Indications

Tizaro is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Limitations of use:
. It has not been studied in patients with a history of pancreatitis.
. It is not indicated for use in patients with type 1 diabetes mellitus.

Pharmacology

Tirzepatide is a GIP receptor and GLP-1 receptor agonist. It is a 39-amino-acid modified peptide with a C20 fatty diacid moiety that enables albumin binding and prolongs the half-life. It selectively binds
to and activates both the GIP and GLP-1 receptors, the targets for native GIP and GLP-1. It enhances first and second-phase insulin secretion and reduces glucagon levels, both in a glucose dependent
manner.

Dosage & Administration

Route of administration: Tirzepatide should be administered as a subcutaneous injection.

Dosing instructions-
. The recommended starting dosage is 2.5 mg injected subcutaneously once weekly. The 2.5 mg dosage is for treatment initiation and is not intended for glycemic control.
. After 4 weeks, increase the dosage to 5 mg once weekly. If additional glycemic control is needed, increase the dosage in 2.5 mg increments after at least 4 weeks on the current dose. The
maximum dosage is 15 mg injected subcutaneously once weekly.
. If a dose is missed, instruct patients to administer it as soon as possible within 4 days (96 hours) after the missed dose. If more than 4 days have passed, skip the missed dose and administer the
next dose on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing schedule.
. The day of weekly administration can be changed, if necessary, as long as the time between the two doses is at least 3 days (72 hours).
Preparation and administration-
. The needle cover of the pre-filled syringe contains dry natural rubber (a derivative of latex), which may cause allergic reactions.
. Do not freeze. Do not use Tirzepatide that has been frozen.
. Protect pre-filled syringes from light.
. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use any pre-filled syringes exhibiting particulate matter and
discoloration.
. Handle it carefully. If the pre-filled syringe dropped on a hard surface, do not use it.
. Do not dilute Tirzepatide and do not administer in conjunction with other drug solutions.
Administration instructions-
Administer once weekly, any time of day, with or without meals.
. Inject it subcutaneously in the abdomen, thigh or upper arm. Rotate injection sites with each dose. When using with insulin, administer as separate injections and never mix. It is acceptable to
iniect Tirzepatide and insulin in the same body region, but the iniections should not be adiacent to each other.