Watch for Mounjaro, a New Injectable Diabetes Med

There’s buzz about Mounjaro (tirzepatide), a new Rx injectable for type 2 diabetes.

You’ll hear that it’s the first “twincretin.”

That’s because this GLP-1/GIP agonist works in two ways to mimic incretins...hormones that help increase insulin release, decrease blood sugar, and promote fullness, especially after meals.

Mounjaro may also help patients with diabetes lose weight...up to 25 lb over 10 months.

When you get an Rx for Mounjaro, choose products carefully from the computer and fridge...it comes in SIX different strengths.

Plus the generic name tirzepatide can easily be mistaken for the osteoporosis med teriparatide (Forteo, etc). Their names look and sound alike...and they’re both prefilled pens that are kept refrigerated.

Be prepared to enter more than one Rx for Mounjaro. Patients will start by injecting 2.5 mg subcutaneously once weekly...then increase the dose monthly to reach their blood sugar goal, or to a max of 15 mg/week.

Enter a 28 days’ supply for each carton of Mounjaro. Four pens come in a package...and patients will use one pen each week.

Don’t automatically override drug interactions.

For example, Mounjaro may reduce absorption of oral contraceptives...so patients will need to use another form of contraception for 4 weeks after initiation and each dose increase.

Anticipate prior auths...Mounjaro costs about $1,000/month.

Include a MedGuide with Mounjaro Rxs...to help inform patients about side effects (nausea, etc) and rare risks (gallbladder disease, etc).

Tell patients to store Mounjaro in the fridge. But if needed, they can keep a pen at room temp for up to 21 days.

Work with your pharmacist to discontinue Rxs for GLP-1 agonists (Victoza, etc) if there’s a switch to Mounjaro...since these meds have overlapping effects.

Stay tuned to see if Mounjaro will be approved for obesity in patients withOUT diabetes. These patients may lose as much as 47 lb over 18 months...much higher than all other products (phentermine, etc).

Review our resource, Drugs for Type 2 Diabetes, for more on how Mounjaro stacks up.

Key References

  • N Engl J Med. 2021 Aug 5;385(6):503-515
  • Lancet Diabetes Endocrinol. 2021 Sep;9(9):563-574
  • N Engl J Med. 2022 Jun 4. doi: 10.1056/NEJMoa2206038
  • Medication pricing by Elsevier, accessed Jun 2022
Pharmacy Technician's Letter. July 2022, No. 380701



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