Tirzepatide / Mounjaro / Zepbound)

Weight Loss

What are Tirzepatide/Mounjaro/Zepbound?

Mounjaro (brand name of tirzepatide) is an FDA-approved prescription medicine used to improve blood sugar (glucose) levels in adults with type 2 diabetes mellitus.

Zepbound (brand name of tirzepatide) is a FDA approved injectable medication used along with diet and exercise to help with weight loss in certain adults who meet criteria for weight management therapy.

Tirzepatide (the active ingredient of Mounjaro/Zepbound) is a weekly injectable prescription medicine that helps the body controlling both weight and blood sugar, thanks to its dual GLP-1/GLP action. It is used along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes mellitus and to reduce weight in adults with overweight or obesity. (GIP=glucose-dependent insulinotropic polypeptide; GLP-1=glucagon-like peptide-1)

Do you take insurance or HSA/FSA accounts?

At Anchor Medical,  we do not participate in insurance plans or HSA/FSA accounts, but we offer affordable self-pay rates at $100 per provider visit monthly and $50 for follow ups in between visits as needed. 

Your insurance may cover the costs for Lab works and prescription medications. We also offer affordable self-pay rates for the Lab works and generic medications (like Semaglutide or Tirzepatide) from FDA approved compounding pharmacy. 

How much does Mounjaro or Zepbound cost?

The cost of your medication will vary. We will assist you in obtaining coverage and will work with you and your budget to select an affordable weight loss medication that’s right for you. 

Tirzepatide Dosage and Cost

Based on the available information to date, here is a reference tirzepatide dosing protocol to induce weight loss in obese or overweight subjects. We need to evaluate your response monthly and decide whether we need to further increase the total weekly dose in 2.5mg increments. 

  • Weeks 1-4: 2.5 mg/week, 4 weeks total for $200;
  • Weeks 5-8: 5.0 mg/week, 4 weeks total for $325;
  • Weeks 9-12: 7.5 mg/week, 4 weeks total for $450;
  • Weeks 13-16: 10.0 mg/week, 4 weeks total for $575;
  • Weeks 17-20: 12.5 mg/week, 4 weeks total for $700;
  • Weeks  21 and above: 15.0 mg/week, 4 weeks total for $825.

Tirzepatide and Weight Loss

A research trial numbered over 2,500 participants and confirmed the peptide’s efficacy in inducing weight loss in obese and overweight patients. Study authors observed average weight reductions of 16% for patients on tirzepatide 5mg/weekly, 21.4% for tirzepatide 10mg/weekly, and 22.5% for tirzepatide 15mg/weekly, over the course of 72 weeks [6, 7].

Tirzepatide and Type 2 Diabetes

Tirzepatide is superior to other diabetes therapies like semaglutide and dulaglutide in terms of blood glucose control and weight loss. Tirzepatide was more effective than semaglutide at lowering hemoglobin A1c and causing weight loss in Type 2 diabetes patients [11, 18]. In several studies with or without other diabetes medications, the percentage of people taking Tirzepatide who reached an A1C of less than 7% ranged from 75% (5 mg) to 90% (10 mg).

Tirzepatide and Cardioprotective Benefits

GLP-1 increases the incretin hormone, which is key to directly regulating risk factors like hypertension and obesity, while indirectly regulating risk factors like inflammation and endothelial cell dysfunction. Tirzepatide’s selective targeting of the GLP-1 receptor may slow the development and progression of cardiovascular complications, particularly in diabetic patients [19]. In a 26-week study on T2D patients, once-weekly tirzepatide injections improved lipoprotein biomarkers associated with insulin resistance and cardiovascular risk, while reducing triglycerides, suggesting a net lowering of the patients’ risk of heart disease [20].

Tirzepatide Side Effects

Tirzepatide is well-tolerated and not linked to any serious adverse effects in obese or overweight adults with or without type 2 diabetes [7, 10, 11, 12, 13, 14].

