Community protocol
Third-partyTirzepatide 10mg
- 01Reconstitution solution
- 1 mL
- 02Dose
- 1 mg
- 03Syringe units
- 10 units
- 04Frequency
- 3x/week
- 05Cycle length
- 30 days
- 06Bacteriostatic water
- 1 mL
- 07Bottle size
- 10 mg
- 08Bottles needed
- 2
Tirzepatide
First approved dual incretin agonist. Phase 3 SURPASS and SURMOUNT programmes reported the largest mean weight reductions of any approved pharmacologic agent to date.
Overview
Tirzepatide activates two gut hormone receptors at once — GLP-1 and GIP — where earlier drugs activated only one. Both hormones are released after eating and both push the pancreas to release insulin. Hitting both appears to produce a larger effect on blood sugar and body weight than hitting either alone. Like semaglutide it is engineered to last about a week in the body, so it is injected once weekly.
Tirzepatide is a 39-amino-acid synthetic peptide built on a GIP sequence backbone with an Aib substitution at positions 2 and 13 conferring DPP-4 resistance, and a C20 fatty diacid conjugated at Lys20 for albumin binding. It is a full agonist at the GIP receptor and a biased partial agonist at GLP-1R, with markedly reduced beta-arrestin recruitment relative to native GLP-1. That bias reduces GLP-1R internalization and desensitization, which is one proposed explanation for its potency despite lower GLP-1R affinity than semaglutide. GIPR agonism contributes through adipocyte GIPR signalling, which affects lipid buffering and adipose blood flow, and through central GIPR populations in the hypothalamus that appear to blunt the nausea response, permitting higher effective dosing.
Research areas
MetabolicObesitySleep apneaCardiovascular
Community-specified data
Community dosage information
Community protocol
Third-partyTirzepatide 15mg
- 01Reconstitution solution
- 1.5 mL
- 02Dose
- 1 mg
- 03Syringe units
- 10 units
- 04Frequency
- 3x/week
- 05Cycle length
- 30 days
- 06Bacteriostatic water
- 1.5 mL
- 07Bottle size
- 15 mg
- 08Bottles needed
- 1
Community protocol
Third-partyTirzepatide 20mg
- 01Reconstitution solution
- 2 mL
- 02Dose
- 1 mg
- 03Syringe units
- 10 units
- 04Frequency
- 3x/week
- 05Cycle length
- 30 days
- 06Bacteriostatic water
- 2 mL
- 07Bottle size
- 20 mg
- 08Bottles needed
- 1
Community protocol
Third-partyTirzepatide 30mg
- 01Reconstitution solution
- 3 mL
- 02Dose
- 1 mg
- 03Syringe units
- 10 units
- 04Frequency
- 3x/week
- 05Cycle length
- 30 days
- 06Bacteriostatic water
- 3 mL
- 07Bottle size
- 30 mg
- 08Bottles needed
- 1
Not medical guidance. These third-party figures have not been independently verified, clinically reviewed, or endorsed by DB Peptide. They may be inaccurate or unsafe and should not replace product labelling or advice from a qualified clinician.
Dosing reported in the literature
Every protocol below is reproduced from a published study or approved labelling, with its source named. These are records of what was studied — not recommendations, and not a suggestion that any of them is appropriate for any person.
| Protocol as reported | Source |
|---|---|
| 2.5 mg weekly for 4 weeks, then escalating by 2.5 mg every 4 weeks to a maintenance dose of 5, 10 or 15 mg weeklyThe 2.5 mg starting dose is described in the protocol as an initiation dose only and not intended for glycaemic control. | SURMOUNT-1 trial protocol (Jastreboff et al., NEJM 2022) |
| 5 mg, 10 mg or 15 mg weekly maintenance in type 2 diabetes | SURPASS-2 trial protocol (Frías et al., NEJM 2021) |
Trial status
Approved. Phase 3 complete across SURPASS (diabetes) and SURMOUNT (obesity) programmes.
Phase 3 — SURPASS-2
Completed1,879 patients with type 2 diabetes randomized against semaglutide 1 mg. HbA1c reductions of 2.01%, 2.24% and 2.30% at 5, 10 and 15 mg tirzepatide vs 1.86% for semaglutide.
Phase 3 — SURMOUNT-1
Completed2,539 adults with obesity and without diabetes. Mean weight change at 72 weeks of -15.0%, -19.5% and -20.9% at 5, 10 and 15 mg vs -3.1% for placebo.
Phase 3b — SURMOUNT-OSA
Completed469 participants with moderate-to-severe obstructive sleep apnea and obesity. Significant reduction in apnea-hypopnea index vs placebo across both trials in the programme.
Reported safety signals
- Gastrointestinal events were dose-related and the most common adverse events across all phase 3 trials.
- Boxed warning for thyroid C-cell tumours carried over from the rodent data class effect.
- Trial protocols excluded participants with a history of pancreatitis; incidence in trials was low but non-zero.
Common questions
What does dual agonism actually add?
SURPASS-2 is the only head-to-head randomized comparison against a single-agonist GLP-1 (semaglutide 1 mg). Tirzepatide produced larger HbA1c and weight reductions at all three doses. Whether that advantage is attributable to GIPR agonism specifically, or to the higher tolerable dose ceiling, has not been resolved.
Primary sources
- 01
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2)
- 02
Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1)
- 03
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
- 04
LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus
Medical disclaimer
This page is for informational and research purposes only. Nothing here constitutes medical advice. The compounds discussed are research chemicals. Consult a qualified clinician before starting any protocol.
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