If you run an OPD in India in 2026, patients are walking in with a printout or a WhatsApp forward about tirzepatide — asking if they can get it. Here is the clear clinical summary every prescribing doctor needs. What Is Tirzepatide? Tirzepatide (brand name Mounjaro, manufactured by Eli Lilly) is a once-weekly injectable that works as a dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptor agonist. This dual mechanism makes it more potent than semaglutide alone for both glycaemic control and weight loss. In landmark trials (SURMOUNT-1 and SURPASS series), tirzepatide at 15 mg achieved mean weight reductions of 20–22% — a level previously achievable only with bariatric surgery. Approved Indications In India, tirzepatide is indicated for: Type 2 diabetes mellitus — as an adjunct to diet and exercise when glycaemic control is inadequate Chronic weight management — in adults with BMI ≥27 kg/m² with at least one weight-related comorbidity, or BMI ≥30 kg/m² The updated ESI obesity guidelines (2025) specifically recommend tirzepatide when a 15–20% weight loss target is required. Tirzepatide (Mounjaro) – 2026 India OPD Quick Guide for Prescribers 1. What It Is Class: Dual GIP + GLP‑1 receptor agonist Route: Once‑weekly subcutaneous injection Key effects: Potent glucose lowering in type 2 diabetes Mean 20–22% weight loss at 15 mg (SURMOUNT‑1, SURPASS) Tirzepatide in Indian OPD (2026): Quick Prescriber’s Guide 1. What Is Tirzepatide? Class: Dual GIP + GLP-1 receptor agonist Brand (India): Mounjaro (Eli Lilly) Route: Once-weekly SC injection Key effect: Superior glycaemic control and weight loss vs semaglutide Efficacy: SURMOUNT-1 / SURPASS – ~20–22% mean weight loss at 15 mg (bariatric-range weight loss) 2. Approved Indications (India) Type 2 Diabetes Mellitus (T2DM) Adjunct to diet + exercise when glycaemic control is inadequate. Dosing and Escalation Week 1–4: 2.5 mg SC once weekly Week 5–8: 5 mg once weekly Increase by 2.5 mg every 4 weeks as tolerated: 7.5 → 10 → 12.5 → 15 mg Maximum dose: 15 mg SC once weekly Sites: Abdomen, thigh, or upper arm. Rotate each injection. Store refrigerated (up to 21 days at room temperature). Contraindications Absolute: Personal or family history of medullary thyroid carcinoma (MTC) or MEN2; known hypersensitivity Use with caution: Prior pancreatitis, diabetic retinopathy, gastroparesis, pregnancy (stop and advise contraception), severe CKD (eGFR <15) Side Effects and Management Common (GI, dose-dependent): Nausea (up to 20–30%), vomiting, diarrhoea or constipation, decreased appetite, injection-site reactions Managing nausea: Small low-fat meals; stay at current dose longer before escalating; short antiemetic course if needed Serious but rare: Acute pancreatitis (stop immediately if severe upper abdominal pain), gallbladder disease, worsening retinopathy with rapid HbA1c fall Combining with Other Antidiabetics Safe to combine with: Metformin, SGLT-2 inhibitors, basal insulin Reduce insulin by 10–20% at initiation to prevent hypoglycaemia; titrate by SMBG Reduce or stop sulphonylureas if recurrent hypoglycaemia Stop DPP-4 inhibitors when starting tirzepatide (redundant mechanism) Cost and Affordability in India 2.5 mg: ~₹8,000–10,000/month 5–10 mg: ~₹12,000–18,000/month 15 mg: ~₹22,000–28,000/month Not covered under Ayushman Bharat, CGHS, or most private insurance. Discuss cost upfront — stopping leads to partial weight regain Monitoring Protocol Baseline: HbA1c, fasting glucose, lipids, renal function, LFTs, weight, waist, BP, fundus (if diabetic retinopathy risk) Monthly (first 3 months): Weight, BP, GI tolerability, hypoglycaemia symptoms Every 3 months: HbA1c (diabetic patients), weight, renal function Annually: Full metabolic panel, fundus exam, ECG if CVD risk Key Messages for Patients “This works best with diet and exercise — it is not a quick fix.” “You will feel nauseous for the first few weeks at each dose increase. This passes in 2–4 weeks.” “If you stop, much of the weight will return. This is a long-term treatment.” “Severe stomach pain going to your back — call me or go to hospital immediately.” How Doctrust Can Help Your Clinic Managing tirzepatide patients needs structured follow-up: dose escalation schedules, monthly monitoring, HbA1c tracking, and dose adjustments. Doctrust gives Indian clinics structured EMR templates for metabolic patients, automated follow-up reminders, digital prescriptions with titration plans, and teleconsultation for routine reviews. Visit www.doctrust.in to see all features and book a demo today to digitise your clinic in one click.