Here we list the minor side effects, usually GI tract-related, which will generally cease with discontinuation of therapy or after lowering the total dosage [7, 10, 11, 12, 13, 14]: nausea, vomiting, diarrhea, reduced appetite, constipation, indigestion, dyspepsia, abdominal pain, hypersensitivity reactions, 

But patients typically have fewer side effects on tirzepatide than they do on semaglutide medications like Ozempic and Wegovy. Some people who don’t tolerate Semaglutide (Ozempic/Wegovy) do much better on Tirzepatide (Mounjaro/Zepbound).

Tirzepatide vs Semaglutide-- How do They Differ?

Semaglutide (Ozempic/Wegovy) is in a glucagon-like peptide 1 (GLP-1) agonists. This mimics a protein in your own body called GLP-1 and activates GLP-1 receptors in your body, increasing the production of insulin, a hormone that helps escort blood sugar to your cells where it can be used for energy.

Tirzepatide (Mounjaro/Zepbound) targets two hormonal receptors GIP and GLP-1, instead of just one. The benefit is increased weight loss.

Tirzepatide-- Who can not take it?

Tirzepatide should not be administered to subjects who have a history of medullary thyroid carcinoma, as it has been found to cause thyroid C-cell tumors in rats. Tirzepatide is also contraindicated in subjects with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

How to take Tirzepatide?

Tirzepatide is designed to be injected subcutaneously in the fatty tissue just under the subject’s skin, most commonly into belly fat.

Is Tirzepatide a Steroid?

No. Tirzepatide is not an anabolic-androgenic steroid, but rather a peptide agonist of both the GLP-1 and GIP receptors [2].

Does Tirzepatide Increase Testosterone?

No. Tirzepatide’s action at the GLP-1 and GIP receptors does not have any known effect on testosterone.

Does Tirzepatide Build Muscle?

No. Tirzepatide is not known to build muscle.

Does Tirzepatide Cause Weight Gain?

No. Tirzepatide is not known to cause weight gain. Quite the opposite: clinical trials have demonstrated the efficacy of tirzepatide in inducing weight loss in obese and overweight patients, with further results pending [6, 7].

