Product Intro:
Mounjaro is a next-generation antidiabetic medication developed by Eli Lilly. It is the first and only dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist approved for the treatment of type 2 diabetes. It mimics natural incretin hormones to help regulate blood sugar and support weight reduction.

1. Uses:
   – Management of type 2 diabetes mellitus in adults
   – Improves glycemic control along with diet and exercise
   – Aids in significant weight loss in overweight or obese adults
   – May reduce cardiovascular risk in diabetic patients (ongoing research)
   – May be considered off-label for obesity management (under supervision)
   – Helps reduce insulin resistance and fasting glucose levels

2. Storage Instructions:
   – Store in a refrigerator at 2°C to 8°C.
   – Do not freeze or expose to heat or direct sunlight.
   – May be stored at room temperature (up to 30°C) for up to 21 days.
   – Keep the injection pen in its original carton to protect from light.
   – Keep out of reach of children.

3. How It Works (Mechanism of Action):
   Tirzepatide is a dual incretin mimetic. It activates two gut hormone receptors:
   – GIP (Glucose-dependent Insulinotropic Polypeptide) – enhances insulin secretion and reduces glucagon levels.
   – GLP-1 (Glucagon-like Peptide-1) – slows gastric emptying, promotes satiety, and enhances insulin response after meals.
   This dual action improves blood sugar levels and reduces appetite, leading to weight loss and better metabolic control.

4. Side Effects:
   Common side effects:
   – Nausea
   – Vomiting
   – Diarrhea
   – Constipation
   – Decreased appetite
   – Injection site reactions

Severe side effects (rare):
– Pancreatitis (severe abdominal pain)
– Hypoglycemia (especially when used with sulfonylureas or insulin)
– Gallbladder problems
– Acute kidney injury (due to dehydration from nausea/vomiting)
– Thyroid tumors (observed in animal studies – black box warning)

5. Dosage (Typical Recommended Dose):
   – Start with 2.5 mg subcutaneously once weekly for the first 4 weeks (not for glycemic control – only to reduce GI side effects).
   – After 4 weeks, increase to 5 mg once weekly.
   – The dose may be gradually increased to 10 mg, 12.5 mg, or 15 mg weekly based on response and tolerance.
   – Administer on the same day each week, with or without food.

6. Method of Administration (How to Take It):
   – Administer subcutaneously in the abdomen, thigh, or upper arm.
   – Rotate injection sites weekly.
   – Do not inject into muscles or veins.
   – Use a new prefilled pen for each dose.
   – If needed, the day of the weekly injection can be changed, provided the time between doses is at least 3 days (72 hours).

7. Precautions (Things to Consider Before Taking It):
   – Not for use in patients with type 1 diabetes or diabetic ketoacidosis.
   – Do not use if you or a family member has a history of medullary thyroid carcinoma (MTC) or MEN 2 (Multiple Endocrine Neoplasia syndrome type 2).
   – Caution in patients with a history of pancreatitis.
   – Monitor kidney function in patients with severe GI side effects.
   – Use with caution in combination with insulin or sulfonylureas (risk of hypoglycemia).
   – Not recommended in pregnancy or during breastfeeding unless clearly needed.

8. Drug Interactions (Medicines That May Interact):
   – Insulin or sulfonylureas – may increase hypoglycemia risk
   – Oral medications – delayed gastric emptying may affect absorption
   – Other GLP-1 receptor agonists – avoid concurrent use
   – Diuretics – risk of dehydration
   – Certain antibiotics or thyroid medications – monitor absorption when co-administered

9. Allergies (Warnings for Allergic Reactions):
   – Avoid use if you are allergic to Tirzepatide or any component of the injection.
   – Allergic reactions may include rash, swelling, itching, dizziness, or difficulty breathing.
   – Seek immediate medical attention if any allergic symptoms occur.

10. Overdose Information (What to Do if Overdosed):
    – Overdose may cause severe nausea, vomiting, diarrhea, and low blood sugar.
    – There is no specific antidote.
    – Provide supportive care and monitor blood glucose and hydration status.
    – Seek emergency medical help in case of overdose.

11. Missed Dose Instructions:
    – If a dose is missed, take it within 4 days (96 hours) of the missed dose.
    – If more than 4 days have passed, skip the missed dose and resume the regular schedule.
    – Do not take two doses at the same time to make up for a missed dose.

12. Additional Notes:
    – Mounjaro may lead to substantial weight loss even in non-diabetic patients (off-label use being studied).
    – Clinical trials (SURPASS) have shown superior glycemic control and weight loss compared to other GLP-1 therapies.
    – Patients using Mounjaro should be educated about potential GI side effects and the importance of dose titration.
    – A balanced diet, exercise, and regular blood sugar monitoring enhance results.
    – Follow-up every 4–6 weeks is advised during dose titration.