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Research reference — not for sale

Tirzepatide

A
best evidence
Peptide
also called — tirzepatide · dual GIP/GLP-1 receptor agonist ("twincretin") · brands Mounjaro (T2D), Zepbound (obesity + OSA). Manufacturer: Eli Lilly. INCI: none
metabolictype-2 diabetesobesity / weightobstructive sleep apnea (all approved)

Reference entry — NOT a sellable lane. Same status as semaglutide: an FDA-approved, patented blockbuster; compounded copies now largely prohibited. In the register for reference and completeness, not commerce. No dosing published here. Why the flagships sit in the register but not the shop — the ven

In brief

Tirzepatide is a dual GIP/GLP-1 agonist and, in the only head-to-head obesity trial (SURMOUNT-5), produced greater weight loss than semaglutide (−20.2% vs −13.7%). It is FDA-approved for type-2 diabetes (Mounjaro) and for obesity and obstructive sleep apnea (Zepbound), on a large Phase 3 base (grade A). Compounded copies are now largely prohibited following the December-2024 shortage resolution.

Legal standing, by region
European Union
Approved / prescription

approved as Mounjaro (and Zepbound in the US; brand naming varies by market).

United States · your region
Approved / prescription

FDA-approved (Mounjaro / Zepbound; Eli Lilly only). Compounding: shortage declared resolved by the FDA (Declaratory Order, Dec 2024, all strengths); 503A enforcement discretion ended Feb 2025 → compounded tirzepatide now largely prohibited. Gray-market/counterfeit versions are unapproved and not FDA-reviewed.

Evidence, by outcome

An honest grade per outcome — drawn from the evidence, not any catalogue. Hype and undemonstrated marketing claims grade low.

OutcomeEvidence base · effectGrade
Type-2 diabetes glycemic control
SURPASS Phase 3; FDA-approved · Robust HbA1c reduction (superior to semaglutide in SURPASS-2)
A
Chronic weight management (obesity)
Effect wanes if stopped; GI tolerability
SURMOUNT Phase 3 (~20–22%); SURMOUNT-5 head-to-head; FDA-approved · Substantial weight loss, greater than semaglutide
A
Obstructive sleep apnea (with obesity)
First drug approved for OSA
SURMOUNT-OSA; FDA-approved (2024) · Fewer breathing disruptions; ~½ no longer met OSA symptom threshold
A
Safety
GI effects (nausea/diarrhea/constipation/vomiting); labeled risks; clinical oversight
Large trials + post-marketing · Well-characterised

Identity a single 39-amino-acid synthetic peptide (< 40 aa → peptide) that activates both the GIP and GLP-1 receptors (the two natural incretin hormones), with a C20 fatty-diacid for once-weekly dosing. ## Mechanism (as proposed) a dual agonist of the GIP and GLP-1 receptors — combining incretin pathways yields greater glycemic and weight effects than GLP-1 agonism alone (glucose-dependent insulin ↑, glucagon ↓, gastric emptying slowed, appetite ↓).

Sources — 1 cited
01SURPASS, SURMOUNT, SURMOUNT-OSA and SURMOUNT-5 (NEJM) Phase 3 programmes; FDA prescribing information (Mounjaro/Zepbound); FDA Declaratory Order resolving the tirzepatide shortage (Dec 2024).
Review status
Not yet reviewed

A credentialed reviewer (PharmD / PhD / MD) will be named before this entry is finalised. Until then, treat it as a working draft. Last updated July 2026.

Grades reflect the published evidence, not our interest. No dosing, reconstitution, or administration is published for research compounds — that restraint is deliberate.

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Tirzepatide (Mounjaro / Zepbound) — evidence & status · Vallydia