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Tirzepatide is a medication used to treat type 2 diabetes and obesity. Tirzepatide is administered via subcutaneous injections (under the skin). Developed by Pharmaceutical company Eli Lilly, Tirzepatide is US FDA-approved under the brand name Mounjaro for diabetes treatment and Zepbound for weight loss and treatment of obstructive sleep apnea. In Singapore, Tirzepatide (Mounjaro) was approved in 2023 by Health Sciences Authority (HSA) for the treatment of type 2 diabetes. Tirzepatide (ZepBound) is pending approval in Singapore. Both Mounjaro and Zepbound are not yet available in Singapore (as of April 2025), with supply expected in 2026-2027.
Tirzepatide is a gastric inhibitory polypeptide (GIP) and Glucagon Like Peptide-1 (GLP-1) receptor agonist. After a meal, hormones known as GIP and GLP-1 are released by the gut. These hormones trigger insulin release, suppress appetite, slow gastric emptying, and increase satiety (the feeling of fullness). Tirzeptide mimics the hormones GIP and GLP-1 by activating the GIP and GLP-1 receptors that are present in the pancreas, brain, gut and fatty tissues.
The most common side effects include nausea, vomiting, diarrhea, decreased appetite, constipation, upper abdominal discomfort, and abdominal pain. These side effects are usually transient and improve with time. The dosage of Tirzepatide is gradually increased to reduce the severity of side effects.
Tirzepatide (as Mounjaro) is indicated to improve blood sugar control in adult patients with type 2 diabetes.
Tirzepatide (as Zepbound) is indicated for the treatment of adult patients with obesity (BMI >30) or overweight with complications (BMI >27 with weight-related complications) and to treat moderate to severe obstructive sleep apnea in adults with obesity.
Tirzepatide and heart failure: In a phase III trial, tirzepatide has demonstrated significant benefits in obese patients with heart failure, reducing the risk of major complications, including urgent heart failure visits, hospitalizations, increased diuretic treatment, and cardiovascular-related deaths, by 38% compared to placebo.
In this landmark clinical trial published in the New England Journal of Medicine 2021, Tirzepatide (Mounjaro) was compared against Semaglutide (Ozempic). In this open-label, 40-week, phase 3 trial, 1879 patients were randomly assigned, in a 1:1:1:1 ratio, to receive tirzepatide at a dose of 5 mg, 10 mg, or 15 mg or semaglutide at a dose of 1 mg per week. At baseline, the mean glycated hemoglobin level was 8.28%, the mean age was 56.6 years, and the mean weight was 93.7 kg. The primary endpoint was the change in the glycated hemoglobin level from baseline to 40 weeks. Tirzepatide at all doses was noninferior and superior to semaglutide. Reductions in body weight were greater with tirzepatide than with semaglutide. The side effect profiles of both medications were similar.
SURMOUNT-1 Study: In this phase 3 double-blind, randomised, controlled trial, 2539 adult patients were assigned in a 1:1:1:1 ratio to receive once-weekly, subcutaneous tirzepatide (5 mg, 10 mg, or 15 mg) or placebo for 72 weeks, including a 20-week dose-escalation period. At baseline, the mean body weight was 104.8 kg, the mean BMI was 38.0, and 94.5% of participants had a BMI of 30 or higher. The mean percentage change in weight at week 72 was −15.0% with 5-mg weekly doses of tirzepatide, −19.5% with 10-mg doses, and −20.9% with 15-mg doses and −3.1% with placebo (P<0.001 for all comparisons with placebo). The percentage of participants who had weight reduction of 5% or more was 85%, 89%, and 91% with 5 mg, 10 mg, and 15 mg of tirzepatide, respectively, and 35% with placebo; 50% and 57% of participants in the 10-mg and 15-mg groups had a reduction in body weight of 20% or more, as compared with 3% in the placebo group (P<0.001 for all comparisons with placebo). The most common adverse events with tirzepatide were gastrointestinal, and most were mild to moderate in severity, occurring primarily during dose escalation. Adverse events caused treatment discontinuation in 4.3%, 7.1%, 6.2%, and 2.6% of participants receiving 5-mg, 10-mg, and 15-mg tirzepatide doses and placebo, respectively.
Tirzepatide (Mounjaro and Zepbound) is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm. Use Mounjaro 1 time each week, at any time of the day.
Mounjaro can last unrefrigerated for up to 21 days. Ensure the temperature of the medication stays below 30C. Avoid heat and direct sunlight
Remove the Pen from the refrigerator.
Leave the gray base cap on until you are ready to inject.
Check the Pen label to make sure you have the right medicine and dose and that it has not expired. Inspect the Pen to make sure that it is not damaged.
Make sure the medicine:
Choose your injection site: stomach or inner thigh
You will know your injection is complete when the gray plunger is visible.
After your injection, place the used Pen in a sharps container.
Tirzepatide (Mounjaro and ZepBound) comes in dosages of 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg. Each dose is once a week, starting at the lowest dose of 2.5mg and increasing gradually every 4 weeks till the effects of the medication are optimal or side effects become unbearable. A maximum dose of 15mg per week is allowed.
Tirzepatide (Mounjaro and Zepbound) are prescription-only medications and can only be obtained from medical clinics with a doctor’s consultation and prescription. Currently, there is no stock for Tirzepatide (Mounjaro and Zepbound) in the whole of Singapore, with supply expected to arrive in 2026-2027 due to a worldwide shortage.
Tirzepatide (Mounjaro and Zepbound) are currently unavailable in Singapore due to a global shortage, hence, no price is available. In the USA, Mounjaro costs USD $1000-1200 for a month’s supply.
Note: Tirzepatide (Mounjaro and Zepbound) are currently unavailable in Singapore. Patients with diabetes and obesity are currently receiving treatment with alternative medications such as Ozempic or Rybelsus.
