Tirzepatide is used to help reduce body weight in obese or overweight individuals who have weight-related health problems (e.g. high blood pressure, high level of fats in the blood).
This medicine is meant to be used as part of a comprehensive weight management programme that should include exercise, a healthy diet and lifestyle change.
Use Tirzepatide exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
This medicine should be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm, or abdomen area) at any time of the day, with or without meals. Try to administer it on the same day each week.
Tirzepatide is available as a single-dose pre-filled pen or vial and multiple-dose pre-filled pen. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
How to use the vial:
- Gather all the supplies you will need for injection (e.g. vial, syringe, alcohol swab, cotton).
- Wash your hands with soap and water.
- Pull off the protective colour cap of the medicine (on the top of the vial) then you will see a grey rubber stopper. Wipe the top of the grey rubber stopper with alcohol swab.
- Remove the needle cover of the syringe recommended by your doctor. Draw air, equal to your required dose, into the syringe by pulling back the plunger.
- Put the vial on a flat surface then insert the needle down the grey rubber stopper.
- Push the plunger of the syringe down to inject the air and keep the needle inside the vial.
- Turn the vial upside down. Slowly pull back the plunger to fill the syringe with your dose.
- Keep the needle inside the vial. To remove air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of syringe then slowly push the plunger up. Pull the plunger back down to measure your required dose.
- Remove the prepared syringe and needle from the vial and hold it in your hand that will inject the medicine.
- Wipe the selected injection site with alcohol swab and pinch the skin using your other hand. Push the plunger of the syringe as far as it will go to deliver your dose.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Place a cotton ball over the injection site and press for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist's instructions. Use a new needle and syringe for each injection.
Ensure that you are using the correct type of syringe. Check with your doctor or nurse if you are not sure.
How to use the pre-filled pen:
- Prepare the injection pen as instructed by your doctor or nurse.
- If you are using the multiple-dose pre-filled pen, attach the needle to the injection pen. Ensure that the needle is screwed on securely, then dial the correct dose. If you are using the single-dose pre-filled pen, pull off the grey base cap and avoid touching the needle. Ensure that the pen is locked.
- Swab the injection site area with alcohol.
- Hold the injection pen with your thumb over the injection button.
- Press the injection pen against your body using the subcutaneous (under the skin) injection method. Additionally for the single-dose pre-filled pen, unlock the pen by turning the lock ring.
- Use your thumb to push the injection button until it stops. Continue to hold the injection button in that position while slowly counting up to 10 to get a full dose.
- Withdraw the injection pen from your body.
- For the multiple-dose pre-filled pen, remove the needle from the pen. Never store the injection pen with the needle attached. Ensure to reset your pen as instructed by your healthcare provider.
- Throw away the used needle or single-dose pre-filled pen. Recap your multiple-dose pre-filled pen and store it in the refrigerator between 2-8°C or at room temperature not exceeding 30°C.
- Use a new needle every time you use the multiple-dose pre-filled.
Remember to rotate the choice of injection site area. Do not inject into the same area all the time. Do not inject near the navel (belly button). New injection sites should be at least 1.5 inches away from the previous injection site.
Do not mix this medicine with any insulin formulation.
Do not share your Tirzepatide injection with anyone else.
Your doctor will also discuss the use of this medicine as different brands of Tirzepatide may only be used for a specific condition. Do not change from one brand to another.
Do not use this medicine for any conditions other than what is prescribed by your doctor.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your response to the medication.
If you miss a dose and it is 4 days or less since you have used Tirzepatide, inject the missed dose as soon as you remember and return to your normal dosing schedule.
If more than 4 days have passed since you have used this medicine, skip the missed dose and return to your usual dosing schedule.
DO NOT double a dose to make up for a missed dose.
Inform your doctor or pharmacist immediately if you forgot to administer your dose.
Do not use Tirzepatide if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you have the following conditions:
- personal or family history of a certain type of thyroid cancer known as medullary thyroid carcinoma
- multiple endocrine neoplasia syndrome type 2 (a rare inherited disorder characterised by cancer in the thyroid gland and other tumours affecting specific glands in the endocrine system)
as Tirzepatide may not be suitable for you.
Inform your doctor if you have the following conditions:
- history of pancreatitis (inflammation of the pancreas)
- history of severe allergic reactions to similar medicines
- stomach or bowel problems e.g. gastroparesis (delayed emptying of food in the stomach)
- diabetic retinopathy (visual problems related to diabetes)
- kidney disease
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
It is important that you do not get pregnant while being treated with this medicine. You may wish to discuss birth control methods with your doctor or pharmacist.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are using Tirzepatide.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. kidney function, blood sugar level) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your doctor may also need to check your weight regularly to check your response to the medication.
- Regular monitoring for signs and symptoms of pancreatitis, gallbladder disease, bowel or thyroid problems, changes in behaviour, and worsening depression may also be needed.
What lifestyle changes should I make to lose weight and maintain my ideal weight?
A healthy, balanced diet and regular exercise are keys to helping you maintain your ideal weight. You should avoid relying only on medication to maintain your ideal weight.
Try to control the type and amount of food you eat at each meal. Include lots of fruits and vegetables in your diet. If you have not been exercising, start slow and gradually step up your exercise capacity. You will find that keeping to a regular exercise regimen is enjoyable and helps keep your weight off.
If stress causes you to reach out for snacks too often, replace unhealthy snacks with healthier choices. Learn to manage your stress levels. Alcohol also commonly causes weight gain. Try to avoid alcohol or set a limit on how much you drink.
Do not share this medicine with anyone else, even if they are overweight. This medicine may not be suitable for everyone.
If you are using this medicine with anti-diabetic medicines, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, and sweating. These signs are your body's way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at the first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don't have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms not improve after the second serving.
Tirzepatide may cause any of the following side effects: dizziness, constipation, indigestion, stomach wind, stomach pain, tiredness, decreased appetite, and itching, pain or redness at the injection site.
This medicine may cause nausea, vomiting, and diarrhoea which may lead to excessive water loss from the body. Drink plenty of water or other fluids to stay hydrated during treatment.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of allergic reaction e.g. rashes, breathlessness, swelling of the face, eyes, mouth, or throat
- signs and symptoms of thyroid problems e.g. lump or swelling in the neck, hoarseness of voice, difficulty swallowing, shortness of breath
- severe and persistent stomach pain that may radiate to the back, with or without vomiting
- unusual changes in mood or behaviour (being too depressed), having thoughts of self-harm
- fever, pain in the upper right area of the stomach, yellowing of the skin or eyes, clay-coloured stools
- blurred vision, eye floaters, sudden vision loss, pain or pressure in the eye
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- medicines for diabetes e.g. insulin
- birth control pills
This list does not include all medicines that may interact with Tirzepatide.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
If you have not yet opened it, store Tirzepatide in a refrigerator between 2-8°C. Do not allow it to freeze. If frozen, this medicine will become ineffective and should not be used.
Once opened, this medicine may be stored in the refrigerator between 2-8°C. Alternatively, it may also be kept at room temperature not exceeding 30°C up to 21 days for a single-dose vial or pre-filled pen, and up to 30 days for a multiple-dose pre-filled pen. Throw away any remaining injection solution after the recommended period, even if the injection pen or vial is not empty.
Protect from light.
Do not use this medicine if it has changed colour or has become cloudy. Throw it away and use a new injection.
Keep this medicine away from the reach of children.
Make sure you know how to store your medicine. Tirzepatide may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Medicines must not be used past the expiry date.
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