Tirzepatide ($ Mounjaro, Zepbound)
Glucagon-like peptide-1 (GLP-1) agonist
- SE-weight loss
- May reduce alcohol/nicotine use
Features
Dosing
Start: 2.5 mg inj weekly. Target: 5, 10 or 15 mg inj weekly, increasing in 2.5mg increments every 4 weeks.
Management
Only use if BMI > 30 or > 27 with an obesity related health condition (hypertension, dyslipidemia, diabetes).
May reduce addictions (alcohol, nicotine). May improve mood and cognition.
TOLERABILITY: Nausea, vomiting, diarrhea, and constipationAdvise patient to eat more protein (to prevent muscle wasting) and avoid over-eating (to prevent reflux).
RISKS: Gastric slowing, pancreatitis, gall bladder problems, thyroid cancer.
EMR Text
Obesity
Terzepatide use based on FDA approval in obesity, including controlled trials of GLP-1 agonists in psychiatric populations with obesity.
Terzepatide’s risks, including slowed gastric motility, medullary thyroid cancer, and hypoglycemia, reviewed with patient.