| Name | Compounded Tirzepatide & Branded Tirzepatide (Mounjaro®, Zepbound®) |
| Uses | Adjunct to diet and exercise for chronic weight management in adults with obesity or overweight with weight-related conditions; type 2 diabetes management. |
| Route Of Administration | Subcutaneous (SC) injection. |
| Frequency Of Use | Once weekly, on the same day each week, at any time of day, with or without food. |
| Concentration(s) | Compounded: 2.5 mg/mL, 5 mg/mL, 10 mg/mL; Branded: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg per dose. |
| Maximum Dosage (Day, Wk) | Max dose: 15 mg SC once weekly. |
| Contraindications | Personal or family history of medullary thyroid carcinoma (MTC), multiple endocrine neoplasia syndrome type 2 (MEN 2), severe hypersensitivity to tirzepatide or excipients. |
| Possible Side Effects | Common: nausea, vomiting, diarrhea, decreased appetite, fatigue. Rare: pancreatitis, gallbladder disease, thyroid tumors, severe allergic reaction. |
| Compatibility With Other Treatments/Drugs | Use caution with insulin or sulfonylureas due to hypoglycemia risk. Avoid with other GLP-1 receptor agonists. |
| Allergies | Assess for hypersensitivity to tirzepatide, preservatives, or stabilizing agents in compounded formulations. |
| Administration Time | Once weekly injection, at any time of day, with or without food. |
| Dosing/Settings | Start at 2.5 mg SC once weekly for 4 weeks, then increase to 5 mg weekly. Titrate by 2.5 mg every 4 weeks as tolerated, max 15 mg weekly. |
| Test Spot Requirement | Not required for tirzepatide. |
| Pre-Treatment Guidelines | Assess baseline A1C (if diabetic), renal and hepatic function, weight history, and contraindications. |
| Provider Clearance Guidelines | NP, PA, MD, or DO must approve; confirm absence of contraindications and assess cardiovascular/metabolic risk factors. |
| Pre-Treatment Screening Workflow | 1. Confirm no history of MTC or MEN 2. 2. Review kidney and liver function. 3. Assess for prior pancreatitis or gallbladder disease. |
| What To Do If Adverse Reaction Occurs | For mild GI symptoms: supportive care. For severe reactions: discontinue, initiate emergency response if anaphylaxis or pancreatitis suspected. |
| Clinic Implementation Guidelines | Store at 2-8°C (36-46°F). Do not freeze. Use within stability period per compounding pharmacy or manufacturer guidelines. |
| Photographic Documentation Protocol | Not required for tirzepatide therapy. |
| Post-Treatment Care | Monitor for gastrointestinal symptoms, assess for weight loss progress, schedule follow-up in 4-6 weeks. |
| Additional Documentation Requirements | Signed informed consent, treatment logs, patient education on administration and side effects, adverse event documentation if applicable. |