Mounjaro®

What is Mounjaro

Mounjaro is a medication containing the active substance tirzepatide. It is used for two medical applications:

1. Weight loss and weight maintenance in adults with obesity (BMI ≥ 30) or overweight (BMI 27–30) with weight-related health problems, such as high blood pressure, sleep apnea, or high cholesterol.
2. Treatment of type 2 diabetes in adults, when diet and exercise alone are not sufficient to lower blood sugar.

At The Body Clinic, a doctor assesses during the consultation whether medication treatment is suitable within a medical weight management program. More information about our medical approach can be found in our treatment program.

Instructions for Mounjaro Use

Below you will find brief usage information for the pen. Always read the package leaflet or ask your doctor/pharmacist for an explanation.

Important information about the pen

• Each pen contains one fixed dose.
• You can inject 4 times with one pen (once a week).
• After 4 injections, the pen automatically locks.
• There will always be some residual fluid left; this is not a full dose.

Check before each injection

1. Place a new needle on the pen.
2. Turn the back 2 clicks until the first line appears in the window.
3. Press the back until a '0' reappears on the screen.
4. If a drop appears on the needle, the pen is ready for use.
5. If you do not see a drop, repeat the steps; if this persists after 2 attempts, replace the needle and repeat the check.
6. If a drop appears, turn the pen completely until '1' is displayed on the screen and administer the dose.

Storage

• In the refrigerator (2–8 °C), do not freeze and protect from light.
• After opening: up to 30 days at room temperature (max. 30 °C) possible.

Tirzepatide

Tirzepatide is the active substance in Mounjaro and is produced by Eli Lilly. It is an incretin mimetic: it activates both the GIP and GLP-1 receptors. These receptors play a role in the release of insulin after meals, reducing glucagon secretion, and influencing appetite and satiety. Through this combined action, tirzepatide helps to regulate blood sugar and supports weight loss and weight maintenance for the appropriate indications.

Mounjaro for Weight Loss

Mounjaro contains tirzepatide, a substance that acts like two natural hormones in your body: GIP and GLP-1. These hormones are produced in the intestines after a meal and help the body properly utilize sugar from food. Under their influence, the pancreas produces more insulin when blood sugar rises, and the liver releases less sugar into the blood.

Summarized action:

• lowering blood sugar levels when they are too high;
• slowing down gastric emptying, so food remains in the stomach longer;
• providing a feeling of satiety, causing you to eat less; and thus supporting weight loss and weight maintenance in obesity or overweight.

The effect gradually builds up during treatment. Mounjaro only lowers blood sugar when it is too high.

Results after 12 months (SURPASS-3)

The table below shows the average weight change and the percentage of participants who achieved at least 5%, 10%, or more than 15% weight loss after 52 weeks of Mounjaro treatment, alongside diet and exercise.

Dosage per week	Average weight loss	≥ 5% weight loss	≥ 10% weight loss	> 15% weight loss
5 mg	−7,5 kg	81%	55%	34%
10 mg	−10,7 kg	89%	73%	50%
15 mg	−12,9 kg	91%	80%	57%
Comparison group	+2,3 kg	26%	8%	3%

Mounjaro price

The price of Mounjaro is determined by the pharmacy and may vary by strength and dosage. At The Body Clinic, a doctor assesses during the consultation whether medication treatment is suitable within a medical weight management program. More information about our medical approach can be found in our treatment program.

Who is Mounjaro suitable for?

Mounjaro can be prescribed to adults with:

• BMI ≥ 30 (obesity), or BMI 27–30 (overweight) with at least one weight-related condition (e.g., hypertension, dyslipidemia, or sleep apnea),
• Adults with type 2 diabetes when diet and exercise alone are insufficient.

Mounjaro prescription

Mounjaro is only available on prescription. A BIG-registered doctor assesses whether you meet the medical criteria and can then issue a prescription. At The Body Clinic, a doctor assesses during the consultation whether medication treatment is suitable within a medical weight management program. More information about our medical approach can be found in our treatment program.

Mounjaro reimbursement by health insurer

Mounjaro may in some cases be reimbursed for the treatment of type 2 diabetes when other agents have insufficient effect. For use in weight loss, Mounjaro is usually not covered by basic insurance. Inquire with your health insurer or pharmacy.

How Mounjaro works

Mounjaro contains tirzepatide. This substance resembles the hormones GIP and GLP-1, which are released after a meal. They help the body properly utilize sugar from food. Under their influence, the pancreas produces more insulin when blood sugar rises, and the liver releases less sugar into the blood.

Summarized action:

• lowering blood sugar levels when they are too high;
• slowing down gastric emptying (food remains in the stomach longer);
• providing a feeling of satiety (less hunger),
• and thus supporting weight loss and weight maintenance. The effect gradually builds up; Mounjaro only lowers blood sugar when it is too high.

The substances in Mounjaro

Mounjaro is a pre-filled pen with a fixed strength per pen. Below you will find the composition as stated in the official product information.

• Active substance: tirzepatide.
• Other excipients: sodium chloride, dibasic sodium phosphate heptahydrate, and water for injection.

