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Understanding Tirzepatide: What It Is: Dual GIP/GLP-1 receptor agonist First-in-class medication combining two mechanisms Activates both GIP and GLP-1 receptors Produces superior weight loss to single-agonist medications Half-life of approximately 5 days (allows once-weekly dosing) Brand Names: Zepbound: Indication: Chronic weight management in adults with obesity or overweight with comorbidities FDA Approval: November 2023 Doses: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg (weekly) Manufacturer: Eli Lilly Cost: $1,069/month Mounjaro: Indication: Type 2 diabetes management FDA Approval: May 2022 Doses: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg (weekly) Manufacturer: Eli Lilly Cost: $1,069/month Note: Identical to Zepbound, prescribed off-label for weight loss Compounded Tirzepatide: Source: FDA-registered compounding pharmacies Indication: Prescribed for weight loss by licensed providers Doses: Custom concentrations available Cost: $349-$699/month Same active ingredient as Zepbound/Mounjaro Why Tirzepatide Is More Effective: Dual Mechanism: GLP-1 Effects (Same as Semaglutide): Appetite suppression through brain receptors Slowed gastric emptying Increased insulin secretion Decreased glucagon production Additional GIP Effects: Enhanced insulin response beyond GLP-1 alone Improved insulin sensitivity in tissues Effects on fat metabolism and energy expenditure Synergistic appetite reduction Additional weight loss mechanisms Result: The combination produces 5-7% more weight loss than GLP-1 agonists alone

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Clinical Manifestations of G6PD Deficiency The most classic manifestation of G6PD deficiency is acute hemolytic anemia (AHA)

Moreover, efpeglenatide therapy reduced the risk of CV disease by about 27% compared to the placebo in the Effect of Efpeglenatide on Cardiovascular Outcomes (AMPLITUDE-O) study [51]