Monograph
A10BX16 - Tirzepatide |
Propably not porphyrinogenic |
PNP |
Important Information
Side effects such as nausea, vomiting and loss of appetite may be potentially porphyrinogenic through reduction in carbohydrate intake. If used for weight management, carbohydrate intake must be kept at a sufficient level.
Side effects
Nausea and vomiting are reported as very common adverse reactions of tirzepatide, and decreased appetite is common. [SmPC] These side effects may potentially be porphyrinogenic if they lead to a decrease in carbohydrate intake.
Rationale
Tirzepatide is a hormone analogue that is not eliminated via CYP metabolism, and is not an inducer or inhibitor of CYP.
Chemical description
Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. (SmPC, DrugBank)
Therapeutic characteristics
Tirzepatide is indicated in adults with type 2 diabetes mellitus to improve glycaemic control and is also used for weight management. It is administered once weekly as a subcutaneous injection (SmPC).
Metabolism and pharmacokinetics
Tirzepatide is metabolised by proteolytic cleavage of the peptide and other protein catabolism pathways (SmPC, DrugBank). Tirzepatide is not expected to affect the cytochrome P450 system, and in vitro studies suggest that tirzepatide does not inhibit or induce CYP enzymes (EMA EPAR). No CYP-related interactions are listed in drug-drug interaction databases (Micromedex; Lexicomp; Stockley’s Interaction Checker)
Published experience
(no case reports found)
Similar drugs
References
| # | Citation details | PMID |
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| * | Drug reference publications | |
| 1. | DrugBank. Tirzepatide. (Accessed: 01 March 2024)
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| * | Government bodies | |
| 2. | European Medicines Agency (EMA). EPAR Procedural steps taken and scientific information after authorization – Mounjaro. Updated 22 February 2024. (Accessed: 01 March 2024)
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| 3. | European Medicines Agency (EMA). European Public Assessment Report – Mounjaro. [EMA/791310/2022]. Published 25 November 2022. (Accessed: 01 March 2024)
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| * | Drug interaction databases | |
| 4. | Lexicomp® Online, Drug Interactions. Waltham, MA: UpToDate,Inc. (Accessed: 05 March 2024).
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| 5. | Merative™ Micromedex® Drug Interaction Checking (electronic version). Ann Arbor, Michigan, USA: Merative. (Accessed: 19 February 2024).
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| 6. | Preston, C.L. (ed). Stockley’s Interaction Checker. London: Pharmacutical Press. (Accessed: 05 March 2024).
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| * | Other sources | |
| 7. | Summary of Product Characteristics (SmPC). Mounjaro KwikPen 15mg solution for injection in pre-filled pen (tirzepatide). Eli Lilly and Company Ltd. Date of revision of text: 25 January 2024. (Accessed: 19 February 2024).
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