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The dose can be increased at 4-week intervals to 0.5 mg, 1 mg, or 2 mg per week, if needed, for blood sugar control

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Drug Des Devel Ther 7:963970

So compounding pharmacies stepped in to fill the gap, making their own versions of the drugs for more than two years

Unlike earlier medications that targeted a single pathway, tirzepatide is a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist