Tirzepatide

MOUNJARO

Open Tirzepatide in the interactive console ↗

Pronunciation: tir-ZEP-a-tide

Tirzepatide ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Tirzepatide ballicule

Tirzepatide MOUNJARO mascot mnemonic cartoon — Visual mnemonic: Tirzepatide mascot
**“Tear zeppelin (over) Mount ‘jaro”**
Tide pod → GLP-1 agonist

What it isDual GIP and GLP-1 receptor agonist; type 2 diabetes and obesity.

Why this oneIt generally produces greater glucose and weight reductions than single-pathway incretins, making it the escalation benchmark.

What limits itGI intolerance drives discontinuation, so titrate slowly. Delayed gastric emptying matters before anesthesia.

Tirzepatide molecular structure (skeletal formula) — Molecular structure: Tirzepatide

FDA-approved for

type 2 diabetes (2022)
obesity (2023)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Risk of thyroid C-cell tumors: causes thyroid C-cell tumors in rats; human relevance unknown; contraindicated with personal/family history of MTC or MEN 2.

FDA dosing	Population	Start	Target	Max
Type 2 diabetes mellitus	Adults	2.5 mg SC once weekly x4 weeks, then 5 mg weekly	increase by 2.5 mg after ≥4 weeks as needed	15 mg weekly
Type 2 diabetes mellitus	Pediatric ≥10 yr	2.5 mg SC once weekly x4 weeks, then 5 mg weekly	increase by 2.5 mg after ≥4 weeks as needed	10 mg weekly

Titration Increase in 2.5 mg increments after at least 4 weeks on current dose

Renal No adjustment needed

Hepatic No adjustment needed

At least 3 days (72 hours) between doses

Instructions

Inject subcutaneously in abdomen, thigh, or upper arm; rotate sites
Administer once weekly at any time of day, with or without meals
2.5 mg dose is for initiation only, not for glycemic control
Missed dose: give within 4 days (96 h); otherwise skip; keep doses ≥3 days apart
Do not mix with insulin; give as separate injections
Never share a KwikPen between patients

Available strengths

inj 4.17, 8.33, 16.7, 20.8, 25 mg/mL

Contraindications

Personal or family history of medullary thyroid carcinoma (MTC) or MEN 2

Cautions

Acute pancreatitis
Hypoglycemia with concomitant insulin secretagogues or insulin
Serious hypersensitivity reactions (anaphylaxis, angioedema)
Acute kidney injury from volume depletion
Severe GI reactions; not recommended in severe gastroparesis
Diabetic retinopathy complications
Acute gallbladder disease
Pulmonary aspiration during anesthesia/deep sedation

Adverse reactions

Nausea
Diarrhea
Decreased appetite
Vomiting
Constipation, dyspepsia, abdominal pain

Pregnancy Insufficient human data; animal studies show possible fetal harm; use only if benefit justifies risk

Lactation Undetectable or low in breast milk; consider benefits and risks

Cost

Tirzepatide (MOUNJARO)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/unit	brand $/unit	CostPlus
4.17 mg/mL	inj	per unit	—	$201.26/mL	not offered
8.33 mg/mL	inj	per unit	—	$201.04/mL	not offered
16.7 mg/mL	inj	per unit	—	$281.62/mL	not offered
20.8 mg/mL	inj	per unit	—	$281.99/mL	not offered
25 mg/mL	inj	per unit	—	$281.43/mL	not offered

Other forms: Tirzepatide (obesity) (ZEPBOUND)

Generic entry2036 est.

⚠ BOXED WARNING

Thyroid C-cell tumors in rodents

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryNot assigned — PLLR-era drug

Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.

Open Tirzepatide in the interactive console ↗

Memory aids: interaction avatars

Box: minimal PK interactions

Open Tirzepatide in the interactive console ↗