What Is Tirzepatide?

Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist – Brand names: Mounjaro (for type 2 diabetes), Zepbound (for weight management) – Developed by Eli Lilly – FDA approved Mounjaro in May 2022, Zepbound in November 2023 – Administered as once-weekly subcutaneous injection – First medication to target both GIP and GLP-1 receptors

How Tirzepatide Works - GLP-1 receptor activation

Slows gastric emptying (feel full longer)
– Reduces appetite and food cravings.
– Improves insulin secretion
– Decreases glucagon secretion

  • GIP receptor activation:
    • Enhances insulin secretion
    • May improve fat metabolism
    • Complements GLP-1 effects
    • Potentially reduces side effects
  • Combined effects:
    • Significant appetite reduction
    • Decreased caloric intake
    • Improved metabolic function
    • Better blood sugar control
    • Sustained weight loss
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Tirzepatide vs. Semaglutide

| Feature | Tirzepatide | Semaglutide  | Mechanism | Dual GIP/GLP-1 agonist | GLP-1 agonist only | | Average weight loss | 20-25% | 15-17% | | Dosing frequency | Weekly | Weekly | | Side effects | Generally comparable | GI side effects common | | Cost (brand) | $1,000-1,200/month | $1,000-1,400/month |

More detail on the science behind GIP and GLP-1 – Explanation of how these hormones naturally work in the body – Why dual-action is more effective – Comparison with older weight loss medications

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SURMOUNT Clinical Trial Program

SURMOUNT-1 Trial (published in NEJM 2022): – 2,539 participants without diabetes – 72-week study – Results by dose: * 5 mg: 15.0% weight loss * 10 mg: 19.5% weight loss * 15 mg: 20.9% weight loss * Placebo: 3.1% weight loss – 89% of participants on 15 mg dose lost at least 5% body weight – 57% lost at least 20% body weight on highest dose

SURMOUNT-2 Trial: – Participants with type 2 diabetes – Average weight loss 12-15% (diabetes makes weight loss harder) – Significant improvements in HbA1c and cardiovascular risk factors

SURMOUNT-3 Trial: – Weight maintenance after initial loss – Participants who continued tirzepatide maintained weight loss – Those who switched to placebo regained significant weight

Additional Benefits Observed: – Reduced waist circumference – Improved blood pressure – Better cholesterol levels – Decreased liver fat – Improved quality of life scores

Expand by adding: – More details on study design and methodology – Specific patient examples from trials – Comparison with other weight loss interventions (surgery, other medications) – Long-term follow-up data

Who Is a Candidate for Tirzepatide?

FDA-Approved Indications: – For weight management (Zepbound): * BMI ≥30 (obesity), OR * BMI ≥27 (overweight) with at least one weight-related condition: – Type 2 diabetes – High blood pressure – High cholesterol – Sleep apnea – Cardiovascular disease

  • For type 2 diabetes (Mounjaro):
    • Diagnosed type 2 diabetes
    • Used alongside diet and exercise
    • Can be combined with other diabetes medications

Ideal Candidates: – Struggled with traditional diet and exercise – Have significant weight to lose (30+ pounds) – Committed to lifestyle changes – No contraindications (see below) – Willing to use weekly injections – Can afford medication or have insurance coverage

Who Should NOT Use Tirzepatide: – Personal or family history of medullary thyroid carcinoma – Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) – Pregnant or planning pregnancy – Breastfeeding – History of pancreatitis – Severe gastroparesis – Type 1 diabetes (not approved for this)

More detail on weight-related conditions – Explanation of BMI and how to calculate it – Discussion of when to consider medication vs. other interventions – Importance of medical supervision

Tirzepatide Dosing and Administration

Standard Dosing Schedule:

Titration Protocol: – Start: 2.5 mg weekly for 4 weeks (starter dose, minimal weight loss expected) – Increase to 5 mg weekly for 4 weeks – Increase to 7.5 mg weekly for 4 weeks (optional step) – Increase to 10 mg weekly for 4 weeks – Increase to 12.5 mg weekly for 4 weeks (optional) – Maximum: 15 mg weekly

Why Gradual Titration: – Minimizes gastrointestinal side effects – Allows body to adjust to medication – Helps identify optimal dose for each patient – Reduces risk of nausea and vomiting

