MOUNJARO Solution for injection Ref.[50478] Active ingredients: Tirzepatide

Source: European Medicines Agency (EU)  Revision Year: 2023  Publisher: Eli Lilly Nederland B.V., Papendorpseweg 83, 3528 BJ Utrecht, The Netherlands

4.1. Therapeutic indications

Mounjaro is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise:

  • as monotherapy when metformin is considered inappropriate due to intolerance or contraindications
  • in addition to other medicinal products for the treatment of diabetes.

For study results with respect to combinations, effects on glycaemic control and the populations studied, see sections 4.4, 4.5 and 5.1.

4.2. Posology and method of administration

Posology

The starting dose of tirzepatide is 2.5 mg once weekly. After 4 weeks, the dose should be increased to 5 mg once weekly. If needed, dose increases can be made in 2.5 mg increments after a minimum of 4 weeks on the current dose.

The recommended maintenance doses are 5, 10 and 15 mg.

The maximum dose is 15 mg once weekly.

When tirzepatide is added to existing metformin and/or sodium-glucose co-transporter 2 inhibitor (SGLT2i) therapy, the current dose of metformin and/or SGLT2i can be continued.

When tirzepatide is added to existing therapy of a sulphonylurea and/or insulin, a reduction in the dose of sulphonylurea or insulin may be considered to reduce the risk of hypoglycaemia. Blood glucose self-monitoring is necessary to adjust the dose of sulphonylurea and insulin. A stepwise approach to insulin reduction is recommended (see sections 4.4 and 4.8).

Missed doses

If a dose is missed, it should be administered as soon as possible within 4 days after the missed dose. If more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing schedule.

Changing the dosing schedule

The day of weekly administration can be changed, if necessary, as long as the time between two doses is at least 3 days.

Special populations

Elderly, gender, race, ethnicity or body weight

No dose adjustment is needed based on age, gender, race, ethnicity or body weight (see sections 5.1 and 5.2).

Renal impairment

No dose adjustment is required for patients with renal impairment including end stage renal disease (ESRD). Experience with the use of tirzepatide in patients with severe renal impairment and ESRD is limited. Caution should be exercised when treating these patients with tirzepatide (see section 5.2).

Hepatic impairment

No dose adjustment is required for patients with hepatic impairment. Experience with the use of tirzepatide in patients with severe hepatic impairment is limited. Caution should be exercised when treating these patients with tirzepatide (see section 5.2).

Paediatric population

The safety and efficacy of tirzepatide in children aged less than 18 years have not yet been established.

No data are available.

Method of administration

Mounjaro is to be injected subcutaneously in the abdomen, thigh or upper arm.

The dose can be administered at any time of day, with or without meals.

Injection sites should be rotated with each dose. If a patient also injects insulin, they should inject Mounjaro into a different injection site.

Patients should be advised to read the instructions for use included with the package leaflet carefully before administering the medicinal product.

For further information before administration see section 6.6.

4.9. Overdose

In the event of overdose, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms. Patients may experience gastrointestinal adverse reactions including nausea. There is no specific antidote for overdose of tirzepatide. A prolonged period of observation and treatment of these symptoms may be necessary, taking into account the half-life of tirzepatide (approximately 5 days).

6.3. Shelf life

2 years.

6.4. Special precautions for storage

Store in a refrigerator (2ยบC–8ยบC).

Do not freeze.

Store in original package in order to protect from light.

Mounjaro may be stored unrefrigerated for up to 21 cumulative days at a temperature not above 30ยบC and then the pre-filled pen must be discarded.

6.5. Nature and contents of container

Glass syringe encased in a disposable pre-filled pen.

The pre-filled pen has a hidden needle, which will automatically insert into the skin when the injection button is pressed.

Each pre-filled pen contains 0.5 ml of solution.

Pack sizes of 2 pre-filled pens, 4 pre-filled pens and multipacks containing 12 (3 packs of 4) pre-filled pens. Not all pack sizes may be marketed.

6.6. Special precautions for disposal and other handling

Instructions for use

The pre-filled pen is for single-use only.

The instructions for using the pen, included with the package leaflet, must be followed carefully. Inspect Mounjaro visually before use and discard for particulate matter or discolouration. Mounjaro that has been frozen must not be used.

Disposal

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

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