How to Take Mounjaro: Step-by-Step Injection Guide

Understanding Mounjaro and Its Usage

Mounjaro, containing the active ingredient tirzepatide is a licensed medication used to treat type 2 diabetes. Recently, Mounjaro was approved by the MHRA to treat obese and overweight patients to help manage their weight and support weight loss.

So how does Mounjaro work? The active ingredient tirzepatide, works by activating two pathways in the body - GLP-1 (Glucagon-like peptide 1) and GIP (Glucose-dependent insulinotropic polypeptide). Mounjaro has multiple effects on the body and works by:

• Helping the body release insulin when blood sugar is high - removing excess sugar from the blood.

• Slowing down how quickly food is leaving the stomach - reducing how much food is eaten.

• Stopping the liver from making and releasing too much sugar.

These effects lower blood sugar in diabetic patients but also result in weight loss.

The Mounjaro pen is pre-filled - containing 4 doses - and is available in the following strengths:

• 2.5 mg

• 5 mg

• 7.5 mg

• 10 mg

• 12.5 mg

• 15 mg

Initially, patients start on a weekly dose of 2.5 mg and increase as necessary until they reach the maximum dosage of 15mg once weekly. Dosage instructions must be adhered to carefully. Failure to follow directions may result in an increased risk of side effects and plateaus in treatment.

Unlike other weight loss injections available on the market, Mounjaro 5mg is licensed for maintenance. This means once you have reached the 5mg, you can continue on this for as long as it continues to produce the desired effects.

Before You Begin: Precautions and Interactions

As with all medicines, Mounjaro comes with precautions for you to consider:

• Thyroid tumors - Mounjaro may cause thyroid tumours including thyroid cancer. Symptoms include trouble swallowing, a lump or swelling in the neck, hoarseness or shortness of breath. Do not use Mounjaro if you or your family have had a type of thyroid cancer called medullary thyroid carcinoma (MTC).

• Multiple endocrine neoplasia syndrome type 2 (MEN 2) - do not use Mounjaro if you have this condition.

• Allergies - do not use Mounjaro if you are allergic to any of the ingredients.

• Type 1 diabetes - Mounjaro is not suitable for individuals who have type 1 diabetes.

• Age - Mounjaro is not suitable for those under the age of 18.

• Mounjaro cannot be used in pregnant and/or breastfeeding women.

If you are currently taking the birth control contraceptive pill, there may be a chance its effectiveness is reduced when used alongside Mounjaro. Patients currently on birth control pills are advised to use an alternative method of contraception for the first 4 weeks of starting Mounjaro and for 4 weeks after increasing the dosage.

Step 1: Consult Your Healthcare Provider

Mounjaro is a prescription-only medication and so it is extremely important that you consult with a registered healthcare professional. A doctor or prescriber is optimally placed to offer all the information you need to ensure successful treatment. They can determine if the medication is safe and appropriate for you. If you have any questions about side effects, precautions or what to expect, this is the optimal time to discuss this.

Individuals initiating Mounjaro would begin on 2.5mg once weekly. Over the course of this initial dose, you should assess how you are getting on with the medication including if you are experiencing side effects.

For your second month, you can either maintain at 2.5mg or if you feel like you could benefit from an increased dose, you can increase to 5mg. If unsure, speak to your healthcare provider. Here at Quick Meds, we have experienced clinicians who are ready to advise on the most appropriate treatment plan, based on your individual circumstances.

It is not essential for you to increase the dosage of your pen every month. If your current dose is sufficient to make you feel fuller, and quicker for longer, then it is advised to maintain on this until a point when this is no longer the case. Remember if a lower dosage is making you feel fuller, a higher dosage would not now make you feel "more fuller."

In all cases, you should discuss treatment with an appropriate healthcare professional before beginning treatment so they can assess suitability and safety.

Step 2: Preparing the Mounjaro Pen

When you receive your medication, the box will contain the pre-filled pen, containing 4 doses as well as the patient information leaflet and a second leaflet which shows you how to inject Mounjaro. Unlike other weight loss injections, Mounjaro does not come pre-packaged with needles. Here at Quick Meds, we will include needles with every Mounjaro order free of charge.

