Zepatid 15/Tirzepatide is a GIP receptor and GLP-1 receptor agonist. It is a 39-amino-acid modified peptide with a C20 fatty diacid moiety that enables albumin binding and prolongs the half-life. It selectively binds to and activates both the GIP and GLP-1 receptors, the targets for native GIP and GLP-1. It enhances first- and second-phase insulin secretion and reduces glucagon levels, both in a glucose-dependent manner.
Use in children and adolescents: Safety and effectiveness of Zepatid have not been established in patients under 18 years of age.
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Zepatid is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It has not been studied in patients with a history of pancreatitis. It is not indicated for use in patients with type 1 diabetes mellitus.
Dosing instructions-
Preparation and administration-
The most common side effects are nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, and abdominal pain.
Drug interaction with medication: Consider reducing the dose of concomitantly administered insulin secretagogues (e.g., sulfonylureas) or insulin to reduce the risk of hypoglycemia. Zepatide delays gastric emptying and thereby has the potential to impact the absorption of concomitantly administered oral medications. Monitor patients on oral medications dependent on threshold concentrations for efficacy and those with a narrow therapeutic index (e.g., warfarin) when concomitantly administered. Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with it. Hormonal contraceptives that are not administered orally should not be affected.
Tirzepatide is contraindicated in patients with known hypersensitivity to tirzepatide or any other components of this product. It is also contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2).
There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy. Tirzepatide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for tirzepatide and any potential adverse effects on the breastfed infant from tirzepatide or from the underlying maternal condition.
Counsel patients regarding the potential risk for MTC with the use of Zepatid and inform them of symptoms of thyroid tumors. After initiation, observe patients for signs and symptoms of pancreatitis. If pancreatitis is suspected, discontinue Zepatid and initiate appropriate management. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogue) or insulin. If hypersensitivity reactions occur, discontinue use of Zepatid; treat promptly per standard of care and monitor until signs and symptoms resolve. Monitor renal function when initiating or escalating doses in patients with renal impairment reporting severe gastrointestinal adverse reactions. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy. If cholelithiasis is suspected, gallbladder diagnostic studies and appropriate clinical follow-up are indicated.
Keep out of the reach and sight of children. Store in a refrigerator at 2°C to 8°C. Do not freeze and protect from light. Do not use if it has been frozen. To be taken and sold only on the prescription of a registered physician.
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