GIP & GLP-1 Medication FAQ’S
Mounjaro (generic name: tirzepatide) is a novel injectable medication approved for the management of diabetes and weight loss. It is the first in its class of drugs and is a dual GLP-1 and GIP receptor agonist. This dual mechanism enhances insulin secretion in response to elevated blood glucose levels, suppresses glucagon secretion, thereby contributing to better glycaemic (glucose) control in patients with Type 2 diabetes. It also controls appetite effectively and slows gastric emptying (emptying of the stomach) resulting in significant weight loss in patients with or without Type 2 diabetes.
Mounjaro is administered through a subcutaneous (under the skin) injection, typically in the abdomen, thigh, or upper arm. The initial dose is usually low, to minimise side effects, and is gradually increased based on the individual’s response and tolerance. If you are beginning on Mounjaro at Dr Frank’s, please be assured you will receive training and guidance from healthcare professionals on proper injection techniques and dosing schedules.
While Mounjaro is generally well-tolerated, it can cause side effects ranging from mild to severe.
Common side effects include gastrointestinal symptoms such as:
- nausea
- vomiting
- diarrhoea
- abdominal pain
- indigestion
- constipation
These often transient and resolve completely over time and as your body acclimatises to the medication. Less common side effects may include:
- pancreatitis
- gall stone formation
- inflammation of the gall bladder
- severe hypoglycemia (low blood sugars), especially when used with certain diabetes medications.
Individuals are always advised to monitor for severe symptoms and seek medical attention immediately.
Mounjaro's effect on weight loss is attributed to its action on appetite regulation centrally in the brain and delayed gastric emptying, leading to reduced food intake and increased satiety. While it offers an effective adjunctive treatment for individuals with obesity and type 2 diabetes, it's important to recognise that to gain the maximum benefit from treatment it should always be part of a comprehensive lifestyle and behaviour change program, including diet and physical activity.
Mounjaro is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma or in individuals with Multiple Endocrine Neoplasia syndrome type 2.
The safety and efficacy of Mounjaro in pregnant and breastfeeding women have not been established. Animal studies have shown potential adverse effects on the fetus, so it should not be used during pregnancy or breast feeding.
Women with reproductive potential need to use contraception during treatment.
Mounjaro may interact with other medications, including sulfonylureas and insulin (used if you have Type 2 diabetes), increasing the risk of hypoglycemia. Dose adjustments and careful monitoring may be necessary when combining these medications. Your clinician will go through these and advise you as needed.
Additionally, Mounjaro may delay gastric emptying, which could impact the absorption of orally administered medications.
Your clinicians will conduct a thorough medication review to identify potential interactions and adjust treatment regimens accordingly. If you are taking other medications that are of concern in conjunction with Mounjaro, please schedule a call with one of our specialist nurses HERE
Mounjaro should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F) and protected from light. It should not be frozen, and if accidentally frozen, it should be discarded. From the moment of dispensing and once in use, the pen can be kept at room temperature (up to 30°C/86°F) for a specific period (up to 30 days).
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, you can then resume the regular once-weekly dosing schedule.
If you have doubled on up doses and/or believe you have overdosed with the medication, please get in touch with us immediately and we can schedule a call with one of our specialist nurses to review your clinical signs and symptoms.
Patients may experience gastrointestinal adverse reactions, including nausea.
There is no specific antidote for overdose of Mounjaro. A prolonged period of observation and treatment of these symptoms may be necessary, taking into account the half-life of Mounjaro (approximately 5 days).
Each individual will have a unique experience and treatment plan based on their progress and symptoms.
If you are starting as a new customer not on any weight loss medication, you will begin month one with the starting dose of 2.5mg and then increase in month two to 5.0mg. From here, the dosing schedule is individualised with dosage increased to 7.5mg > 10.0mg > 12.5mg > 15.0mg.
Please be advised that our specialist nurses will review your reported progress and updates on a monthly basis and prescribe your next dose in line and according to the information provided.