Where do you inject Mounjaro?

Mounjaro is administered as an injection under the skin (subcutaneous). Below you can read where to inject and what to pay attention to during first use.

Do not inject into a vein or muscle. Suitable injection sites:

• front of the thigh abdomen (front of waist)
• upper arm Have your doctor or nurse show you how to use the pen before the first use.

Tips for using Mounjaro

Always use Mounjaro as instructed by your doctor or pharmacist and read the package leaflet. Practical instructions:

• Administer the injection once a week, preferably on the same day.
• Rotate the injection site (abdomen, thigh, upper arm).
• Missed dose: administer within 4 days; after that, skip and continue according to schedule. No double dose.
• Storage: in the refrigerator (2–8 °C), do not freeze; after opening, up to 30 days at room temperature (max. 30 °C) possible.

The difference between Mounjaro and Zepbound

Mounjaro and Zepbound both contain tirzepatide and are produced by Eli Lilly.

• Application Mounjaro: weight loss/weight maintenance and type 2 diabetes. Zepbound: weight loss/weight maintenance.
• Active substance and class Both: tirzepatide (GIP + GLP-1 receptor agonist).
• Dosage/frequency of use Both: once a week (titration according to SmPC).
• Registration status/Availability Mounjaro: available in the Netherlands/EU. Zepbound: not available on the Dutch market.

The difference between Mounjaro and Saxenda

• Application Mounjaro: weight loss/weight maintenance and type 2 diabetes. Saxenda: weight loss/weight maintenance.
• Active substance and class Mounjaro: tirzepatide (GIP + GLP-1). Saxenda: liraglutide (GLP-1).
• Dosage/frequency of use Mounjaro: 1× per week (2.5–15 mg; titration). Saxenda: 1× per day (0.6–3 mg; titration).

The difference between Mounjaro and Ozempic

• Application Mounjaro: weight loss/weight maintenance and type 2 diabetes. Ozempic: type 2 diabetes (not registered for weight loss).
• Active substance and class Mounjaro: tirzepatide (GIP + GLP-1). Ozempic: semaglutide (GLP-1).
• Dosage/frequency of use Both: 1× per week (titration according to SmPC).

The difference between Mounjaro and Wegovy

• Application Mounjaro: weight loss/weight maintenance and type 2 diabetes. Wegovy: weight loss/weight maintenance.
• Active substance and class Mounjaro: tirzepatide (GIP + GLP-1). Wegovy: semaglutide (GLP-1).
• Dosage/frequency of use Both: 1× per week (titration according to SmPC).

Mounjaro side effects

Possible side effects

• nausea
• diarrhea
• decreased appetite
• vomiting
• constipation
• abdominal pain
• indigestion (heartburn)
• flatulence or belching reflux (backflow of stomach acid)
• fatigue
• injection site reactions (itching, redness, or pain)

Other reported side effects

• dizziness
• rapid heartbeat (tachycardia)
• pancreatitis (inflammation of the pancreas)
• gallbladder disorders (such as gallstones)
• changes in kidney function with dehydration
• hypersensitivity reactions such as rash angioedema (sudden swelling of skin or mucous membranes)
• anaphylactic reaction (severe allergic reaction)
• worsening of diabetic retinopathy with rapid improvement in blood sugar levels

Serious side effects – contact your doctor immediately

• persistent severe abdominal pain with or without vomiting (possible pancreatitis)
• severe or prolonged nausea, vomiting, or diarrhea (risk of dehydration or kidney damage)
• swelling of the face, lips, tongue, or throat (possible allergic reaction)
• pain in the upper right abdomen or jaundice (possible gallbladder or liver problem)
• sudden worsening of vision (diabetic retinopathy)

Contraindications for Mounjaro use

Mounjaro should not be used in the following situations:

• if you are allergic to tirzepatide or any of the other ingredients of this medicine (such as sodium chloride, sodium phosphate, or water for injection);
• if you have severe stomach or intestinal problems leading to delayed gastric emptying, such as gastroparesis; - if you have severe liver or kidney problems, as there is insufficient experience with safe use; in children and adolescents under 18 years of age (safety and efficacy have not been established).

In addition, Mounjaro should be used with caution together with insulin or other blood sugar lowering agents, as this may increase the risk of low blood sugar (hypoglycemia).

Mounjaro during pregnancy or breastfeeding

Mounjaro should not be used during pregnancy. There are no data on use in pregnant women. In animal studies, harm to the unborn animal was observed at high doses. Women who wish to become pregnant should stop Mounjaro at least one month before pregnancy, as the drug remains active in the body for a long time. It is unknown whether tirzepatide (the active substance) passes into breast milk. Therefore, the use of Mounjaro during breastfeeding is not recommended. There is no evidence that Mounjaro affects human fertility.

Sources

• EMA – SmPC Mounjaro (tirzepatide), 23-08-2023 (EN)
• Mounjaro Package Leaflet (EN, 2023)
• SmPCs of comparison products (Saxenda, Wegovy, Ozempic) via ema.europa.eu