Thursday, June 13, 2024, 01:24
One of the medications that has been talked about the most in recent times is about to arrive in Spain, as announced by the pharmaceutical company Lilly. On Monday, June 24, in Madrid, it will be presented Mounjaro (Wegovy in the US), “the first drug in its therapeutic class – already authorized by the European Medicines Agency (EMA) – with a dual indication,” the company has indicated, referring to the fact that it is indicated for “people who live with obesity or type 2 diabetes.
To discuss the product, an event has been organized with several experts, who will present data on the impact of obesity and diabetes in our country and the progress that the arrival of this treatment represents. Thus, there will be José Antonio Sacristán, medical director of Lilly; José Manuel García, representative of the Spanish Diabetes Federation (FEDE), Federico Moya, representative of the ABHispalis Patient Association; Dr. Mar Malagón, president of the Spanish Obesity Society (SEEDO); Dr. Alfredo Michan Doña specialist in Internal Medicine. Coordinator of the Diabetes, Obesity and Nutrition Group of the Spanish Society of Internal Medicine (SEMI) and Dr. Javier Escalada, president of the Foundation of the Spanish Society of Endocrinology and Nutrition (FSEEN).
According to the leaflet approved by the Spanish Agency for Medicines and Health Products, «Mounjaro contains an active ingredient called tirzepatide and is used to treat adults with type 2 diabetes mellitus. Mounjaro reduces the level of sugar in the body only when sugar levels are high. Mounjaro is also used to treat adults who are obese or overweight (with a BMI of at least 27 kg/m2). “Mounjaro influences the regulation of appetite, which can help you eat less food and reduce your body weight,” says the leaflet, which you can consult with its contraindications.
Mounjaro is applied (subcutaneously) under the skin of the stomach (abdomen), thigh, or upper arm.
Use for diabetics
Mounjaro is an injectable medication that, in type 2 diabetes, Mounjaro is used in two ways:
• on your own when you cannot take metformin (another diabetes medicine).
• in combination with other diabetes medicines when they are not enough to control your blood sugar levels. These other medications may be taken orally and/or may be an insulin injection.
Use for weight loss
Mounjaro is also used along with diet and exercise to lose weight and help keep weight under control in adults, who have:
– a BMI equal to or greater than 30 kg/m² (obesity) or
– a BMI of at least 27 kg/m², but less than 30 kg/m² (overweight) and weight-related health problems (such as prediabetes, type 2 diabetes, high blood pressure, abnormal levels of fat in the blood, breathing problems during sleep called “obstructive sleep apnea” or a history of myocardial infarction, stroke or vascular problems)
The price of Mounjaro
Prescription drug prices can be confusing, Lilly explains. “Two people can pay different prices for the same medication, depending on your insurance.”
Mounjaro’s list price, also known as wholesale acquisition cost or WAC, which is the price at which Lilly sells its products to wholesalers and may not represent the actual transactional prices patients pay at the pharmacy, is $1,069.08 per prescription in the United States, “but the amount you pay will largely depend on your insurance plan,” Lilly explains on its website, which emphasizes that data on the price of the specific insurance plan is not yet available because Mounjaro is a new medicine.
How much to use
The starting dose is 2.5 mg once a week for four weeks. After four weeks, your doctor will increase your dose to 5 mg once a week.
Your doctor may increase your dose in 2.5 mg increments to 7.5 mg, 10 mg, 12.5 mg, or 15 mg once a week if needed. In each case, your doctor will tell you to stay on a particular dose for at least 4 weeks before moving on to a higher dose.
Contraindications
According to Lilly on its website, “Mounjaro could cause thyroid tumors, including thyroid cancer. Be alert for possible symptoms, such as a lump or swelling in the neck, hoarseness, difficulty swallowing, or shortness of breath. If you have any of these symptoms, tell your health care professional.
In addition, it offers information on when it should not be used:
– Do not use Mounjaro if you or someone in your family has had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
– Do not use Mounjaro if you suffer from Multiple Endocrine Neoplasia type 2 (MEN 2) syndrome.
– Do not use Mounjaro if you are allergic to it or any of its ingredients.
Like all medicines, this medicine can cause side effects, although not everyone gets them.
Serious adverse effects
1. Uncommon (may affect up to 1 in 100 people)
– Inflammation of the pancreas (acute pancreatitis) which may cause severe pain in the stomach and back that does not go away. See your doctor immediately if you experience these symptoms.
2. Rare (May affect up to 1 in 1,000 people)
Severe allergic reactions (for example, anaphylactic reaction, angioedema). You should get immediate medical help and inform your doctor if you experience symptoms such as breathing problems, rapid swelling of the lips, tongue and/or throat with difficulty swallowing and rapid heartbeat.
Other adverse effects
Very common (may affect more than 1 in 10 people)
• Nausea
• Diarrhea
These side effects are usually not serious. They are more common when starting tirzepatide, but decrease over time in most patients.
• Low blood sugar (hypoglycemia) is very common when tirzepatide is used together with other medicines that contain a sulfonylurea and/or insulin. If you are taking a sulfonylurea or insulin for type 2 diabetes, you may need to have your dose reduced while using tirzepatide (see section 2, “Warnings and precautions”). Symptoms of low blood sugar may include headache, drowsiness, weakness, dizziness, feeling hungry, confusion, irritability, rapid heartbeat, and sweating. Your doctor should tell you how you can treat low blood sugar.
Common (may affect up to 1 in 10 people)
• Low blood sugar (hypoglycemia) when tirzepatide is used for type 2 diabetes with metformin together with a sodium-glucose cotransporter type 2 inhibitor (another diabetes medicine)
• Allergic (hypersensitivity) reaction (for example, rash, itching and eczema)
• Dizziness reported in patients treated for weight control
• Low blood pressure reported in patients treated for weight control
• Less hunger (decreased appetite) reported in patients treated for type 2 diabetes
• Stomach (abdominal) pain
• Vomiting – usually goes away over time
• Indigestion (dyspepsia)
• Constipation
• Stomach bloating
• Belching
• Gas (flatulence)
• Reflux or heartburn (also called gastroesophageal reflux disease – GERD) – a disease caused by stomach acid rising into the tube that connects the stomach to the mouth
• Hair loss reported in patients treated for weight control
• Tiredness (fatigue)
• Reactions at the injection site (for example, itching or redness)
• Rapid pulse
• Increased levels of pancreatic enzymes (such as lipase and amylase) in the blood.
Uncommon (may affect up to 1 in 100 people)
• Low blood sugar (hypoglycemia) when tirzepatide is used with metformin for type 2 diabetes
• Stones in the gallbladder
• Inflammation of the gallbladder
• Weight loss reported in patients treated for type 2 diabetes
• Pain at the injection site
• Increased calcitonin levels in the blood.