Yes, this request is possible, however it does require a call with one of our specialist nurses. To transition from Wegovy or Ozempic to Mounjaro, you can book a call with one of our nurses HERE to discuss further. This must be individualised and requires discussion. Please be aware that not all Mounjaro doses are currently available in the U.K. and there is a requirement for a discussion with a specialist nurse before any prescription can be arranged.
It’s important to know that Semaglutide isn’t a type of insulin, but instead it mimics a hormone that’s produced by your gut once you’ve eaten. Semaglutide helps many people to feel fuller and more satisfied for longer after eating smaller portions, ultimately resulting in eating less food and consuming fewer calories. In turn, this leads to weight loss when used alongside a healthy diet and lifestyle.
Wegovy and Ozempic share the common active ingredient, semaglutide, yet they are promoted for distinct purposes. Ozempic is approved and licensed for managing type 2 diabetes and has been available since 2017 - although, it is has been found in a number of studies that it can also support and be effective for weight loss. In contrast, Wegovy is a more recent introduction licensed specifically for weight loss.In essence, Wegovy and Ozempic operate identically, eliciting the same physiological response. However, disparities exist in factors such as the dosage of semaglutide and the medical conditions they are indicated for in their respective marketing.
Semaglutide is administered through injections once a week. When initiating the medication, you will commence with a lower dose, gradually increasing each month until reaching the maintenance dose. It is crucial to adhere to the prescribed dosage as directed by our healthcare professionals. You can find direction on how to use semaglutide injection pens here: https://www.youtube.com/watch?v=nKhku_1WZ-EWe do also have the offering of semaglutide in a tablet form, Rybelsus. Rybelsus is administered once per day, following the prescribed dosing and instruction as informed by one of our specialist nurses. Consume the medication with a small amount of water. It is important to ingest Rybelsus 30 minutes before your meals, beverages, or any other daily medications. Consuming food or drinks within the 30-minute window after taking Rybelsus may diminish the drug's effectiveness.
If you receive a prescription for semaglutide, the key component in Rybelsus and Ozempic, to address weight loss, it falls under the category of 'off-label' prescribing. In such cases, the medication is recommended for a purpose diverging from its officially licensed use. This occurs when experts recognise the benefits of the medication for an alternative purpose, although the manufacturer has not yet updated the license. Semaglutide, the active ingredient, is already prescribed for weight loss under various brand names and formulations.Our healthcare professionals will only prescribe an off-label medication if they deem it safe and effective for your specific situation. *Due to high demand for Wegovy, this product may not always be available, in this instance you will be offered an appropriate alternative.
Common side effects of semaglutide include:
Nausea
Stomach pain
Diarrhoea
Vomiting
Constipation
Headache
Tiredness
Belching
Dizziness
Bloating
Gas
Upset stomach
Heartburn
These effects typically subside as your body acclimates to the medication and dosage. If you encounter challenges with the side effects, our healthcare professionals are available to offer support and guidance.
Rare or uncommon side effects of semaglutide include:
Pancreatitis (inflammation of the pancreas)
Gallstones
Hypoglycemia (low blood sugar) in patients with type 2 diabetes
Anaphylactic/ allergic reaction
Diabetic retinopathy (an eye condition) complications in patients with type 2 diabetes
Palpitations or feelings of a racing heartbeat while at rest
If you experience any of the serious side effects listed above, seek medical attention immediately.
Semaglutide, under the brand name Ozempic, was sanctioned for type 2 diabetes treatment in 2017. It is administered through injection into the stomach, leg, or arm fatty tissue. Rybelsus later introduced an alternative delivery method of Semaglutide as an oral tablet. Rybelsus received approval for treating type 2 diabetes in 2019, but its active ingredient, semaglutide, obtained approval earlier, in the injectable form of Ozempic.
Extensive clinical trials preceded the licensing of semaglutide, with injections approved for weight loss under the name Wegovy. This followed promising research results.