Before using, assess the pen for any damage. At Quick Meds, we package your Mounjaro pen - which needs to be refrigerated - with an ice pack in an insulated pouch. This is placed into a suitably sized box which protects the pen from damage.

When you are preparing to inject:

• Ensure your hands are washed with soap and water.

• Check the expiry date of the pen and that you have received the correct strength of the pen in its original carton.

• Remove the Mounjaro pen from the outer packaging and inspect for any damage.

• Remove the cap from the pen and inspect the dosage window, ensuring the liquid is clear and free of particles. The liquid should not be cloudy or frozen. If frozen, you cannot defrost and use it, this must be reported to your healthcare provider.

• Allow the pen to reach room temperature before injecting.

• Follow the instructions on the "how to use" leaflet provided in the box which provides a step-by-step guide.

• Discard your used needles appropriately. You can purchase a sharps disposal bin from Quick Meds.

Step 3: Choosing and Preparing the Injection Site

Prior to injecting Mounjaro, you must choose and prepare your injection site.

The recommended injection sites are:

• Your abdomen.

• The fronts of your thighs.

• The back of your upper arms

It is important to note that you should rotate your injection site. Injecting in the same spot may result in a build-up of fatty tissue. You may use the same area each week e.g. your upper arm, but avoid injecting into the exact same spot.

• Ensure the area you are injecting Mounjaro into is clean and dry.

• Follow the instructions on the "how to use" leaflet provided in the box to inject

Step 4: Administering the Mounjaro Injection

Prior to administration, your new pen will need to be primed. To do this:

• Take the cap off your pen.

• Wipe the inner red seal with a swab.

• Select a new needle from the box and take off the paper tab - ALWAYS use a new needle for each injection. This will prevent infection and blocked needles.

• Push the capped needle onto the pen and twist until the needle is on tightly.

• Take off the outer needle shield and keep it to one side. Then take off the inner needle shield and dispose of it.

• Slowly turn the knob at the end of the pen until you hear two clicks and see the extended line in the dose window. This is the prime position.

• Hold the pen upwards and gently tap on the cartridge so the bubbles collect at the top.

• Push the button at the back of the pen in to release some medicine and hold it in for 5 seconds. A '0' should now show in the dose window and you should see a small amount of medicine at the tip of the needle. This is NOT to be injected. Priming your pen removes air from the cartridge and ensures the pen is working properly. If you do not see any medicine, repeat the priming method up to an additional two times. If you still do not see the medicine, remove the needle and attach a new one. If this next attempt at priming is unsuccessful, get in touch with one of our team members.

Once primed, you are ready to inject.

• Choose your injection site. If you want to inject Mounjaro into your upper arm, seek help from someone.

• Turn the dose knob all the way until it stops and show a '1' in the dose window.

• Insert the needle into your skin. You do not need to pinch the skin when injecting.

• Push the dose knob in to inject the medication until you hear a click. Then count to 5 whilst holding the dose knob in. A '0' should show in the window before you remove the needle.

• Pull the needle out of your skin. You may see a drop of medicine at the end of the needle but this is normal and will not affect your treatment.

• If you see a small amount of blood at the injection site, take some cotton wool or gauze and lightly press on the area. Avoid rubbing the skin.

• Carefully place the outer needle shield onto the needle and then dispose of it in a sharps container.

• Replace the pen cap and store your pen away until your next dose.

You have now injected your first dose of Mounjaro.

The box you receive your pen in will contain the patient information leaflet but also a 'How to use.' Refer to this before you use your first dose. Always read the leaflet prior to using a new medication, even if you have used a related medicine before.

Step 5: After the Injection

After you have injected your dose, you should start to feel the effects shortly after.

If you notice any bleeding at the site of injection, press a small piece of cotton wool or gauze onto the area.

If you notice any bruising after your injection, rest assured this is common and occurs when you nick a blood vessel when injecting, causing minor bleeding under the skin. This bruise should fade away after a few days.

Dosing Schedule

It is important for you to be following a consistent dosing schedule to avoid plateaus in treatment or an increased risk of side effects.

