Mounjaro

What is Mounjaro?

Mounjaro, one of the new diabetes medications approved by the Food and Drug Administration in May 2022, is the brand name for tirzepatide. It is a GIP receptor and a GLP-1 receptor agonist and the first of Eli Lilly diabetes drugs in this class.

An agonist is a chemical or a biological substance that binds to an internal or external cell receptor site and produces the same action as a substance that usually binds to that site. GIP is an abbreviation for glucose dependent insulinotropic polypeptide. This hormone stimulates insulin secretion and is classified as an incretin molecule. GLP-1 also stimulates insulin secretion and inhibits the secretion of glucagon.

Tirzepatide has become one of the more common treatments for type 2 diabetes, as well as pre-diabetes. A healthcare provider can also prescribe tirzepatide for other medical conditions such as prediabetes, PCOS (an endocrine system condition), and obesity. This is especially important for people at increased risk for diabetes due to a personal or family history.

How Does Mounjaro Work to Control Blood Sugar?

Mounjaro works to control blood sugar by controlling both insulin and glucagon secretion. To understand this, it’s important to understand incretins. Incretin hormones are secreted after the ingestion of nutrients. They stimulate the release of insulin by the pancreatic B cells and restrict the discharge of glucagon by the a cells of the pancreas. Insulin decreases the amount of blood glucose by facilitating the entry of blood sugar into the cells. Glucagon increases blood sugar. Therefore, Tirzepitide is a hormone mimetic that is dual acting.

The most effective diabetes medication will help gradually increase blood sugar and gradually decrease blood sugar. In other words, your healthcare provider can prescribe the dose of Mounjaro that will ameliorate both high blood sugar and low blood sugar.

What Does Mounjaro Do to Your Body?

Mounjaro is unlike other diabetes medications. It is the first and only dual GIP/GLP-1 receptor agonist hormone that controls both insulin and glucagon secretion. These two hormones work together as a single molecule. In clinical trials, Mounjaro was superior to other medications in reducing A1C. A treatment plan that includes tirzepatide has been shown to increase insulin sensitivity throughout the body.

Taking Mounjaro does more than treat diabetes. The GIP hormone controls lipids and fat disposition. This can be a great asset to people trying to lose weight.

Acting in the brain, stomach, pancreas, and bowel, Mounjaro leads to decreased appetite, fullness, and improved metabolism. When the hypothalamus signals you to stop eating, reduction of appetite makes weight loss much easier. Weight loss is also enhanced because taking Mounjaro delays gastric emptying.

Mounjaro (tirzepatide) Molecule – Image credit: Michael D. Turnbull, Wikimedia Commons

What Are the Ingredients in Mounjaro?

Tirzepatide is the active ingredient in Mounjaro. It also contains the following excipients: sodium phosphate dibasic heptahydrate, sodium chloride, and water. To adjust the pH, hydrochloric acid solution and/or sodium hydroxide solution may be added.

Can Mounjaro Be Prescribed for Weight Loss?

Yes, Mounjaro can be prescribed for weight loss by your healthcare provider. However, this is considered off label usage while it awaits final FDA approval as a weight loss medication. Because it is not yet approved as a weight loss drug, it is not generally included in insurance coverage.

The reason a healthcare provider would use Mounjaro as opposed to other diabetes medications that cause weight loss is its ability to increase insulin sensitivity and increase insulin production only when there’s an increase in blood sugars. This is especially important for people dealing with insulin resistance stomach and weight gain from diabetes.

Fat that accumulates deep in the abdomen often becomes insulin resistant and increases the risk of type 2 diabetes. Diabetic belly is caused by and causes weight gain. People struggling with insulin resistance and belly fat are often on a roller-coaster of weight loss and weight regain. Insulin resistance often doesn’t respond to diet and exercise alone. Mounjaro provides the balance; GIP stimulates insulin secretion as GLP-1 inhibits the secretion of glucagon. This makes it one of the top contenders in diabetes medications.

How Do You Qualify for Mounjaro?

Qualifications for Mounjaro:

• You must be an adult.
• Having a body mass index (BMI) greater than 30 is recommended to start treatment.
• You can start treatment if you have a body mass index above 27 if you have any of the following medical conditions: endocrine system condition, high cholesterol, high blood pressure, or sleep apnea.

How Much Weight Can I Lose with Mounjaro?

You can lose up to 15% of your body weight taking the 5mg low dose of Mounjaro and up to 25% of your body weight with the 10mg and 15mg doses.

How Long Does It Take to Start Losing Weight on Mounjaro?

