How to Get Tirzepatide

What Is Tirzepatide?

Tirzepatide, a revolutionary medication primarily developed for the treatment of type 2 diabetes, is making waves due to its excellent additional effectivity for weight loss. In fact, it is the fastest-growing drug of 2024, with $5.1 billion in combined revenue in the first half of the year. If you're wondering how to get tirzepatide, it's important to know that in the US, it is sold under the branded names Mounjaro and Zepbound.

Tirezepatide works by targeting two critical hormones involved in regulating blood sugar and body weight, called GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide).

GLP-1 and GIP are hormones that the body naturally releases after eating to help control blood sugar levels. They work by:

• Stimulating insulin release, 

• Reducing sugar production in the liver, and 

• Slowing down the speed at which food leaves the stomach.

Tirzepatide is very similar to the active substance of the other well-known diabetes and weight loss drug, semaglutide (branded as Ozempic). Unlike Ozempic, however, which targets only the GLP-1 receptor, tirzepatide activates both the GLP-1 and GIP receptors. 

This dual action is thought to boost these natural processes more effectively, helping to manage blood sugar levels and support weight loss by reducing appetite and promoting a feeling of fullness.

The Benefits of Tirzepatide

Tirzepatide is highly effective in managing type 2 diabetes and facilitating weight loss. Furthermore, recent studies suggest it may have an additional advantage for people with sleep apnea. Here’s a general overview of the benefits:

• Effective Blood Sugar Control
  
  In a 40-week study involving 1,878 patients with type 2 diabetes who were taking metformin, tirzepatide was found to reduce A1C levels by up to 2.3 percentage points. Ozempic, as a reference, achieved a reduction of 1.86 percentage points in the same study.
  
  A1C, or glycated hemoglobin, is a blood test that reflects a person's average blood sugar levels over the past two to three months. It provides a picture of how well a person’s diabetes is being managed. For most people with diabetes, an A1C level below 7% is considered good and indicates that blood sugar levels have been well controlled. Higher A1C levels suggest that blood sugar has been too high, which increases the risk of diabetes-related complications like heart disease, kidney problems, and nerve damage.

  • Improved Results Compared to Insulin
    
    In another 52-week study of 1,995 overweight individuals with type 2 diabetes and high cardiovascular risk, those treated with tirzepatide experienced a reduction in A1C by 2.43 to 2.58 percentage points, which is significantly more effective than the 1.44 percentage points reduction achieved with daily insulin glargine. Moreover, tirzepatide led to fewer episodes of severe low blood sugar (6-9%) compared to insulin (19%).

• Substantial Weight Loss
  
  Tirzepatide is a very effective weight loss drug, even more than Semaglutide (Ozempic). In a study of over 2,500 adults with obesity but without diabetes, participants lost between 15% and 20.9% of their body weight over 72 weeks with tirzepatide. That’s compared to just 3.1% with a placebo (a dummy treatment with no real effect).
  
  In another trial, called the SURMOUNT-2 trial, which included 938 participants with both obesity and type 2 diabetes, those taking tirzepatide lost between 12.8% and 14.7% of their body weight over 72 weeks, while those on a placebo lost only 3.2%. Notably, 31% of participants on the highest dose of tirzepatide lost 20% or more of their body weight.

• Role in Reduced Sleep Apnea Severity
  
  In a year-long study with people who have sleep apnea (a condition where breathing stops and starts during sleep), tirzepatide was reported to help reduce the number of breathing interruptions by 25 times per hour. In comparison, people who took a placebo (a dummy treatment with no real effect) saw a reduction of only about five interruptions per hour.
  
  These breathing interruptions, called apnea or hypopnea events, happen when the airway gets blocked or partially blocked, causing a person to stop breathing or take very shallow breaths during sleep. Each time this happens, the body wakes up briefly to restore normal breathing, which disrupts sleep and prevents deep, restful sleep.

Who Is Tirzepatide for?

Approved Uses by the FDA

Tirzepatide is currently approved by the FDA for the management of type 2 diabetes and chronic weight.

