Tirzepatide

The manufacturers claim it works on a second glucagon receptor (GIP) in addition to the GLP-1. Eli Lilly claim Mounjaro is better than its rivals, and the media in USA, where it has been available for a couple of years, refer to it as the “King Kong” of weight-busters. There is inevitably a certain amount of hyperbole here, but early results with my patients do suggest a significant improvement in weight loss. I was initially transferring patients who were not achieving satisfactory results, or were experiencing side-effects. Most have achieved greater weight loss, and also reduction in the frequency or severity of side effects (usually nausea, bloating or abdominal pain). I have now started to initiate treatment with Mounjaro. 

 

The principles of treatment are the same: weekly injections for 4 weeks, increasing the dose each 4 weeks until satisfactory weight loss gradient is achieved. The doses available are 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg. The advice given to me when discussing it with the representatives was that there was not much evidence of increased effectiveness between the 10mg, 12.5mg and 15mg, so I tend to keep the highest maintenance dose at 10mg, though future experience may change this policy. 

 

Surprisingly, there is not a significant difference in prices between Ozempic/Wegovy and Mounjaro: American prices do tend to be rather higher (the charges for Ozempic/Wegovy in USA were 4-5x higher than in Europe), but you should still shop around as different pharmacies charge different amounts. 

 

Irritatingly, Mounjaro does not come with the needles, so you will need to purchase them separately (easily available on the internet). The mechanism is slightly different from Ozempic, so make sure you ask the pharmacist to give you a “demo”. 

 

As with other new medication, I believe it is inappropriate to prescribe without “face-to-face” consultation, and regularly in the early stages, and I deprecate the internet dispensing of these drugs. 

 

Is the word “Mounjaro” a play on the French (manger) or Italian (mangiare) word for “eat”? Who knows…