Following a regular dosing schedule, people who use Mounjaro begin noticeably losing weight after just 2-3 weeks. In our practice, patients have experienced significant weight loss after only 6 weeks. Our real-world patient results align with Mounjaro clinical trials showing continued significant weight loss through 28 weeks and beyind.

More Clinical Trials for Weight Loss with Mounjaro

The most recent SURMOUNT-1 study followed 2,539 participants for over 72 weeks. Their average starting body weight was 231 pounds. At a low dose, 5 mg, participants taking the Eli Lilly Mounjaro lost 15% of their body weight. At higher doses, 10 and 15 mg, participants lost 25% of their body weight. More than half of the participants taking the higher dose lost 25% of their body weight compared with only 1.3% taking a placebo. The people taking Mounjaro had an average weight loss of 52 lbs. This study did not include any other diabetes medications prescribed by a doctor or pharmacist. It also did not include a diet and exercise program prescribed by a healthcare provider.

“Participants taking tirzepatide lost up to 52 lb. (24 kg) in this 72-week phase 3 study.”

Citation: Eli Lilly and Company “Lilly’s tirzepatide delivered up to 22.5% weight loss in adults with obesity or overweight in SURMOUNT-1, April 25, 2022

What’s the Difference Between Mounjaro and Ozempic?

Ozempic and Mounjaro are both incretin mimetics, however they do have some differences. Mounjaro affects GIP and GLP-1 receptors, while Ozempic affects GLP-1 receptors only. They are both prescription medicines that must be prescribed by a doctor or pharmacist. When you use Mounjaro, you can expect to lose an average of 17 to 25 lbs. Weight loss with Ozempic is generally 13 lb.

How Does Mounjaro Compare with Other Diabetes Medicines?

Mounjaro (tirzepatide) – Eli Lilly compares favorably to other GLP-1 agonists and might even be better for weight loss than other diabetes treatments.

Ozempic (semaglutide) – Novo Nordisk is a GLP-1 agonist used to improve glucose levels in adults with type 2 diabetes, prediabetes, and insulin resistance.

Wegovy (semaglutide) – Novo Nordisk is a GLP-1 agonist approved for the treatment of obesity and is one of 6 medications approved by the Food and Drug Administration for this purpose.

Rebelsus (oral semaglutide) – Novo Nordisk is a GLP-1 agonist taken once daily. It can be taken by adults for glucose management and weight loss.

Adlyxin (lixisenatide) – Sanofi is a GLP-1 agonist that is used to control blood glucose in adults with type 2 diabetes.

Bydureon BCise (exenatide extended-release) – AstraZeneca is a GLP-1 agonist that can be used for glucose control in type 2 diabetics 10 years old and up. It should be used with diet and exercise supervised by a healthcare provider.

Byetta (exenatide) – AstraZeneca is a GLP-1 agonist that is short-acting and can be used with other oral diabetes therapies.

Saxenda (liraglutide) – Novo Nordisk is a GLP-1 agonist that is prescribed for weight loss for people with weight-related medical issues. It is used under the supervision of a healthcare provider in conjunction with diet and exercise.

Trulicity (dulaglutide) – Eli Lilly is a GLP-1 agonist approved by the FDA for glycemic control.

Victoza (liraglutide) – Novo Nordisk is a GLP-1 agonist used with diet and exercise to reduce A1C and reduce the risk of cardiovascular events.

Mounjaro Doses

Mounjaro Dose for Weight Loss

It is recommended that you start with 2.5 mg to watch for an allergic reaction or serious side effects. The dose is increased every four weeks as follows: 2.5 mg, 5 mg once weekly, 7.5 mg once weekly, 10 mg once weekly, 12.5 mg once weekly, and 15 mg once weekly. The maximum dose is 15 mg.

Mounjaro Dose for Diabetes

It is recommended to start with 2.5 mg for the first four weeks to make sure you do not experience an allergic reaction, and then increase to 5 mg for the next four weeks. If your healthcare provider feels you need greater glycemic control, the amount can be increased in 2.5 mg increments for four weeks at a time. The maximum dose is 15 mg.

How Often Do You Take Mounjaro?

Use Mounjaro once weekly; the time of day is flexible. If you want to change your dose day, it important to ensure that there are at least 3 days between doses. You don’t want to take too much Mounjaro. If you take too much Mounjaro, seek medical help immediately. In the event of a missed dose, use Mounjaro within 4 days after the missed dose. After 4 days have passed, skip that dose and take the next dose on your scheduled day.

Where Is the Best Place to Inject Mounjaro?

