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10.1007/978-3-319-66682-2_14 70 HernndezJ

Examples include anticholinergic medications and opioid pain medications (e.g., hydrocodone, morphine) Metabolism and clearance Tirzepatide is metabolized by proteolytic cleavage of the peptide backbone, beta-oxidation of the C20 fatty diacid moiety and amide hydrolysis DOSING Dosage forms Single-dose pen and single-dose vials 2.5 mg/0.5 ml 5 mg/0.5 ml 7.5 mg/0.5 ml 10 mg/0.5 ml 12.5 mg/0.5 ml 15 mg/0.5 ml Kwikpen (each pen contains 4 doses) 4 doses of 2.5 mg: 10 mg/2.4 mL (4.17 mg/mL) 4 doses of 5 mg: 20 mg/2.4 mL (8.33 mg/mL) 4 doses of 7.5 mg: 30 mg/2.4 mL (12.5 mg/mL) 4 doses of 10 mg: 40 mg/2.4 mL (16.7 mg/mL) 4 doses of 12.5 mg: 50 mg/2.4 mL (20.8 mg/mL) 4 doses of 15 mg: 60 mg/2.4 mL (25 mg/mL) Multi-dose vial (each vial contains 4 doses) 4 doses of 2.5 mg/0.6 mL: 10 mg/2.4 mL (4.17 mg/mL) 4 doses of 5 mg/0.6 mL: 20 mg/2.4 mL (8.33 mg/mL) 4 doses of 7.5 mg/0.6 mL: 30 mg/2.4 mL (12.5 mg/mL) 4 doses of 10 mg/0.6 mL: 40 mg/2.4 mL (16.7 mg/mL) 4 doses of 12.5 mg/0.6 mL: 50 mg/2.4 mL (20.8 mg/mL) 4 doses of 15 mg/0.6 mL: 60 mg/2.4 mL (25 mg/mL) Dosing (adults and pediatric patients aged 10 - 17 years) Starting: 2.5 mg subcutaneously once weekly

A GLP-1 maintenance dose may involve: Staying at a mid-range dose Reducing to a lower dose Avoiding escalation once weight is stable There is no requirement to reach the maximum licensed dose to remain on treatment