• It got its approval for diabetes management on May 13, 2022, under the branded name Mounjaro. 

• It was later approved solely for chronic weight management on November 8, 2023, under the branded name Zepbound.

The manufacturer, active substance, and dosage forms are identical between Mounjaro and Zepbound. The name distinction is made purely for marketing and insurance reasons.

Still, if you’re interested in getting tirzepatide for weight loss, for example, asking your insurance company about getting Mounjaro for weight loss is unlikely to be successful. That’s because the approved tirzepatide drug for weight loss is branded as Zepbound, while Mounjaro is approved only for people with type 2 diabetes.

Who Cannot Be Prescribed Tirzepatide?

There are some conditions which make patients straight out ineligible for tirzepatide therapy. These are also known as absolute contraindications, and include:

• Prior allergy to tirzepatide

• Pregnancy

• Having a history of Medullary thyroid cancer, and

• Suffering from a condition called Multiple Endocrine Neoplasia type 2 (MEN 2).

Additionally, certain conditions may not wholly rule out tirzepatide therapy but require careful consideration before use. These are known as relative contraindications, and include:

• A history or current problems with your pancreas or kidneysю

• Severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food.

• A history of diabetic retinopathy. 

Indications for Use - Conditions Under Which Tirzepatide Is Prescribed

After doctors rule out absolute and potentially relative contraindications for tirzepatide, they will then check if using tirzepatide will have more benefits than risks for you.

• For diabetes
  
  Tirzepatide is prescribed for type 2 diabetes management if no satisfactory results are being achieved with metformin alone or when obesity is a significant comorbidity of the patient.

• For overweight patients, the patient:

  • Must have a BMI of >30 or a BMI of >27 plus a weight-related comorbidity such as high lipid levels, cardiovascular disease, type 2 diabetes, hypertension, or obstructive sleep apnea, and

  • Must be willing to use subcutaneous (under-the-skin) injections

Consulting With Your Doctor

What to Discuss With Your Healthcare Provider

An honest discussion with your healthcare provider is crucial. Don’t hesitate to ask anything that’s on your mind, including how to get tirzepatide and whether it’s the right option for you. As a general guide, it’s always wise to discuss with your doctor the following:

• What to Expect
  
  Talk about what might happen during treatment, including the process of losing weight. Keep in mind that weight loss can vary and will require a healthy diet and exercise. Understand how the medication might affect your blood sugar, mood, and overall well-being. Learn to watch out for signs of serious problems and when to get medical help.

• Proper Use of Tirzepatide Injections
  
  Learn the correct technique for injecting tirzepatide, including the recommended sites (such as the abdomen, thigh, or upper arm) and rotation of injection areas to avoid skin irritation or damage. Make sure to follow your healthcare provider’s instructions regarding the dosage and frequency of the injections.

• Side Effects
  
  When you start taking the medication, you might feel sick to your stomach, throw up, have diarrhea, stomach pain, or not feel hungry. These are normal at first but should get better as time goes on. If these issues are really bad, stick around, or get worse, get in touch with your doctor. Also, make sure to ask about more serious side effects like thyroid cancer, pancreatitis, or kidney problems. If you notice a lump in your neck, have trouble swallowing, or your voice stays hoarse, tell your doctor right away.

• Extra Steps
  
  Make sure you know about any additional things you need to do, like getting regular blood tests, thyroid ultrasounds, or changes to your diet, exercise, and other medications. If it applies to you, ask about alternatives to oral contraceptives as their efficacy could be reduced at certain points during treatment.

• Tirzepatide Price
  
  Tirzepatide can be a pricey medication. Although health is crucial, spending too much on medication can still harm your overall well-being. Cheaper alternatives for both diabetes and chronic weight management are available. It’s a good idea to discuss all of the options available with your healthcare provider. 

How to Obtain a Prescription

You can get a prescription for tirzepatide through your primary care physician or endocrinologist. Of course, that's assuming they think you're a good fit.

