Tirzepatide Injection

What is this medication?

TIRZEPATIDE (tir ZEP a tide) treats type 2 diabetes. It works by increasing insulin levels in your body, which decreases your blood sugar (glucose). Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): MOUNJARO

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Endocrine tumors (MEN 2) or if someone in your family had these tumors
• Eye disease, vision problems
• Gallbladder disease
• History of pancreatitis
• Kidney disease
• Stomach or intestine problems
• Thyroid cancer or if someone in your family had thyroid cancer
• An unusual or allergic reaction to tirzepatide, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is injected under the skin. You will be taught how to prepare and give it. It is given once every week (every 7 days). Keep taking it unless your health care provider tells you to stop.

If you use this medication with insulin, you should inject this medication and the insulin separately. Do not mix them together. Do not give the injections right next to each other. Change (rotate) injection sites with each injection.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can unless it is more than 4 days (96 hours) late. If it is more than 4 days late, skip the missed dose. Take the next dose at the normal time. Do not take 2 doses within 3 days of each other.

What may interact with this medication?

• Alcohol containing beverages
• Antiviral medications for HIV or AIDS
• Aspirin and aspirin-like medications
• Beta-blockers like atenolol, metoprolol, propranolol
• Certain medications for blood pressure, heart disease, irregular heart beat
• Chromium
• Clonidine
• Diuretics
• Female hormones, such as estrogens or progestins, birth control pills
• Fenofibrate
• Gemfibrozil
• Guanethidine
• Isoniazid
• Lanreotide
• Male hormones or anabolic steroids
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Medications for weight loss
• Medications for allergies, asthma, cold, or cough
• Medications for depression, anxiety, or psychotic disturbances
• Niacin
• Nicotine
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Octreotide
• Other medications for diabetes, like glyburide, glipizide, or glimepiride
• Pasireotide
• Pentamidine
• Phenytoin
• Probenecid
• Quinolone antibiotics such as ciprofloxacin, levofloxacin, ofloxacin
• Reserpine
• Some herbal dietary supplements
• Steroid medications such as prednisone or cortisone
• Sulfamethoxazole; trimethoprim
• Thyroid hormones
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress.

Drink plenty of fluids while taking this medication. Check with your care team if you get an attack of severe diarrhea, nausea, and vomiting. The loss of too much body fluid can make it dangerous for you to take this medication.

A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.

Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.

Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you might need to change the dose of your medication.

Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.

Pens should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medication and dosage times.

Birth control may not work properly while you are taking this medication. If you take birth control pills by mouth, your care team may recommend another type of birth control for 4 weeks after you start this medication and for 4 weeks after each increase in your dose of this medication. Ask your care team which birth control methods you should use.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Change in vision
• Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
• Gallbladder problems—severe stomach pain, nausea, vomiting, fever
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
• Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Constipation
• Diarrhea
• Loss of Appetite
• Nausea
• Stomach pain
• Upset stomach
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Refrigeration (preferred): Store unopened pens in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Keep it in the original carton until you are ready to take it. Do not freeze or use if the medication has been frozen. Protect from light. Get rid of any unused medication after the expiration date on the label.

Room Temperature: The pen may be stored at room temperature below 30 degrees C (86 degrees F) for up to a total of 21 days if needed. Protect from light. Avoid exposure to extreme heat. If it is stored at room temperature, throw away any unused medication after 21 days or after it expires, whichever is first.

The pen has glass parts. Handle it carefully. If you drop the pen on a hard surface, do not use it. Use a new pen for your injection.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.