Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Limitations of use:

Tirzepatide is a GIP receptor agonist and GLP‑1 receptor agonist.
It is a 39‑amino‑acid peptide with a C20 fatty acid moiety that enables albumin binding and prolongs half‑life.
Enhances first‑ and second‑phase insulin secretion and reduces glucagon levels in a glucose‑dependent manner.

Route: Subcutaneous injection.
Starting dose: 2.5 mg once weekly (for initiation only, not for glycemic control).
After 4 weeks: Increase to 5 mg once weekly.
If additional control is needed, increase by 2.5 mg increments every ≥4 weeks.
Maximum dose: 15 mg once weekly.
Missed dose: Administer within 4 days (96 hours). If more than 4 days have passed, skip and resume regular schedule.
Injection sites: abdomen, thigh, or upper arm. Rotate sites.
Do not mix with insulin; administer separately.

Increased risk of hypoglycemia with insulin or sulfonylureas.
Delays gastric emptying, may affect absorption of oral drugs (e.g., warfarin).
Oral contraceptives may be less effective; use alternative or barrier methods for 4 weeks after initiation and dose escalation.

Nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, abdominal pain.

Use only if potential benefit outweighs risk.
Consider risks of uncontrolled diabetes in pregnancy.
Unknown if excreted in breast milk; weigh benefits of breastfeeding vs. therapy.