Tirzema
Generic Name
Tirzema 5 mg Injection
Manufacturer
Healthcare Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tirzema 5 mg injection | ৳ 2,100.00 | N/A |
Description
Overview of the medicine
Tirzema 5 mg injection contains Tirzepatide, a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. It is used to improve blood sugar control in adults with type 2 diabetes mellitus and for chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity.
Uses & Indications
Dosage
Adults
Initial dose is 2.5 mg subcutaneously once weekly. After 4 weeks, increase to 5 mg once weekly. Further dose escalations (7.5 mg, 10 mg, 12.5 mg, 15 mg) can be made in 2.5 mg increments, after at least 4 weeks on the current dose. The maximum recommended dose is 15 mg once weekly.
Elderly
No dose adjustment is required based on age. Exercise caution in elderly patients with impaired renal function.
Renal_impairment
No dose adjustment is required for patients with renal impairment, including end-stage renal disease. Experience is limited in patients with ESRD receiving dialysis.
How to Take
Administer subcutaneously in the abdomen, thigh, or upper arm once weekly, any time of day, with or without meals. Rotate injection sites. Do not inject into a vein or muscle. If administered on the same day as insulin, inject at a different site.
Mechanism of Action
Tirzepatide acts as a dual agonist on both GIP and GLP-1 receptors. Both GIP and GLP-1 are incretin hormones released from the gut in response to food intake. By activating these receptors, tirzepatide enhances glucose-dependent insulin secretion, suppresses glucagon secretion, slows gastric emptying, and increases satiety, leading to improved glycemic control and weight reduction.
Pharmacokinetics
Onset
Clinical effects on glucose reduction seen within days; weight loss effects are gradual over several weeks/months.
Excretion
Primarily excreted renally via metabolism products.
Half life
Approximately 5 days (about 120 hours), supporting once-weekly administration.
Absorption
Slowly absorbed after subcutaneous injection, reaching peak plasma concentration in 8 to 24 hours.
Metabolism
Metabolized by proteolytic cleavage into smaller peptides and amino acids; no single primary metabolic pathway identified.
Side Effects
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC).
- Patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Known hypersensitivity to tirzepatide or any of the excipients.
- Pregnancy (unless benefits outweigh risks) and lactation (due to lack of data).
Drug Interactions
Oral Contraceptives
Tirzepatide may reduce the efficacy of oral contraceptives due to delayed gastric emptying. Advise patients using oral contraceptives to switch to a non-oral contraceptive method or add a barrier method for 4 weeks after initiation and for 4 weeks after each dose escalation.
Other Oral Medications
Delayed gastric emptying can affect the absorption of concomitantly administered oral medications. Monitor patients receiving drugs with a narrow therapeutic index or those requiring rapid gastrointestinal absorption.
Insulin Secretagogues (Sulfonylureas) or Insulin
Risk of hypoglycemia. A dose reduction of sulfonylurea or insulin may be necessary when co-administered with tirzepatide.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. If refrigeration is not possible, store at room temperature (below 30°C / 86°F) for a maximum of 21 days.
Overdose
In the event of an overdose, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms. A prolonged period of observation and treatment for these symptoms may be necessary, taking into account the long half-life of tirzepatide.
Pregnancy & Lactation
Pregnancy: Use is not recommended during pregnancy due to potential fetal harm observed in animal studies. Lactation: It is unknown if tirzepatide is excreted in human milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC).
- Patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Known hypersensitivity to tirzepatide or any of the excipients.
- Pregnancy (unless benefits outweigh risks) and lactation (due to lack of data).
Drug Interactions
Oral Contraceptives
Tirzepatide may reduce the efficacy of oral contraceptives due to delayed gastric emptying. Advise patients using oral contraceptives to switch to a non-oral contraceptive method or add a barrier method for 4 weeks after initiation and for 4 weeks after each dose escalation.
Other Oral Medications
Delayed gastric emptying can affect the absorption of concomitantly administered oral medications. Monitor patients receiving drugs with a narrow therapeutic index or those requiring rapid gastrointestinal absorption.
Insulin Secretagogues (Sulfonylureas) or Insulin
Risk of hypoglycemia. A dose reduction of sulfonylurea or insulin may be necessary when co-administered with tirzepatide.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. If refrigeration is not possible, store at room temperature (below 30°C / 86°F) for a maximum of 21 days.
Overdose
In the event of an overdose, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms. A prolonged period of observation and treatment for these symptoms may be necessary, taking into account the long half-life of tirzepatide.
Pregnancy & Lactation
Pregnancy: Use is not recommended during pregnancy due to potential fetal harm observed in animal studies. Lactation: It is unknown if tirzepatide is excreted in human milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months when stored unopened in the refrigerator. After first use, it can be stored at room temperature (below 30°C) for up to 21 days.
Availability
Pharmacies, hospitals, specialized clinics
Approval Status
FDA approved (USA), EMA approved (EU), DGDA approved (Bangladesh)
Patent Status
Patented by Eli Lilly and Company
Clinical Trials
Tirzepatide was evaluated in the SURPASS clinical trial program for type 2 diabetes, demonstrating superior HbA1c and weight reductions compared to placebo, GLP-1 agonists, and insulin. The SURMOUNT clinical trial program evaluated tirzepatide for chronic weight management, showing significant weight loss.
Lab Monitoring
- HbA1c levels
- Blood glucose levels (fasting and postprandial)
- Renal function tests (e.g., serum creatinine, eGFR)
- Liver function tests
- Lipid profile (cholesterol, triglycerides)
- Pancreatic enzymes (if pancreatitis is suspected)
- Thyroid function tests (consider if MTC risk factors)
Doctor Notes
- Educate patients on proper injection technique and site rotation.
- Counsel on symptoms of pancreatitis, cholelithiasis, and hypoglycemia.
- Advise patients on the importance of diet and exercise as adjuncts to therapy.
- Monitor patients for signs of thyroid C-cell tumors if risk factors are present.
Patient Guidelines
- Administer once weekly on the same day each week, at any time of day, with or without meals.
- Rotate injection sites (abdomen, thigh, or upper arm) each week.
- Do not mix with insulin or other injectables in the same syringe.
- Store in the refrigerator, protect from light. Do not freeze.
- Report persistent severe abdominal pain, nausea, vomiting, or diarrhea to your doctor immediately.
Missed Dose Advice
If a dose is missed, administer it as soon as possible within 4 days (96 hours) after the missed dose. If more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. Do not administer two doses within 3 days (72 hours) of each other.
Driving Precautions
Tirzepatide has no or negligible influence on the ability to drive and use machines. However, patients should be advised to take precautions to avoid hypoglycemia, particularly when used in combination with sulfonylureas or insulin, which could affect concentration.
Lifestyle Advice
- Follow a reduced-calorie diet as advised by your healthcare provider.
- Engage in regular physical activity.
- Monitor blood sugar levels regularly as instructed by your doctor.
- Maintain regular follow-up appointments with your doctor.
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