Mounjaro — tirzepatide, FDA-approved for type 2 diabetes.

Mounjaro is tirzepatide (Eli Lilly) formulated for type 2 diabetes. FDA-approved in 2022 — the first dual GIP/GLP-1 agonist on the U.S. market. Same molecule as Zepbound, which is the same drug labeled for chronic weight management.

For T2DM patients, Mounjaro showed superior glycemic control compared to semaglutide in head-to-head trials (SURPASS-2), and the dual mechanism is particularly suited to patients with significant insulin resistance.

Dual agonist — activates both GLP-1 and GIP receptors. The GIP component enhances insulin secretion above what GLP-1 alone produces, which translates to better glycemic outcomes in T2DM specifically (where insulin resistance is the underlying issue).

Mounjaro tends to fit:

• T2DM patients (FDA-labeled indication)
• T2DM patients with significant insulin resistance
• T2DM patients who've plateaued on semaglutide / Ozempic
• T2DM patients with substantial weight to lose (the weight effect is meaningful)

For weight management without T2DM, Zepbound is the appropriate prescription — same molecule, labeled for weight rather than diabetes.

Six-step escalation: 2.5mg → 5mg → 7.5mg → 10mg → 12.5mg → 15mg, once weekly. Maintenance is whichever dose produces target HbA1c with tolerable side effects — many T2DM patients do well at 5–10mg.

HbA1c reductions of 2–2.5% at the higher doses (more than semaglutide head-to-head). Weight loss as secondary benefit: typically 15–20%, which is larger than Ozempic but substantial. Side effects: GI-related, similar profile to semaglutide.

Same as Ozempic — Mounjaro is prescribed for its labeled T2DM indication. Coordinate with existing diabetes specialty care where relevant. For weight-only patients, Zepbound or compounded tirzepatide are the appropriate paths.