Tirza 2.5 AutoGuarded Prefilled Syringe

✔️ Pharmacology

Tirzepatide is a synthetic 39-amino-acid peptide with a C20 fatty diacid moiety, enhancing its albumin binding and extending its half-life.
It selectively activates GIP and GLP-1 receptors, boosting insulin secretion (first and second phase) and reducing glucagon—both in a glucose-dependent manner.

✔️ Side Effects

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Decreased appetite
• Dyspepsia
• Abdominal pain

✔️ Administration Instructions

• Inject once weekly any time of the day, with or without meals.
• Injection sites: Abdomen, thigh, or upper arm—rotate sites with each dose.
• Do not mix with insulin. If used together, inject at separate sites (not adjacent).
• Inspect syringe for discoloration or particles before use.
• Do not freeze. Discard if frozen or dropped on a hard surface.
• Latex allergy warning: Needle cover contains dry natural rubber (latex derivative).

✔️ Dosage & Administration

Route: Subcutaneous injection

Start with 2.5 mg once weekly (initiation dose, not for glycemic control)

After 4 weeks, increase to 5 mg once weekly

Further titration: Increase in 2.5 mg increments every 4 weeks as needed

Maximum dose: 15 mg once weekly

Pediatrics (<18 years): Safety and efficacy not established.

Geriatric patients: No dosage adjustment based solely on age.

Renal or hepatic impairment: Monitor closely; consider dose adjustments based on tolerability.

Missed Dose:

• Administer within 96 hours (4 days).
• If >4 days have passed, skip the missed dose and resume the regular schedule.
• The weekly injection day may be changed, but maintain at least 72 hours between doses.

✔️ Interaction

• Insulin or insulin secretagogues (e.g., sulfonylureas): Risk of hypoglycemia—dose adjustment may be needed.
• Oral medications: Tirza delays gastric emptying, potentially affecting absorption of critical drugs (e.g., warfarin).
• Hormonal contraceptives (oral): Recommend switching to a non-oral or barrier method for 4 weeks after initiation and after any dose escalation.
• Non-oral contraceptives are not affected.

✔️ Contraindications

• Hypersensitivity to tirzepatide or any component of the formulation
• Personal or family history of medullary thyroid carcinoma (MTC)
• History of multiple endocrine neoplasia syndrome type 2 (MEN 2)

✔️ Use in Pregnancy & Lactation

• Use during pregnancy only if benefits outweigh risks—uncontrolled diabetes also poses fetal risks.
• During breastfeeding, weigh potential effects on the infant against maternal benefit.
• Consider alternative treatments if needed.

✔️ Precautions & Warnings

• Thyroid tumors (MTC): Counsel patients and monitor for symptoms (e.g., neck mass, dysphagia).
• Pancreatitis: Discontinue immediately if suspected.
• Hypoglycemia: May need to reduce insulin or sulfonylurea dose.
• Hypersensitivity: Discontinue and manage accordingly.
• Renal impairment: Monitor function if severe GI symptoms develop.
• Diabetic retinopathy: Monitor for progression.
• Gallbladder disease: Evaluate if cholelithiasis is suspected.

✔️ Storage Conditions

• Store in a refrigerator (2°C to 8°C)
• Do not freeze
• Protect from light
• Keep out of reach of children
• For use only with a registered physician's prescription