Administration Instructions: – Subcutaneous injection (under the skin) – Injection sites: abdomen, thigh, or upper arm – Rotate injection sites each week – Can be taken any day of week, same day each week – Can be taken with or without food – Store in refrigerator (36-46°F) – Allow to reach room temperature before injecting

What’s Included: – Pre-filled pen or vial with syringes – Alcohol swabs – Sharps container for safe disposal – Detailed injection instructions

Expand by adding: – Step-by-step injection instructions with more detail – Tips for minimizing injection discomfort – What to do if you miss a dose – How to travel with tirzepatide – Storage and handling precautions

Expected Results and Timeline

Typical Weight Loss Timeline:

Weeks 1-4 (2.5 mg dose): – Minimal weight loss (2-4 pounds) – Reduced appetite begins – Some may experience mild nausea – Body adjusting to medication

Weeks 5-12 (5-7.5 mg doses): – Noticeable weight loss (8-15 pounds total) – Significant appetite reduction – Food cravings decrease – Energy levels may improve

Weeks 13-24 (10-12.5 mg doses): – Steady weight loss continues (15-25 pounds total) – Appetite control well-established – Lifestyle changes becoming habits – Improved metabolic markers

Weeks 25-52 (12.5-15 mg doses): – Continued weight loss (20-30+ pounds total) – Approaching weight loss goals – Maintenance phase begins – Long-term habits established

Weeks 52+ (Maintenance): – Weight stabilization – Continued appetite control – May reduce to lower maintenance dose – Focus on sustaining results

Factors Affecting Results: – Starting weight and BMI – Adherence to medication schedule – Diet and exercise habits – Individual metabolism – Dose achieved – Consistency over time

Realistic Expectations: – Average: 15-22% total body weight loss over 72 weeks – Individual results vary significantly – Medication works best with lifestyle changes – Weight loss typically plateaus after 60-72 weeks – Some regain weight if medication stopped

Expand by adding: – Real patient examples (hypothetical but realistic) – Graphs showing typical weight loss curves – Discussion of plateaus and how to overcome them – Non-scale victories (clothing size, energy, health markers)

Potential Side Effects

Common Side Effects (>5% of patients):

Gastrointestinal (most common): – Nausea (especially first few weeks) – Diarrhea – Decreased appetite (desired effect) – Vomiting – Constipation – Abdominal pain – Indigestion

Other Common Effects: – Injection site reactions – Fatigue – Headache – Dizziness

Managing Common Side Effects: – Eat smaller, more frequent meals – Avoid high-fat, greasy foods – Stay well-hydrated – Eat slowly and stop when full – Avoid lying down immediately after eating – Take anti-nausea medication if prescribed – Most GI effects improve after 4-8 weeks

Serious Side Effects (rare but important): – Pancreatitis (severe abdominal pain) – Gallbladder problems – Kidney problems – Severe allergic reactions – Thyroid tumors (seen in animal studies) – Diabetic retinopathy complications – Severe hypoglycemia (if combined with insulin/sulfonylureas)

When to Contact Your Doctor: – Severe, persistent abdominal pain – Signs of pancreatitis – Vision changes – Severe nausea/vomiting preventing fluid intake – Signs of dehydration – Allergic reaction symptoms – Lump in neck or difficulty swallowing

Expand by adding: – More detail on each side effect – Statistics on how common each side effect is – Tips for prevention and management – When side effects typically resolve – Comparison of side effect rates vs. other weight loss medications

Compounded Tirzepatide

Mounjaro (for diabetes): – FDA-approved for type 2 diabetes – Often used off-label for weight loss – Insurance may cover for diabetes indication – Eli Lilly savings card available (if eligible) – Cost: $1,000-1,200/month without insurance

Zepbound (for weight loss): – FDA-approved specifically for weight management – Same medication as Mounjaro, different indication – Insurance coverage varies – Cost: $1,000-1,200/month without insurance

Compounded Tirzepatide:

What Is Compounding: – Custom preparation by licensed compounding pharmacy – Uses same active ingredient (tirzepatide) – Not FDA-approved but legal under certain conditions – Prepared to same pharmaceutical standards – Quality depends on pharmacy certification

Advantages of Compounded: – Significantly lower cost ($300-500/month typical) – More accessible without insurance – Flexible dosing options – Can combine with B12 or other supplements – Available from LegitScript-certified pharmacies like Advanced Scripts

