Phentermine HCl (Commercial)
Weight Management
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Tirzepatide
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Tirzepatide/Glycine/B12
Tirzepatide/Glycine/B12 is an injectable medication that activates both the GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptors to regulate blood sugar, curb appetite, and reduce inflammation. This dual receptor activation amplifies insulin secretion, decreases glucagon levels, slows gastric emptying, and enhances satiety signaling in the brain—resulting in significant improvements in glucose control and weight loss.
ACTIVE INGREDIENTS
Tirzepatide
- GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist
Glycine
- An amino acid that helps to support muscle preservation throughout weight loss
Cyanocobalamin (Vitamin B12)
- Included for its potential role in easing nausea
HOW TO USE
Suggested Dosing
Injections should be administered subcutaneously (under the skin) one time weekly. Dosing typically begins at a lower dose, suggested initiation of 20 units (0.2 mL) weekly for the first 4 weeks, then escalates according to a titration schedule:
- Weeks 1–4: Inject 20 units (0.2 mL) one time per week
- Weeks 5–8: Inject 40 units (0.4 mL) one time per week
- Weeks 9–12: Inject 70 units (0.7 mL) one time per week
- Weeks 13–16: Inject 90 units (0.9 mL) one time per week
- Weeks 17–20: Inject 120 units (1.2 mL) one time per week
- Week 21+: Inject 140 units (1.4 mL) one time per week
Dosing may deviate from this pattern to accommodate patient-specific needs.
DISCLAIMER
This compounded medication is only available when the commercially available product is unavailable or when a prescriber determines that there is a clinically significant difference for the patient.
Medicine Information
Potential Benefits
- Decreases appetite and reduces cravings
- Promotes weight loss
- Lowers A1C levels (a marker of blood sugar control)
- Improves cardiometabolic health measures
- Enhances insulin sensitivity
Treament Protocol
- The medication is not insulin.
- Dose adjustments should aim for the lowest effective dose to limit side effects and improve adherence.
- Side effects such as nausea, constipation, acid reflux, stomach pain, vomiting, diarrhea, and injection site reactions are common.
Legal
Storage Instructions
Warnings
- Contraindicated in patients with a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia Syndromes (MEN 2)
- Not suitable for individuals with type 1 diabetes or diabetic ketoacidosis
- Should not be used alongside other GLP-1 receptor medications
- Gastric emptying may be delayed, requiring caution for procedures involving sedation or general anesthesia due to aspiration risk
- Use caution in those with a history of diabetic retinopathy
- Consult your healthcare provider if you have a history of pancreatitis, as the medication may increase risk
- Serious side effects may involve hypoglycemia, kidney issues, or allergic reactions
- Reports of suicidal thoughts and behaviors have been noted
- Avoid use during pregnancy and breastfeeding. Discontinue two months prior to becoming pregnant.
Manufacturer Info
How It Works
- Enhances glucose-dependent insulin secretion
- Suppresses glucagon secretion
- Slows gastric emptying
- Influences brain regions involved in appetite regulation, leading to reduced hunger and caloric intake
- Supports weight loss
- Improves insulin sensitivity
- Helps to decrease internal inflammation
F.A.Q
Q: How long does it take to see results?
A: Benefits like appetite reduction and weight loss may be observed within weeks, but individual responses vary.
Q: Can I use this with other medications?
A: It can be used with other medications, but it should not be used with other GLP-1 medications. Always inform your healthcare provider about all medications you're taking to to address possible interactions.
Q: Why is it formulated with glycine and vitamin B12?
A: Cyanocobalamin (vitamin B12) and glycine are added to support side effect management and muscle preservation.
Q: What if I miss an injection?
A: Contact your healthcare provider for guidance on missed doses.
References
1. Caruso, I., Di Gioia, L., Di Molfetta, S. et al. The real-world safety profile of tirzepatide: pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database. J Endocrinol Invest 47, 2671–2678 (2024). https://doi.org/10.1007/s40618-024-02441-z
2. Chavda VP, Ajabiya J, Teli D, Bojarska J, Apostolopoulos V. Tirzepatide, a New Era of Dual-Targeted Treatment for Diabetes and Obesity: A Mini-Review. Molecules. 2022 Jul 5;27(13):4315. doi: 10.3390/molecules27134315. Erratum in: Molecules. 2025 Mar 07;30(6):1190. doi: 10.3390/molecules30061190. PMID: 35807558; PMCID: PMC9268041.
3. Tirzepatide. Lexi-Drugs. UpToDate Lexidrug. Wolters Kluwer Health, Inc. Accessed May 12, 2025. https://online.lexi.com/lco/action/doc/retrieve/docid /patch_f/7224042
4. Sardar MB, Nadeem ZA, Babar M. Tirzepatide: A novel cardiovascular protective agent in type 2 diabetes mellitus and obesity. Curr Probl Cardiol. 2024 May;49(5):102489. doi: 10.1016/j.cpcardiol.2024.102489. Epub 2024 Feb 28. PMID: 38417475.