You should be injecting once a week, every week. You should have a regularly scheduled day that you are injecting Mounjaro - noting this down on a calendar may make it easier to remember.

Missed Dose

At times, our lifestyle and schedules may hinder our treatment plans and cause there to be a delay in injecting. The following guidelines will help you to understand when to inject if you have missed your dose.

• If it has been 4 days or less since you should have injected - inject Mounjaro and use your next dose on your regular scheduled day.

• If it has been more than 4 days since you should have injected - miss a dose and inject your next dose on your regular scheduled day.

• For example, if your dosing day is Sunday and you are late to inject Mounjaro, you can inject on Monday or Tuesday or Wednesday. If you remember later than this, such as on Thursday, Friday or Saturday, skip the missed dose and inject on the following Sunday.

If you are unsure, please contact one of our clinicians at Quick Meds.

Step 6: Storage and Handling

Information on storage requirements is limited for the moment as it is a new drug, but we expect to know more over the coming months.

• Store unused pens in the refrigerator between 2°C to 8°C.

• The fourth dose of your pen must be used within 30 days of being despatched.

• Do not freeze. If the pen has been frozen - DO NOT use it.

How to store used Mounjaro pens

• After injecting, your used pen may be stored at room temperature up to 30°C.

• Keep the pen and needles out of the sight and reach of children.

• Keep away from heat.

• Dispose the pen 30 days after first use.

• Dispose the pen after the use of four weekly doses.

• Dispose of used needles in a sharps container immediately after use. Do not dispose of needles in household waste. You can purchase a sharps container from our website.

• Your used pen may be disposed of in household waste after the needle has been removed.

What If I Experience Side Effects?

As with all medication, Mounjaro can cause side effects. These range from common to severe and it is important you are able to spot the signs.

Common side effects include:

• Nausea

• Vomiting

• Diarrhoea

• Constipation

• Decreased appetite

Serious side effects include:

• Pancreatitis - symptoms include severe stomach pain that spreads to the back or chest (this can be worse after eating), fever, nausea and vomiting.

• Gallbladder problems - symptoms of gallstones include severe abdominal pain that may spread to the shoulder, yellowing of the skin and eyes, fever, itchy skin, and clay-coloured stools.

• Severe stomach problems - Severe stomach issues have been reported with the use of Mounjaro. If you experience this stop use of the Mounjaro pen and inform your health care provider immediately.

• Thyroid tumours - Mounjaro may cause thyroid tumours including thyroid cancer. Symptoms include difficulty swallowing, a lump or swelling in the neck, hoarseness or shortness of breath.

• Vision - Inform your healthcare provider immediately if you notice any changes in your vision.

• Kidney problems - There is a risk of dehydration if you have kidney problems and are taking Mounjaro. Mounjaro causes nausea, vomiting and diarrhoea as a side effect which then leads to fluid loss (dehydration). This may cause kidney issues to worsen so it is important to drink plenty of foods whilst on treatment.

• Hypoglycaemia - or low blood sugar is a risk if you are using Mounjaro alongside other medications that also lower sugar levels, such as insulin or sulfonylurea. Symptoms include dizziness, light-headedness, confusion, sweating, blurred vision, slurred speech and anxiety.

If you experience any of these symptoms, stop using Mounjaro and seek medical help immediately.

Summary and Key Takeaways

Mounjaro is a prescription-only weight loss medication licensed for the use of type 2 diabetes and was recently approved as an aid to weight management in overweight and obese patients. It is a once-weekly injection that is started at a dose of 2.5mg. A regular dosing schedule is recommended as any breaks in treatment can affect how successful your treatment will be.

Mounjaro is not safe for everyone to use. There are precautions that need to be taken in certain groups of people.

Mounjaro can be privately prescribed by our pharmacist-independent prescriber here at Quick Meds. Our clinicians are trained to support you on your weight loss journey.

Mounjaro can be injected into the abdomen, back of your upper arm or fronts of your thigh.

When using Mounjaro, it is important to be transparent and maintain open communication with your doctor or appropriate healthcare provider. If you are unsure about anything or need some advice, feel free to contact us on 0121 628 5318 or click the button below.