Effect of Mounjaro (tirzepatide) once weekly injection on body weight percentage (link: New England Journal of Medicine)

Mounjaro functions by suppressing appetite and promoting a quicker sensation of fullness, thereby facilitating calorie reduction. In simple terms, it makes you feel fuller by slowing down the emptying of your stomach.

Is Mounjaro available in Australia now?

Mounjaro is now accessible in Australia as a prescription medication.

To obtain Mounjaro, a prescription from a medical practitioner (doctor) is required.

Is Mounjaro TGA approved?

Mounjaro (tirzepatide) is currently TGA approved for the treatment of type 2 diabetes in adults, it has not received TGA approval for the specific treatment of obesity.

Mounjaro has been approved in Europe and the US for weight loss and weight management in individuals 18 years and over with a BMI of 30 or more or a BMI of 27 or more and at least one weight related health problem such as pre-diabetes, high blood pressure or high cholesterol.

Is Mounjaro the same as Saxenda or Ozempic?

While all these medications can assist in diabetes and weight management, they employ different mechanisms of action.

Saxenda, containing liraglutide, functions as a GLP-1 receptor agonist and requires daily injections. Ozempic (semaglutide) is also a GLP-1 hormone and works in a similar way with weekly injections.

Mounjaro, on the other hand, contains tirzepatide – this scientific mechanism is that this acts as a dual-acting glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. It is indicated for diabetes management and is administered as a once-a-week injection. The GLP-1 receptor plays a pivotal role in regulating appetite and calorie intake, with receptors present in various brain regions responsible for appetite regulation.

In simple terms, Mounjaro works on two receptors instead of one, as is the case with Ozempic (semaglutide). This is called a synergistic effect. This seems to be the reason for the increased effectiveness of the medication for blood glucose control and weight loss.

How does Mounjaro compare to Ozempic for weight loss?

The latest clinical trials have shown that Mounjaro was more effective than Ozempic, with patients achieving up to 22% weight loss. The top line is that Mounjaro (tirzepatide) is a more effective drug all round, producing more weight loss and a greater reduction in haemoglobin A1C (the key measure of blood gluycose control in diabetes).

How much weight loss occurs with Mounjaro?

The SURMOUNT trial demonstrated the effectiveness of Mounjaro. This phase 3 controlled study involved 2,539 participants who were randomly assigned to receive either tirzepatide (at 5, 10, or 15 mg) or a placebo. After 72 weeks of treatment, the following outcomes were observed:- Those who received the placebo experienced an average weight loss of 3.1 percent.
– Participants taking 5 mg of tirzepatide achieved an average weight loss of 15 percent.
– The 10 mg tirzepatide group saw an increased weight loss of 19 percent.
– In the 15 mg tirzepatide group, the average weight loss reached 20.9 percent.

The majority of weight reduction occurred in the first 12 months.

It will also help with insulin sensitivity and blood glucose  control reducing the complications of diabetes. 

The starting dose is 2.5mg once a week. The doctor will adjust the dose every four weeks to a maximum of 15mg weekly.

What if I am taking other medications?

Certain medications have the potential to disrupt the effectiveness of Mounjaro.

Speak with our pharmacists – Ben, Zuzanna, Sheryl & Joe, as Mounjaro may influence the function of some medications.

How is Mounjaro injected?

Currently in Australia, Mounjaro is only available in a single-use vials.

It is administered via subcutaneous injection once a week. How to inject Mounjaro can be explained to you by our pharmacists – and there is a video link on our website - https://www.easternroadpharmacy.com.au/weight-management-information.

After being trained, you can inject Mounjaro yourself at home or if you prefer, our pharmacists can also help. Read important Consumer medicines information on Mounjaro.

How is Mounjaro stored?

We store Mounjaro in a temperature-controlled approved and monitored refrigerator between 2 to 8 degrees Celsius. Once supplied, it is ok to store Mounjaro vials out of the fridge below 30 degrees Celsius for up to 21 days.

It may even ease administration to inject it when at room temperature. So, you can feel assured if that while your medicine is in transit being delivered for instance, it is ok and will not require any special refrigeration while in transit. 

When is Mounjaro not suitable?

Certain conditions and medical histories may preclude the use of Mounjaro. It is crucial to be aware of these contraindications.  Your doctor as a prescriber, will confirm the following which are contraindications to Mounjaro use.

·       Personal or family history of thyroid cancer or multiple endocrine neoplasia.

·       Hypersensitivity to tirzepatide.

·       Pregnancy or individuals under 18 years of age.

·       Pre-existing conditions, including pancreatitis, kidney disease, gallbladder disease, diabetic retinopathy.

·       BMI below 27

Side effects and risks of Mounjaro

Mounjaro may be associated with some common side effects, including nausea, diarrhea, vomiting, constipation, or reflux. In studies, most nausea, vomiting and diarrhea events occurred while the dose of Mounjaro was being increased. These events decreased over time. Please discuss this with our pharmacists, or your doctor.

Serious side effects are rare but may include pancreatitis (inflammation of the pancreas), kidney or gallbladder problems or an allergic reaction to Mounjaro. In these cases, the prescriber should be notified immediately. 

Can you switch from Ozempic to Mounjaro?

Yes, this is a potential option if it is deemed appropriate and safe by your prescribing clinician. The transition process would typically begin with shifting from your current Ozempic dose to 2.5mg of Mounjaro, starting seven days after your last Ozempic dose. After a four-week period on either the 2.5mg or the 5mg, it is possible that the higher doses may be explored.

