Tirzepatide
Tirzepatide (Mounjaro, Zepbound)
Dual GLP-1/GIP agonist — stronger than Semaglutide
About
A dual agonist that activates both GLP-1 and GIP receptors. FDA approved 2022. Shows 20-22% weight loss in clinical trials.
Mechanism
Activates both GLP-1 and GIP, producing synergistic effects on glycemic control, insulin sensitivity, and adipose-tissue regulation.
Dosage
Draw to 75 units on a U-100 insulin syringe
10 mg · 3 mL BAC
When to take: Same day each week. Any time of day, with or without food.
Reconstitution
Vial size (mg): 10 mg · BAC water (mL): 3 mL · Concentration: 3.33 mg/mL
Compounded version. Prescription pen is pre-filled.
Dosing reference
Units to draw at the typical dose range, per vial size.
| Vial | Water | Typical draw |
|---|---|---|
| 10 mg | 3 mL | 75–450 units |
| 20 mg | 3 mL | 37.5–225 units |
| 30 mg | 3 mL | 25–150 units |
| 40 mg | 3 mL | 19–112.5 units |
| 60 mg | 3 mL | 12.5–75 units |
Benefits
- 20-22% weight loss (SURMOUNT trials)
- Stronger effects than Semaglutide (head-to-head trial)
- Improved glycemic control
- Lowered blood pressure
- Improved lipid profile
Side effects
- Nausea (common initially)
- Diarrhea
- Reflux
- Constipation
- Abdominal pain
Gender notes
Cautions
- Medullary thyroid carcinoma
- MEN 2 syndrome
- Pregnancy
- History of pancreatitis
- Severe gastrointestinal disease
Research
- SURMOUNT-1: Tirzepatide for obesity
New England Journal of Medicine · 2022
2539 participants, 22.5% weight loss on 15 mg dose at 72 weeks.
- SURMOUNT-5: Tirzepatide vs Semaglutide head-to-head
New England Journal of Medicine · 2025
Tirzepatide produced 20.2% weight loss vs 13.7% for Semaglutide at 72 weeks.