Despite Rybelsus and Ozempic not being licensed for weight loss, they share the same active ingredient, semaglutide, that is contained in Wegovy. While all medications carry potential side effects, for most individuals, they are mild and manageable. And, at Dr Frank's, our dedicated and experienced team are able to be contacted to provide the support and guidance that is required when needed.
For Wegovy and Ozempic:Before initial use, store it in a refrigerator away from any freezing elements. Do not freeze the medication, and do not use it if it becomes frozen.
Following usage, you can either store the pen in the refrigerator or in a shielded, dark space below 30°C.
In the rare circumstance that the pen was not refrigerated before the first use, it remains suitable for use if the storage temperature is below 30°C. Dispose of the pen after 6 weeks, following the manufacturer's recommendation.
For Rybelsus:
Unlike other GLP-1 therapies, Rybelsus does not require refrigeration. It should be stored at room temperature between 20-25°C. Ensure it is stored in a dry place away from moisture.
Your medications undergo cold storage whilst in the assigned pharmacy or chemist, and have further cold-chain packaging for transportation ensuring the appropriate cold-chain regulations are met throughout the supply chain. The cold-chain packaging that the pharmacies dispense the medication in are designed to uphold a refrigerator temperature of 2 - 8°C for up to 72 hours.
In the rare circumstance that the pen has not been refrigerated before initial use, it remains suitable for use for up to 56 days after the dispatch date. If uncertain and would like a discussion with a member of our dedicated team, please do not hesitate to get in touch with us.
An unopened pen will stay viable and suitable for use when kept in the refrigerator until its expiry date (which you can find on the medication pen).After opening, refrigeration is advised, but the pen should not be used beyond 56 days from the date of first use.
Our cold chain packaging is designed to uphold a refrigerator temperature (2 - 8°C) for up to 72 hours. If your pen arrives at a temperature higher than that of a fridge, you can still use it for up to 56 days after the dispatch date.
As humans, we’re all different, so the amount of time that it takes to work can vary fromperson to person. However, most people do start seeing results in terms of weight losswithin the first few weeks of taking the injections – even before reaching the therapeuticdose of 1mg or above.
As a general guide, most people taking Semaglutide for weight loss are expected tolose at least 5% of their body weight within 12 weeks of starting treatment. Generally speaking, if Semaglutide doesn’t help you to lose 5% of your starting weight after 12weeks of using it, then our specialist nurses can arrange a referral to our specialistdietitians and nutritionists to look at alternative options/support routes.
At Dr Frank’s, we have an offering of a number of services:
- Video Consultation with one of our specialist nurses leading to a tailored treatment plan
- Online Assessment leading to the choice of a subscription model following standard protocol of dosing for semaglutide (0.25mg, 0.5mg, 1.0mg or higher) – if requiring to speak with a nurse it is £15 per appointment - Dietitian and Nutritionist Appointments
Experiencing video consultations with our specialist nurses allows you to discuss our services, create a unique treatment plan based on your current health position, goals, dietary requirements and lifestyle. If deemed eligible, a monthly video or phone call will be scheduled with one of our specialist nurses to check on your progress and if you are experiencing any side effects – from here, they can tweak and tailor your treatment plan accordingly.
A semaglutide pen has 4 doses , which, if following standard protocol, is one injection per week – this, in turn, means the pen will last you 4 weeks. Similarly, if you are prescribed the semaglutide tablets which are taken daily, this comes in a pack of 30 and will last 30 days.
As healthcare providers, we exclusively prescribe medications that have undergone rigorous clinical trials, establishing their safety and efficacy. Our clinicians collaborate with you to determine the optimal duration for maintaining the prescribed medication, tailored to your individual circumstances.Following comprehensive clinical trials affirming the safety and effectiveness of GLP-1 medications for diabetes, the FDA granted approval for the long-term treatment of obesity with semaglutide. These trials also revealed a reduced risk of adverse cardiovascular events, including heart attacks or strokes.