Your clinician will thoroughly assess your current progress, overall health, and engage in a discussion regarding potential side effects or risks. This collaborative decision will be made after careful consideration of your individual circumstances.

Can you switch from Saxenda to Mounjaro (or Ozempic)?

Yes this is possible under the guidance of your clinician. It’s important to explore the reasons and rationale behind the switch and discuss the risks versus the benefits.

As discussed above, Saxenda is a once daily GLP-1 injection compared to Ozempic and Mounjaro that are once weekly injections.

The dose change will need to be discussed carefully with your clinician.

Your DNA to manage your weight

Ask our pharmacists how your DNA affects the way your body responds to different foods with personalised Weight Management insights.

Research has shown that some genes have strong links to aspects of your nutrition and health, including your ability to store and burn fat, your appetite, and the ability to keep weight off after you lose it.  Our DNA service can assist your weight management program to better understand:

• Appetite & Weight
• Fat Storage
• Body Size & Weight Regain
• Fat Burning & Weight

These insights are:

þ Backed by scientific evidence reviewed by clinical experts

þ Based on your unique DNA results for genes including FTO, PPARG, MTIF3, ADIPOQ

þ Explained in simple, easy-to-understand language

þ Designed to help you make better food choices and reach your ideal weight

Weight management program

Following your initial assessment, our pharmacists can provide a unique service with comprehensive weight management support in collaboration with your doctor. Key elements include:

– Establishing your target weight and body mass index.

– Evaluating your current caloric intake.

– Determining the target caloric intake aligned with your weight management objectives.

– Setting weekly exercise goals, beginning with a daily 20-minute walk.

– Reviewing blood test results.

– Issuing prescriptions for medications if deemed clinically appropriate.

– Providing instructions for at-home care.

– Outlining a program for regular review with the Medmate nursing and medical team.

Diet

A high protein and nutritious diet is paramount to successful weight management.  Guidance through calorie tracking and your daily calorie target may be helpful for some people. In general, it is important to achieve a sustainable daily calorie deficit (at least by 500 calories). Medications may assist in achieving this goal.

Referral to a dietitian may also be recommended to formulate a meal plan aligned with your goals. It’s important to retain lean muscle mass and will involve tracking your macro nutrients to ensure you hit your protein targets for each day.  A tracker such as My Fitness Pal to track daily calories and macros may be a useful tool.

Calculate your basal metabolic rate and subtract 500 to get your daily target. For example if your basal metabolic rate was 2000 calories, subtract 500 to get a daily target of 1500 calories.

Calculate your basal metabolic rate here.

Physical activity

Gradually integrating regular exercise into your routine can contribute to the attainment and maintenance of a calorie deficit and a healthy weight. The objective is to increase daily movement while adhering to your calorie target, eventually creating a calorie deficit conducive to weight reduction. Increasing lean muscle mass over time means your body burns more energy at rest allowing you to maintain a healthy weight and a leaner and more muscular physique. It’s a learning curve, the first step is to kick start the calorie deficit, measure results regularly and learn about how to incorporate both aerobic and resistance activity into your daily life. This is about lifestyle change. In time, your new habits will involve a healthier diet and regular activity that will keep you lean for the long term.

Stress management

Stress can disrupt eating habits and contribute to weight gain. Exploring stress-reduction techniques such as mindfulness, meditation, or yoga can be valuable in maintaining a healthy lifestyle.

Conclusion

In summary, Mounjaro is accessible in Australia via prescription, where appropriate for the patient. Your initial step should involve consulting with a healthcare professional to develop a personalised management plan.

It is essential to recognise that medications are most effective when incorporated into a comprehensive approach for diabetes and weight management, encompassing diet, exercise, and professional guidance.

Achieving and sustaining a healthy weight is a journey, and with the right support and direction, you can make substantial progress toward your objectives. Always prioritise your health and safety by seeking guidance from a healthcare professional before initiating any weight management medication.

Please bear in mind that the information provided in this guide is for informative purposes exclusively and should not replace the advice and direction of a qualified healthcare professional. Always seek professional guidance tailored to your specific health requirements and goals.

Finally, other treatment options that you may discuss include – Xenical (orlistat), Contrave (naltrexone & buproprion), Duromine or Phentodur (phentermine), Saxenda (liraglutide), Trulicity (dulaglutide) and Ozempic (semaglutide).

A comprehensive insight and guidance

Obesity is a chronic metabolic disease – but it can be treated. In the pursuit of a healthier lifestyle and to reduce the risks of obesity and Type 2 Diabetes, Australians are increasingly exploring medical assistance for their journey. Mounjaro (Tirzepatide) was recently published in the New England Journal of Medicine as being an effective medication available for the treatment of obesity. Mounjaro in Australia is TGA-approved for the management of diabetes and requires a prescription following a consultation with a healthcare professional. 

The following is general information and your doctor is required to assist with a personalised treatment plan that may or may not include medications.

Understanding Mounjaro

Mounjaro (active ingredient Tirzepatide) is used to manage blood sugar in people with diabetes and has shown strong evidence in global studies for a reduction in body weight by over 20%.

A major global study published in the New England Journal of Medicine, treating patients with obesity alone (without diabetes) showed over a 20% weight loss, with the majority of weight reduction occurring in the initial 12 months.