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Tirzepatide for Type 2 Diabetes (Mounjaro) Initiated at 2.5 mg weekly (to build tolerance) Bumped to 5 mg after 4 weeks, then titrated by 2.5 mg every 4 weeks as needed Dose adjustment guided by glycemic control (HbA1c targets) and side effect tolerability Typically used alongside diet and exercise and can be combined with other diabetes medications excluding type 1 diabetes Tirzepatide for Obesity (Zepbound) Initiated similarly at 2.5 mg weekly Increased to 5 mg after 4 weeks, with potential further titrations every 4 weeks in 2.5 mg steps Recommended maintenance doses for weight loss are 5 mg, 10 mg, or 15 mg weekly Also indicated for moderate to severe obstructive sleep apnea (OSA) related to obesity, often with doses of 10 mg or 15 mg Prescribed alongside a reduced-calorie diet and increased physical activity Why Gradual Dose Increases Matter Gastrointestinal side effects (nausea, diarrhea, vomiting) are common during initiation and can be dose-limiting Slow titration allows for better medication tolerance and improved adherence Adjustments are based on individual response and tolerance, highlighting the importance of medically supervised care Special Considerations: Who Needs Careful Monitoring