References

  1. Ali, Rouchan & Virendra, Sharma & Chawla, Pooja. (2022). Bumps and humps in the success of Tirzepatide as the first GLP1 and GIP receptor agonist. Health Sciences Review. 4. 100032. 10.1016/j.hsr.2022.100032.
  2. Thomas MK, Nikooienejad A, Bray R, et al. Dual GIP and GLP-1 Receptor Agonist Tirzepatide Improves Beta-cell Function and Insulin Sensitivity in Type 2 Diabetes. J Clin Endocrinol Metab. 2021;106(2):388-396. doi:10.1210/clinem/dgaa863
  3. Coskun T, Sloop KW, Loghin C, Alsina-Fernandez J, Urva S, Bokvist KB, Cui X, Briere DA, Cabrera O, Roell WC, Kuchibhotla U, Moyers JS, Benson CT, Gimeno RE, D’Alessio DA, Haupt A. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Mol Metab. 2018 Dec;18:3-14. doi: 10.1016/j.molmet.2018.09.009. Epub 2018 Oct 3. PMID: 30473097; PMCID: PMC6308032.
  4. Office of the Commissioner. (2022, May 13). FDA Approves Novel, Dual-Targeted Treatment for Type 2 Diabetes. U.S. Food And Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-dual-targeted-treatment-type-2-diabetes
  5. Min T, Bain SC. The Role of Tirzepatide, Dual GIP and GLP-1 Receptor Agonist, in the Management of Type 2 Diabetes: The SURPASS Clinical Trials. Diabetes Ther. 2021;12(1):143-157. doi:10.1007/s13300-020-00981-0
  6. le Roux CW, Zhang S, Aronne LJ, Kushner RF, Chao AM, Machineni S, Dunn J, Chigutsa FB, Ahmad NN, Bunck MC. Tirzepatide for the treatment of obesity: Rationale and design of the SURMOUNT clinical development program. Obesity (Silver Spring). 2023 Jan;31(1):96-110. doi: 10.1002/oby.23612. Epub 2022 Dec 7. PMID: 36478180.
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  10. Rosenstock J, Wysham C, Frías JP, Kaneko S, Lee CJ, Fernández Landó L, Mao H, Cui X, Karanikas CA, Thieu VT. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet. 2021 Jul 10;398(10295):143-155. doi: 10.1016/S0140-6736(21)01324-6. Epub 2021 Jun 27. Erratum in: Lancet. 2021 Jul 17;398(10296):212. PMID: 34186022.
  11. Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, Liu B, Cui X, Brown K; SURPASS-2 Investigators. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503-515. doi: 10.1056/NEJMoa2107519. Epub 2021 Jun 25. PMID: 34170647.
  12. Ludvik, B., Giorgino, F., Jódar, E., Frias, J. P., Landó, L. F., Brown, K., Bray, R., & Rodríguez, Á. (2021, August 6). Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (surpass-3): A randomised, open-label, parallel-group, phase 3 trial. The Lancet. Retrieved August 9, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0140673621014434
  13. Prato, S. D., Kahn, S. E., Pavo, I., Weerakkody, G. J., Yang, Z., Doupis, J., Aizenberg, D., Wynne, A. G., Riesmeyer, J. S., Heine, R. J., & Wiese, R. J. (2021, October 18). Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (surpass-4): A randomised, open-label, parallel-group, multicentre, phase 3 trial. The Lancet. Retrieved August 9, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0140673621021887
  14. Dahl D, Onishi Y, Norwood P, Huh R, Bray R, Patel H, Rodríguez Á. Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes: The SURPASS-5 Randomized Clinical Trial. JAMA. 2022 Feb 8;327(6):534-545. doi: 10.1001/jama.2022.0078. PMID: 35133415; PMCID: PMC8826179.
  15. Thomas MK, Nikooienejad A, Bray R, Cui X, Wilson J, Duffin K, Milicevic Z, Haupt A, Robins DA. Dual GIP and GLP-1 Receptor Agonist Tirzepatide Improves Beta-cell Function and Insulin Sensitivity in Type 2 Diabetes. J Clin Endocrinol Metab. 2021 Jan 23;106(2):388-396. doi: 10.1210/clinem/dgaa863. PMID: 33236115; PMCID: PMC7823251.
  16. Yanai H, Yoshida H. Beneficial Effects of Adiponectin on Glucose and Lipid Metabolism and Atherosclerotic Progression: Mechanisms and Perspectives. International Journal of Molecular Sciences. 2019; 20(5):1190. https://doi.org/10.3390/ijms20051190
  17. Zhang, Qian et al. “The glucose-dependent insulinotropic polypeptide (GIP) regulates body weight and food intake via CNS-GIPR signaling.” Cell metabolism vol. 33,4 (2021): 833-844.e5. doi:10.1016/j.cmet.2021.01.015
  18. Vadher, Karan et al. “Efficacy of tirzepatide 5, 10 and 15 mg versus semaglutide 2 mg in patients with type 2 diabetes: An adjusted indirect treatment comparison.” Diabetes, obesity & metabolism, 10.1111/dom.14775. 19 May. 2022, doi:10.1111/dom.14775
  19. Tate M, Chong A, Robinson E, Green BD, Grieve DJ. Selective targeting of glucagon-like peptide-1 signalling as a novel therapeutic approach for cardiovascular disease in diabetes. Br J Pharmacol. 2015;172(3):721-736. doi:10.1111/bph.12943
  20. Wilson, JM, Nikooienejad, A, Robins, DA, et al. The dual glucose-dependent insulinotropic peptide and glucagon-like peptide-1 receptor agonist, tirzepatide, improves lipoprotein biomarkers associated with insulin resistance and cardiovascular risk in patients with type 2 diabetes. Diabetes Obes Metab. 2020; 22: 2451– 2459.
  21. National Library of Medicine (U.S.). (2020, May 29 – ). A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes (SURPASS-CVOT). Identifier NCT04255433. https://www.clinicaltrials.gov/ct2/show/NCT04255433
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  23. Highlights of prescribing information … – eli lilly and company. (n.d.). Retrieved January 10, 2023, from https://pi.lilly.com/us/mounjaro-uspi.pdf?s=pi