The objective of this presentation is to provide medical professionals with detailed information about MOUNJARO® (tirzepatide), a unique therapeutic option for type 2 diabetes. Highlights include detailed instructions for administering MOUNJARO® vial and pen techniques effectively, allowing healthcare professionals to adequately assist patients. To ensure the medication's efficacy and safety, the presentation will cover critical subjects such as dosage adjustments, storage, and handling instructions. The presentation will address both mild and large side effects, as well as recommendations on how to report, monitor, and manage them in order to ensure patient safety. It also goes over patient education strategies such as adherence guidelines and the need of combining MOUNJARO® with lifestyle changes like exercise and diet. Through this presentation, attendees will be equipped with the knowledge to support patients in the effective use of MOUNJARO®, enhancing therapeutic outcomes and managing the challenges of type 2 diabetes.

1. AN INTRODUCTION
TO MOUNJARO
Created by: Feba Annie Joseph

2. OVERVIEW OF
MOUNJARO®
Product Ingredient: Tirzepatide
Class: GIP and GLP-1 receptor
agonists
Indication: Management of blood
sugar in adults with type 2 diabetes
mellitus.
Formulation: Available as a single-use
vial and single-dose pen for
subcutaneous injection.

3. PHARMACODYNAMICS
AND MECHANISM OF
ACTION
Mechanism of Action: Tirzepatide enhances
glucose-dependent insulin secretion,
suppresses glucagon secretion in hyperglycemic
states, and slows gastric emptying.
Clinical Benefits: Offers potential benefits
including improved glycemic control, weight
reduction, and reduced risk of cardiovascular
events.

4. Initial Dosage: 2.5 mg once weekly, incrementally
increased based on patient response.
Maximum Dose: 15 mg once weekly.
Administration Tips: Administer via
subcutaneous injection preferably in the
abdomen, thigh, or upper arm. Rotate injection
sites to minimise tissue irritation.
DOSAGE AND
ADMINISTRATION

5. Scheduling: Administer on the same day each
week; setting a phone reminder can help.
Missed Doses: If a dose is missed, it can be
taken within 4 days. If more than 4 days have
passed, skip it and take the next dose on the
scheduled day.
Safety Note: Do not take two doses within 3
days (72 hours) of each other.

6. ADVERSE EFFECTS
Common side effects include nausea, vomiting, diarrhea, constipation,
decreased appetite, indigestion, and abdominal pain, which might
decrease as the body adjusts to the medication. More serious concerns
include pancreatitis, characterized by severe abdominal pain and
nausea, and thyroid tumors, including Medullary Thyroid Carcinoma
(MTC), which require vigilant monitoring for symptoms like neck lumps or
persistent hoarseness. Additionally, MOUNJARO® can lead to
hypoglycemia, especially when used with other diabetes medications,
and severe hypersensitivity reactions such as anaphylaxis.
The black triangle symbol on Mounjaro®'s documentation
signals that it's under additional monitoring. This reminder
encourages the reporting of any adverse events to help
identify new safety information quickly. As a new treatment
for type 2 diabetes, reporting side effects from Mounjaro®
is vital for assessing its safety profile effectively.

7. DRUG
INTERACTIONS
Concomitant Medications: Discuss potential
interactions with oral medications, especially those
affected by delayed gastric emptying such as oral
contraceptives or certain antidiabetics.
Adjustments and Monitoring: Adjust doses of
concomitant medications that might interact and
monitor patient response closely.
Important Safety Information
Thyroid Cancer Risk: Advise monitoring for
symptoms such as neck lumps, hoarseness, or
difficulty swallowing.
Pancreatitis: Alert patients to the signs and
symptoms of pancreatitis; discontinue use if
suspected.

8. Administration Instructions for MOUNJARO® pen
Choosing Injection Site:
1.
Suitable sites include the
abdomen, thigh, or back of the
upper arm (if assisted).
Avoid injecting within 2 inches of
the navel or in the same spot as
the previous injection.
2. Pen Preparation:
Check that the pen is locked
before removing the cap.
Remove the gray base cap and
discard immediately to avoid
contamination.
Do not touch the needle to
maintain sterility.
3. Injection Execution:
Place the clear base against the skin,
unlock by turning the lock ring.
Press the purple button and hold until
you hear the first click (start of
injection) and a second click (end of
injection).
Verify completion with the visibility of
the gray plunger in the pen's window.

9. Administration Instructions for MOUNJARO® vial
Injection Process:
1.
Choose injection site: abdomen, thigh, or upper arm. Avoid
damaged or irritated skin.
Clean the site with alcohol and let dry.
Inject the needle at a 90-degree angle, press plunger to
administer dose, and hold for 5 seconds.
Post-Injection Care:
2.
Withdraw needle and apply pressure if bleeding occurs.
Do not recap needle to avoid injury.
Disposal:
3.
Dispose of needle and syringe in a sharps container. If
unavailable, use a sturdy plastic container with a screw-top
lid, label it as hazardous, and ensure it's out of reach of
children.
Storage and Handling:
1.
Remove vial from refrigerator.
Check expiration date and ensure solution is colorless to slightly
yellow, not frozen, cloudy, or containing particles.
2. Syringe Preparation:
Wash hands thoroughly.
Assemble syringe and needle, if separate. Attach needle securely
to syringe
Wipe vial’s rubber stopper with alcohol swab.
3. Drawing Medication:
Draw air into syringe equal to dose amount.
Inject air into vial to equalize pressure, facilitating easier
withdrawal of medication.
Invert vial and syringe, withdraw dose, and remove air bubbles
by tapping syringe and pushing any air out.

10. PROPER
STORAGE AND
HANDLING
Storage Conditions: Keep in the refrigerator at 36°F
to 46°F (2°C to 8°C). Can be kept at room
temperature up to 86°F (30°C) for 21 days if
needed
Handling Cautions: Handle with care due to glass
components. Do not use if dropped or damaged.
Note: Instruct patients using the single-dose vial to
use a syringe equipped with a needle appropriate
for subcutaneous injection (for example, a
tuberculin or insulin syringe with a 28- to 31-gauge
needle more than 2.1 mm in length that is capable
of measuring a 0.5 mL dose volume).

11. Pregnancy and Lactation: Counsel on the limited
data available and potential risks. Discuss
contraceptive methods and breastfeeding
considerations.
Pediatric Use: Not recommended for use in
patients under 18 years due to lack of data.
SPECIAL
CONSIDERATIONS

12. THANK YOU!