20.2%

Average weight change at 72 weeks in adults with obesity, against 13.7% on semaglutide in the same trial

SURMOUNT-5, NEJM 2025

14.7%

Average weight change at 72 weeks on 15 mg in adults with obesity and type 2 diabetes, against 3.2% on placebo

SURMOUNT-2, Lancet 2023

14%

Body weight regained over the year after people who had been taking it were switched to placebo

SURMOUNT-4, JAMA 2024

These are averages from trials, not a result from this clinic and not a prediction for you. Some people lose much more, and some much less. Roughly one person in seven does not respond meaningfully to a given medicine.

How it works

It acts on the receptors for two gut hormones, GIP and GLP-1, that the body releases after a meal. You feel full sooner, you stay full for longer, and food leaves the stomach more slowly. In type 2 diabetes it also helps the pancreas release insulin when blood sugar is high. It is not a stimulant, and it does not work by making you pass more urine or stool.

Who it is for

It is approved in India for adults with obesity, or with excess weight and a weight-related health problem, and for adults with type 2 diabetes. Whether it is right for you is decided in a consultation, from your measurements, your reports and your history.

Who must not take it

You or a close blood relative has had medullary thyroid cancer, or you have MEN2.
You are pregnant, trying to conceive, or breastfeeding.
You have had a serious allergic reaction to this medicine before.

Tell your doctor before starting if

You have had pancreatitis or gallstones.
Your stomach empties very slowly, or you have been told you have gastroparesis.
You have diabetic eye disease.
You have kidney disease.
You take insulin, or a sulfonylurea such as glimepiride or gliclazide.

How the dose is built up

When	Weekly dose	What it is for
Weeks 1 to 4	2.5 mg	Getting your stomach used to it. This is a starting dose, not a treatment dose.
Weeks 5 to 8	5 mg	The first treatment dose. Many people do well here and stay on it.
After that, if needed	7.5, 10, 12.5, 15 mg	Increased in 2.5 mg steps, never faster than once every 4 weeks.

The dose you stay on is the lowest one that is working and that you can tolerate. The highest dose is 15 mg a week. Going up faster does not bring results faster, it brings more nausea. Staying on 2.5 mg to save money is not the same treatment.

Taking it

Once a week, on the same day, at any time of day, with or without food.
Under the skin of the tummy or thigh, or the back of the upper arm if someone else gives it. Use a different spot each week.
If you miss a dose: take it if 4 days or less have passed. If more than 4 days have passed, skip it and take the next dose on your usual day. Never take two doses less than 3 days apart.
To change your injection day: keep at least 3 days between the last dose and the next.
Storage: keep it in the fridge, not the freezer, away from heat and light. The leaflet in the box says how long it may stay out of the fridge. What to do in a power cut is on the storage page.

Side effects

The common ones are nausea, loose motions, constipation, vomiting, indigestion and less appetite. They are worst in the first weeks and after each dose increase, and for most people they settle. Small meals, stopping when you are full, and avoiding fried and very spicy food help. More practical advice is on the side effects page.

Stop the injection and contact us the same day if you have:

Severe tummy pain that does not settle, especially if it goes through to your back.
Pain under the right ribs with fever, or yellow eyes.
Vomiting or loose motions so bad that you cannot keep fluids down. Dehydration can harm the kidneys.
Low sugar symptoms (shaking, sweating, confusion) if you also take insulin or a sulfonylurea.
Swelling of the face, lips or throat, or difficulty breathing. Call 108.

Three things people are not told

The contraceptive pill. It may work less well for 4 weeks after starting and for 4 weeks after each dose increase. Use condoms as well in those weeks, or use a method that is not a pill.
Surgery, endoscopy or sedation. Tell the doctor and the anaesthetist that you take it, because food stays in the stomach longer. They may ask you to hold a dose.
Muscle. Some of the weight lost is muscle unless you eat enough protein and do strength exercise. See the protein and muscle pages.

If you have type 2 diabetes

In a 40 week trial against semaglutide 1 mg, HbA1c fell by 2.30 percentage points on 15 mg against 1.86 on semaglutide (SURPASS-2, NEJM 2021). If you also take insulin or a sulfonylurea, those doses may need to come down as your sugars improve, so check your sugars more often in the first weeks.

In people with type 2 diabetes and existing heart disease, followed for a median of about 4 years, heart attack, stroke or death from heart disease occurred in 12.2% on tirzepatide and 13.1% on dulaglutide, an older medicine already shown to protect the heart. The trial showed it was no worse, not that it was better (SURPASS-CVOT, NEJM 2025). A placebo-controlled heart outcome trial in people with obesity but without diabetes is still running. If you already have established heart disease, that difference matters, and it is one reason the choice between this and semaglutide is not settled by the weight figures alone.

If you have sleep apnoea

In adults with obesity and moderate to severe obstructive sleep apnoea, breathing pauses per hour of sleep fell by about 25 to 29 on tirzepatide against about 5 on placebo over a year (SURMOUNT-OSA, NEJM 2024). This is the only medicine anywhere with a specific approval for obstructive sleep apnoea. If you snore heavily or wake unrefreshed, a home sleep study before starting gives a baseline.

What it costs

A pen holds four weekly doses, so one pen is roughly one month of treatment. Indicative pharmacy prices in September 2026 run from about ₹13,125 a pen for the 2.5 mg starting dose to about ₹25,781 a pen for 15 mg. At a 5 mg pen price of about ₹16,406, a year of the medicine alone is a little over ₹2 lakh. Single-dose vials of the 2.5 mg and 5 mg strengths also exist at about ₹3,281 and ₹4,101 each, which lets you buy a week at a time rather than a month; week for week they cost about the same as the pen.

It is sold in India under more than one brand name. They are the same medicine, from the same manufacturer, in the same pen, and your prescription is for the medicine. Prices change, so check at the pharmacy. Our consultation fees and the cost of monitoring tests are listed separately on the cost page. To see how it compares against what you could sustain for a year, use the treatment options planner.

If you stop

For most people the weight comes back, and so do the rises in blood pressure, cholesterol and sugar that came down with it. In the withdrawal trial, people switched to placebo regained 14% of their body weight over the following year, while those who continued lost a further 5.5% (SURMOUNT-4). That is not a reason never to stop. It is a reason to plan stopping rather than run out of pens. The stopping page explains how.

If you are planning a pregnancy, say so early. It has to be stopped before you try to conceive, and how far ahead depends on your situation.

How follow-up works here

We see you before each dose increase and check weight, waist, blood pressure and, if you have diabetes, your sugars. Between visits, the progress tracker shows whether you are on course against the checkpoints published from the trials.

Sources: SURMOUNT-1 (NEJM 2022), SURMOUNT-2 (Lancet 2023), SURMOUNT-4 (JAMA 2024), SURMOUNT-5 (NEJM 2025), SURMOUNT-OSA (NEJM 2024), SURPASS-2 (NEJM 2021), SURPASS-CVOT (NEJM 2025), and the Indian prescribing information. Prices are indicative Indian maximum retail prices in September 2026, they change often, and they are not a quotation. No medicine is sold or supplied through this website. Reviewed on 11 September 2026 by Dr. Khizer Hussain Junaidy, Diabetologist & Bariatric Physician, Telangana State Medical Council registration no. 04937.

Tirzepatide