Quality Considerations: – Choose LegitScript-certified pharmacy – Verify pharmaceutical-grade ingredients – Check for sterile compounding facility – Confirm proper testing and quality control – Ask about ingredient sourcing

Legal Status: – Compounding is legal when done by licensed pharmacies – Must have valid prescription – FDA allows compounding when brand drug is in shortage or for patient-specific needs – Regulations vary by state

Expand by adding: – More detail on compounding process – How to verify quality of compounded medications – Discussion of FDA’s stance on compounding – Comparison table of brand vs. compounded – Patient testimonials about compounded tirzepatide

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Cost Considerations

Brand Name Costs: – Retail price: $1,000-1,200/month – With insurance: $25-250/month (varies widely) – Manufacturer savings cards: May reduce to $25/month (eligibility restrictions) – Medicare doesn’t cover weight loss medications

Compounded Tirzepatide Costs: – Typical range: $300-500/month – No insurance needed – Consistent pricing – Often includes supplies (syringes, alcohol swabs) – May include B12 or other add-ons

Total Cost of Treatment: – Minimum 6-12 months recommended – Maintenance therapy may be needed long-term – Factor in medical consultations – Lab work and monitoring – Lifestyle program costs (optional)

Making It Affordable: – Check insurance formulary – Apply for manufacturer savings programs – Consider compounded options – Look for pharmacy discount programs – FSA/HSA funds may be usable

Expand by adding: – Detailed cost comparison scenarios – Insurance coverage tips – How to talk to insurance about coverage – ROI discussion (health benefits vs. cost)

Getting Started with Tirzepatide

Step-by-Step Process:

  1. Medical Consultation:
    • Schedule appointment with healthcare provider
    • Discuss weight loss goals and medical history
    • Review medications and conditions
    • Determine if tirzepatide is appropriate
    • Get prescription
  2. Choose Pharmacy:
    • Decide between brand name or compounded
    • For compounded, choose LegitScript-certified pharmacy
    • Advanced Scripts offers compounded tirzepatide with next-day Florida delivery
    • Verify pharmacy credentials
  3. Insurance and Payment:
    • Check insurance coverage
    • Apply for savings programs if using brand
    • Set up payment method
    • Understand ongoing costs
  4. Receive Medication:
    • First shipment includes supplies and instructions
    • Review injection technique
    • Understand storage requirements
    • Know who to contact with questions
  5. Start Treatment:
    • Begin with 2.5 mg starter dose
    • Follow titration schedule
    • Track weight and side effects
    • Stay in contact with healthcare provider
  6. Ongoing Management:
    • Weekly injections on same day
    • Monthly check-ins with provider
    • Periodic lab work
    • Dose adjustments as needed
    • Lifestyle modifications

      More detail on what to expect at first appointment – Questions to ask your doctor – How to prepare for starting medication – Resources for support and education

Frequently asked questions

Most patients need 12-18 months to reach goals, then may continue at lower dose for maintenance. Stopping often leads to weight regain.

Moderate alcohol is generally okay, but may worsen nausea. Discuss with your doctor.

: Many patients regain some weight after stopping. Long-term maintenance or lifestyle changes are key.

Yes, Zepbound is approved for weight loss without diabetes if you meet BMI criteria.

Studies up to 2 years show good safety profile. Longer-term data still being collected.

: Usually yes, but discuss all medications with your doctor. May affect absorption of oral medications.

Take within 4 days of missed dose. If more than 4 days, skip and resume regular schedule.

Coverage varies. More likely to cover Mounjaro for diabetes than Zepbound for weight loss.

Pharmaceutical Supplements FL | Advanced Scripts Pharmacy
BHRT Florida | Advanced Scripts Compounding Pharmacy

Tirzepatide is most effective weight loss medication available - Clinical trials show 20-25% average weight loss - Dual GIP/GLP-1 mechanism more effective than previous options - Requires commitment to weekly injections and lifestyle changes - Compounded options make treatment more affordable - Advanced Scripts provides quality compounded tirzepatide with next-day Florida delivery

About the Author: This article was prepared by the pharmaceutical experts at Advanced Scripts Pharmacy, a LegitScript-certified compounding pharmacy serving patients throughout Florida.

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