrhoea, vomiting, constipation, stomach pain, indigestion, burping, reduced appetite, tiredness and redness or itching at the injection site. These usually ease with time. Eating smaller meals and stopping when full helps.

Get urgent medical help for severe stomach pain that does not go away, with or without vomiting, sometimes spreading to the back (possible pancreatitis); pain in the upper right belly, fever or yellow skin or eyes (gallbladder problems); a lump or swelling in the neck, trouble swallowing or a hoarse voice; signs of dehydration such as very little urine, dizziness or extreme thirst after vomiting or diarrhoea; a severe allergic reaction; low blood sugar that does not improve; or sudden changes in vision.

Pregnancy and Lactation

Do not use during pregnancy. Women who can become pregnant should use effective contraception, and treatment should be stopped at least 1 month before a planned pregnancy, as advised by the doctor. It is not known whether it passes into breast milk; it is not recommended while breastfeeding unless the doctor advises it.

Precautions and Warnings

• Tell your doctor about any past pancreatitis, gallbladder disease, severe stomach or bowel disease (such as gastroparesis), kidney disease or diabetic eye disease (retinopathy).
• Drink enough fluids, especially if you have vomiting or diarrhoea, to protect the kidneys.
• Tell the doctor or anaesthetist that you use tirzepatide before any surgery or procedure that needs sedation.
• Never share a pen or needle with anyone, even if the needle is changed.
• It does not replace a healthy diet and exercise.

Overdose

Too much may cause severe nausea, vomiting and low blood sugar. Because the medicine lasts a long time in the body, effects can continue for days. Seek medical help straight away.

Therapeutic Class

Dual GIP and GLP-1 receptor agonist (medicine for type 2 diabetes and weight management).

Storage

Store in a refrigerator at 2 to 8°C in the original carton to protect from light. Do not freeze, and do not use if it has been frozen. If needed, it may be kept unrefrigerated below 30°C for up to 21 days, or as stated on the pack. Keep out of the reach of children.