You can choose your injection sites but should vary your injection site with each dose. It is recommended that you inject Mounjaro in your thigh, stomach, or in the back of your upper arm.

What Are the Side Effects of Mounjaro?

Common side effects of Mounjaro include the following:

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Constipation
• Indigestion
• Stomach pain

As with any prescription medication, serious allergic reactions are possible. If you experience an allergic reaction, or symptoms such as difficulty breathing, trouble swallowing, swelling in the face or tongue, rapid heartbeat, severe rash or itching, dizziness, or fainting, contact a healthcare provider immediately.

Serious side effects are less common and can include:

• Pancreatic inflammation (pancreatitis)
• Low blood sugar (hypoglycemia)
• Kidney problems
• Stomach problems
• Severe abdominal pain
• Blurred vision
• Gallbladder problems

Should I Be Concerned About Thyroid Cancer with Mounjaro?

Thyroid cancer has appeared in animal studies of Mounjaro. Do not use Mounjaro if you or any family member has had medullary thyroid carcinoma, a type of cancer is caused by thyroid c cell tumors, or any other form of thyroid cancer, such as multiple endocrine neoplasia syndrome type 2 (MEN-2). While there have not been any reported cases of thyroid tumors or thyroid cancer in humans, the results of clinical trials with animals warrant caution.

Are There Any Drug Interactions with Mounjaro?

Yes, there are drug interactions with Mounjaro. You should not mix insulin with Mounjaro in the same injection. Taking insulin or insulin glargine could mask hypoglycemic symptoms when taken with Mounjaro. Birth control pills may not be as effective if you use Mounjaro. In total, there are 248 medications that might interact with this drug.

Always tell your healthcare provider about all prescription medications you are taking, as well as over-the-counter drugs, vitamins, and herbal supplements. Do not start taking another medication without first consulting your doctor. If you begin taking another drug or suppliment, alert your healthcare provider immediately if you have trouble breathing, trouble swallowing, or have any other signs of serious allergic reaction, kidney problems, gallbladder problems, or severe stomach pain.

Who Should Not Take Mounjaro?

Do not take Moujaro if you have any of the following conditions.

• You or any of your family have ever had medullary thyroid carcinoma (MTC), a type of thyroid cancer
• Multiple endocrine neoplasia syndrome type 2 (MEN-2)
• Allergic reaction to tirzepatide or any of the ingredients in Moujaro
• Kidney failure
• Diabetic retinopathy
• Type 1 Diabetes

Tell your doctor if you are breast feeding, pregnant, or plan to become pregnant as it is not yet known whether Mounjaro will harm your unborn baby or be passed into breast milk. Always tell your healthcare provider about any health conditions you have, family medical history – especially history of thyroid cancer, any allergies you have, or if you have experienced serious allergic reaction to Mounjaro or any of its ingredients.

What Are Some Frequently Asked Questions about Mounjaro?

How do I get a prescription for Mounjaro?

You can obtain a prescription for Mounjaro from a licensed physician. This is often an endocrinologist, or specialist in diabetes.

Can you take Mounjaro if you are not diabetic?

Yes, you can take Moujaro if you are not diabetic. It can be taken for weight loss (obesity), prediabetes, and polycystic ovary syndrome (PCOS). If you have an endocrine system condition other than those mentioned above, other drugs may be recommended.

Why is Mounjaro not covered by insurance?

Mounjaro is not covered by insurance for weight loss / obesity or PCOS because they are considered off-label uses. While it may be an effective treatment for those conditions, it has not been FDA approved to treat them. Insurance coverage for Moujaro as a Type-2 Diabetes treatment, for which it has been FDA approved, depends on your insurance plan and/or provider.

What should you eat when taking Mounjaro?

Healthcare providers recommend eating low fat and low carb foods are when taking Mounjaro. Dr. Lipman’s diet plans cover everything you need to know about food while taking Mounjo. Also, check out Dr. Lipman’s curated low-carb food list. It contains food choices and healthy snacks for weight loss that he has personally reviewed and approved for use on diet plans with or without medications.

What foods to avoid on Mounjaro?

Avoid nuts, red meat, seeds, fried foods, spicy foods, raw vegetables, carbonated drinks, and bread while taking Mounjaro.

Can you drink alcohol while on Mounjaro?

As with many drugs, alcohol intake should be limited while on Mounjaro.

How to Maintain Weight Loss on Mounjaro

The best way to maintain weight loss on Mounjaro is to adjust your eating habits to include less sugar and fewer carbs. Dr. Lipman has diet plans designed specifically for patients using Mounjaro. They help you choose the right foods and show you how to keep weight off.