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Advanced · No. 02

Compounded Tirzepatide

a dual-incretin once-weekly injection

2.5 MG → 15 MG · 4-week vial supply

First month
$279.99
$9.33 / day
Brand-name Zepbound cash
$1,349
$45 / day
Begin consultationCommon questions
A modern medical injector pen, Compounded Tirzepatide
Fig. 01 · Compounded TirzepatideLOT 50087439

Tirzepatide is the most effective pharmacological weight-management compound ever to clear a phase-3 trial. It engages two appetite hormones — GLP-1 and GIP — rather than one, producing larger and more durable weight loss than any single-agonist GLP-1.

Mechanism · 02

How it works in the body

Tirzepatide is a synthetic peptide that simultaneously activates two receptors: GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). The combined agonism slows gastric emptying, suppresses appetite via central pathways in the hypothalamus, improves insulin sensitivity, and reduces food noise. The dual mechanism is what produces the larger weight-loss effect compared with single-receptor GLP-1s like semaglutide.

Titration · 03

The dose ladder.

WeekDoseNote
Weeks 01–042.5 mg / weekInitiation. Most people feel nothing or mild nausea.
Weeks 05–085.0 mg / weekAppetite suppression becomes noticeable.
Weeks 09–127.5 mg / weekFirst provider check-in. Re-evaluate fit.
Weeks 13–1610.0 mg / weekMost patients hold here as the working dose.
Weeks 17+12.5–15 mg / weekTherapeutic maximum, only if tolerated and clinically appropriate.
Documented · 04

What the trials show.

20.9%
average body-weight loss at 72 weeks (15 mg cohort)
SURMOUNT-1, NEJM 2022
57%
of participants achieved ≥20% body-weight loss
SURMOUNT-1, NEJM 2022
94%
reduction in progression from pre-diabetes to type-2 diabetes
SURMOUNT-1 sub-analysis
Risks · 05

Side effects, honestly.

Common

  • · Nausea (most common during titration)
  • · Constipation
  • · Diarrhea
  • · Decreased appetite (the therapeutic effect)
  • · Fatigue, mild headache

Serious

  • · Pancreatitis (rare)
  • · Gallbladder disease
  • · Hypoglycemia (especially with other diabetes medications)
  • · Possible thyroid C-cell tumors (animal studies in rats; relevance to humans unknown)
Fit · 06

Who it's for. Who it isn't.

Suitable for

  • · Adults with BMI ≥ 30, or BMI ≥ 27 with a weight-related condition
  • · Patients who have not responded to lifestyle changes alone
  • · Patients seeking the most effective available compound

Not suitable for

  • · Personal or family history of medullary thyroid carcinoma
  • · Multiple Endocrine Neoplasia syndrome type 2 (MEN-2)
  • · History of severe pancreatitis
  • · Pregnant or breastfeeding
  • · Severe gastrointestinal disease
Citations · 07

The published evidence.

  1. 01Jastreboff et al. — Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) — NEJM 2022
  2. 02Garvey et al. — Tirzepatide once weekly for chronic weight management (SURMOUNT-2) — Lancet 2023
  3. 03Wadden et al. — SURMOUNT-3: tirzepatide after intensive lifestyle intervention — Nature Medicine 2023
  4. 04FDA Prescribing Information — Mounjaro / Zepbound (tirzepatide)
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