The prescription is typically transmitted electronically to your selected pharmacy, but they may also provide you with a paper prescription.

Tirzepatide Availability in the Market

Where to Find Tirzepatide

You can enquire about tirzepatide at every licensed pharmacy, but note that its supply has been inconsistent throughout 2024. Tirzepatide can only be found as the marketed brands Zepbound or Mounjaro. Generic Mounjaro (generic tirzepatide) is currently unavailable.

Availability in Pharmacies and Online Platforms

Some pharmacies allow you to buy Zepbound or Mounjaro online as long as you have a valid prescription. The FDA has updated its shortage list to indicate that the availability of certain GLP-1 medications, specifically semaglutide and tirzepatide, has improved slightly. However, they are still officially considered in short supply. This hints that the shortage is easing but not yet entirely resolved.

FDA Approval Status and Implications

When the FDA approves a certain drug, it means that the drug’s effect has been extensively studied and that it can be considered a safe drug. Additionally, FDA approval status has implications for both the prescription process and insurance.

For instance, as discussed earlier, people who want to use tirzapetide for weight loss can not be prescribed Mounjaro, as Mounjaro is prescribed solely for patients with type 2 diabetes. However, most insurance plans include it once Mounjaro is prescribed.

Zepbound, on the other hand, is not included in many insurance plans.

Insurance Coverage and Costs

Zepbound and Mounjaro's costs vary from pharmacy to pharmacy, but they’re still generally considered as an expensive drug. The official listed cost of Mounjaro and Zepbound is about $1,060 for a 28-day supply if you’re uninsured. 

Zepbound is FDA-approved for chronic weight management and may be covered by some insurance plans, often with prior authorization. Medicaid coverage depends on the state, and Medicare does not cover weight-loss medications. The VA and Tricare might provide coverage, but this usually requires additional review. Sixteen states, including California and Texas, cover at least one weight-loss medication under Medicaid. The AMA recently called for broader insurance coverage for these drugs.

Mounjaro is FDA-approved for type 2 diabetes and is often covered by insurance for this use. However, since it is not approved for weight loss, most plans will not cover it for that purpose. Medicare may cover Mounjaro for diabetes with prior authorization but not for weight loss due to legal restrictions.

For cost savings, commercial insurance patients can use the Zepbound savings card to reduce the cost to as low as $25 per prescription or $550 if not covered. The Mounjaro savings card offers similar reductions, potentially lowering the cost to $25 depending on eligibility. 

The introduction of a tirzepatide generic price could significantly impact the prices of Zepbound and Mounjaro.

Legal and Ethical Considerations

The Legality of Purchasing Tirzepatide Online

As mentioned earlier, some pharmacies allow you to purchase tirzepatide online as long as you have a valid prescription for it. That means having a valid Zepbound or Mounjaro prescription.

Risks of Obtaining Tirzepatide Without a Prescription

You should never use tirzepatide medications without a clear prescription from your healthcare provider. The risks of tirzepatide in people without diabetes or those suffering from chronic weight have not been studied and could potentially be severe. 

Ethical Concerns Surrounding the Use of New Medications

There's an ongoing debate about the ethics of selling compounded tirzepatide, which some pharmacies have started producing to increase supply.

Compounded tirzepatide differs from FDA-approved medications like Mounjaro and Zepbound. FDA-approved drugs undergo extensive testing for safety and effectiveness, along with inspections of manufacturing facilities. In contrast, compounded medications are custom-made by mixing active ingredients with inactive ones and do not require FDA approval. While they can be useful for specific needs, such as avoiding allergens, they also carry risks.

Compounded medications, like GLP-1 receptor-based therapies, should only be used when no approved options are available for a critical health need. Consumers should be aware that compounded drugs are not reviewed for safety, quality, or effectiveness and may contain unapproved ingredients or harmful additives.

If choosing to prescribe a compounded drug, the risk can be reduced by selecting a compounding facility registered with a regulatory agency, such as the FDA and accredited by the National Association of Boards of Pharmacy.