Tirzepatide
Metabolic / GLP-1 + GIP
Status & caution. FDA-approved for type 2 diabetes (Mounjaro) and weight management (Zepbound). Like semaglutide, removed from the shortage list, ending most legal compounding of copies. Strong trial evidence for approved use; compounded/grey versions are a different risk profile.
At a glance
Indications & what it's studied for
Type 2 diabetes and obesity; under study for sleep apnea, MASH, and heart failure with preserved ejection fraction. Activates both GIP and GLP-1 receptors.
Contraindications & cautions
Medullary thyroid carcinoma history or MEN-2; hypersensitivity. Caution in pancreatitis, gastroparesis, pregnancy.
Commonly reported dosing
Reported, not recommended. The following describes what appears in research literature and community use. It is not a protocol, and unapproved peptides have no validated human dosing.
Approved dosing titrates from 2.5 mg weekly upward over months. Reported weight loss is dose-dependent; so are GI adverse effects.
Routes of administration
Subcutaneous injection, weekly.
Don't combine with
Other incretin agonists; insulin/sulfonylureas without adjustment; oral contraceptives may need backup methods around initiation/titration.
Reported to stack with
Generally used as monotherapy for weight/glucose; combining incretins is investigational, not routine.
Note: "stacking" combines multiple agents and multiplies unknowns; popularity of a combination is not evidence of its safety.
What the research actually shows
SURPASS (diabetes) and SURMOUNT (obesity) trial programs; head-to-head data suggest greater average weight loss than semaglutide.
Before acting on anything here, see Safety & the grey market and how to read a COA.