Monograph

A10BX16 - Tirzepatide

Propably not porphyrinogenic

Important Information

Side effects such as nausea, vomiting and loss of appetite may be potentially porphyrinogenic through reduction in carbohydrate intake. If used for weight management, carbohydrate intake must be kept at a sufficient level.

Side effects

Nausea and vomiting are reported as very common adverse reactions of tirzepatide, and decreased appetite is common. [SmPC] These side effects may potentially be porphyrinogenic if they lead to a decrease in carbohydrate intake.

Rationale

Tirzepatide is a hormone analogue that is not eliminated via CYP metabolism, and is not an inducer or inhibitor of CYP.

Chemical description

Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. (SmPC, DrugBank)

Therapeutic characteristics

Tirzepatide is indicated in adults with type 2 diabetes mellitus to improve glycaemic control and is also used for weight management. It is administered once weekly as a subcutaneous injection (SmPC).

Metabolism and pharmacokinetics

Tirzepatide is metabolised by proteolytic cleavage of the peptide and other protein catabolism pathways (SmPC, DrugBank). Tirzepatide is not expected to affect the cytochrome P450 system, and in vitro studies suggest that tirzepatide does not inhibit or induce CYP enzymes (EMA EPAR). No CYP-related interactions are listed in drug-drug interaction databases (Micromedex; Lexicomp; Stockley’s Interaction Checker)

Published experience

(no case reports found)

References

#	Citation details	PMID
*	Drug reference publications
1.	DrugBank. Tirzepatide. (Accessed: 01 March 2024)
*	Government bodies
2.	European Medicines Agency (EMA). EPAR Procedural steps taken and scientific information after authorization – Mounjaro. Updated 22 February 2024. (Accessed: 01 March 2024)
3.	European Medicines Agency (EMA). European Public Assessment Report – Mounjaro. [EMA/791310/2022]. Published 25 November 2022. (Accessed: 01 March 2024)
*	Drug interaction databases
4.	Lexicomp® Online, Drug Interactions. Waltham, MA: UpToDate,Inc. (Accessed: 05 March 2024).
5.	Merative™ Micromedex® Drug Interaction Checking (electronic version). Ann Arbor, Michigan, USA: Merative. (Accessed: 19 February 2024).
6.	Preston, C.L. (ed). Stockley’s Interaction Checker. London: Pharmacutical Press. (Accessed: 05 March 2024).
*	Other sources
7.	Summary of Product Characteristics (SmPC). Mounjaro KwikPen 15mg solution for injection in pre-filled pen (tirzepatide). Eli Lilly and Company Ltd. Date of revision of text: 25 January 2024. (Accessed: 19 February 2024).

Citation details

PMID

Drug reference publications

DrugBank. Tirzepatide. (Accessed: 01 March 2024)

Government bodies

European Medicines Agency (EMA). EPAR Procedural steps taken and scientific information after authorization – Mounjaro. Updated 22 February 2024. (Accessed: 01 March 2024)

European Medicines Agency (EMA). European Public Assessment Report – Mounjaro. [EMA/791310/2022]. Published 25 November 2022. (Accessed: 01 March 2024)

Drug interaction databases

Lexicomp® Online, Drug Interactions. Waltham, MA: UpToDate,Inc. (Accessed: 05 March 2024).

Merative™ Micromedex® Drug Interaction Checking (electronic version). Ann Arbor, Michigan, USA: Merative. (Accessed: 19 February 2024).

Preston, C.L. (ed). Stockley’s Interaction Checker. London: Pharmacutical Press. (Accessed: 05 March 2024).

Other sources

Summary of Product Characteristics (SmPC). Mounjaro KwikPen 15mg solution for injection in pre-filled pen (tirzepatide). Eli Lilly and Company Ltd. Date of revision of text: 25 January 2024. (Accessed: 19 February 2024).

Similar drugs

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Tradenames and packages

From some sources, we get a list of packages (United Kingdom, Ireland, Estonia). Other sources contain more or less "clean" versions of the trade name (Denmark, Finland, Iceland, Lithuania, Norway). What you see here is the raw data we get from each country, so there will appear to be duplicates. The bold names are the searchable terms. The gray names that follow are all mapped to the bolded term.

Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors. We strive to improve it continuously.

Netherlands

Mounjaro · Mounjaro 10 mg oplossing voor injectie in injectieflacon · Mounjaro 10 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 10 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen · Mounjaro 12,5 mg oplossing voor injectie in injectieflacon · Mounjaro 12,5 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 12,5 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen · Mounjaro 15 mg oplossing voor injectie in injectieflacon · Mounjaro 15 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 15 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen · Mounjaro 2,5 mg oplossing voor injectie in injectieflacon · Mounjaro 2,5 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 2,5 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen · Mounjaro 5 mg oplossing voor injectie in injectieflacon · Mounjaro 5 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 5 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen · Mounjaro 7,5 mg oplossing voor injectie in injectieflacon · Mounjaro 7,5 mg, oplossing voor injectie in voorgevulde pen · Mounjaro 7,5 mg/dosis KwikPen oplossing voor injectie in voorgevulde pen

Belgium

Mounjaro · Mounjaro 10 mg sol. inj. s.c. flac. · Mounjaro 10 mg/dose sol. inj. s.c. stylo prérempli · Mounjaro 12.5 mg sol. inj. s.c. flac. · Mounjaro 12.5 mg/dose sol. inj. s.c. stylo prérempli · Mounjaro 15 mg sol. inj. s.c. flac. · Mounjaro 15 mg/dose sol. inj. s.c. stylo prérempli · Mounjaro 2.5 mg sol. inj. s.c. flac. · Mounjaro 2.5 mg/dose sol. inj. s.c. stylo prérempli · Mounjaro 5 mg sol. inj. s.c. flac. · Mounjaro 5 mg/dose sol. inj. s.c. stylo prérempli · Mounjaro 7.5 mg sol. inj. s.c. flac. · Mounjaro 7.5 mg/dose sol. inj. s.c. stylo prérempli

United Kingdom

Mounjaro · Mounjaro 2.5mg/0.5ml solution for injection pre-filled pens · Mounjaro 5mg/0.5ml solution for injection pre-filled pens · Mounjaro KwikPen 10mg/0.6ml solution for injection 2.4ml pre-filled pens · Mounjaro KwikPen 12.5mg/0.6ml solution for injection 2.4ml pre-filled pens · Mounjaro KwikPen 2.5mg/0.6ml solution for injection 2.4ml pre-filled pens · Mounjaro KwikPen 5mg/0.6ml solution for injection 2.4ml pre-filled pens · Mounjaro KwikPen 7.5mg/0.6ml solution for injection 2.4ml pre-filled pens · Mounjaro KwikPen · Mounjaro KwikPen 15mg/0.6ml solution for injection 2.4ml pre-filled pens

Denmark