The Mounjaro fifth dose

Mounjaro is the new wonder weight-loss injection that is producing amazing results. In the SURMOUNT-4 study participants taking Mounjaro 15mg achieved an amazing 20.9% reduction in their weight after just 36 weeks. So, what is the Mounjaro fifth dose, and is it safe? Each Mounjaro pen contains 4 pre-measured doses, the fifth dose is the small amount of residual  “buffer” liquid. Many people think that after taking four doses this small mysterious residual quantity represents a fifth dose. In this blog we will go over what this fifth dose is and whether it is safe to take or not.

What is Mounjaro?

Mounjaro contains the active ingredient, tirzepatide and was licensed in November 2023 for weight loss and weight management in:

• adults with obesity (BMI >30 kg/m²),
• or overweight adults (BMI 27–30 kg/m²) with weight-related conditions.

How does Mounjaro work?

Mounjaro mimics two gut hormones, GLP-1 and GIP which help to cause weight loss by:

• Suppressing appetite
• Increasing feelings of fullness (satiety)
• Slowing gastric emptying

How do you take Mounjaro?

Mounjaro is a weekly weight-loss injection and comes in the form of an injectable pen. Each pen contains 4 pre-measured doses.

To learn more about how to administer Mounjaro, read our blog, How to inject Mounjaro.

What is the Mounjaro fifth dose?

We have previously mentioned that Mounjaro contains four pre-measured doses, so why does it look like another is left over after injecting the fourth dose?

Each Mounjaro pen contains 3 ml of liquid, with each dose being 0.6 ml. This means that the pen is designed to provide four doses.

However, there is a small amount of extra liquid left in the pen, often referred to as the “buffer.” This additional liquid ensures that the full four doses can be properly dispensed.

This has led many users of Mounjaro to believe that Eli Lily has given them a free dose. Unfortunately, there is no such thing as a free lunch if life and we will now go on to explain why you should not use this residual amount as a fifth dose.

Why you shouldn’t inject the Mounjaro fifth dose

Each Mounjaro pen is pre-measured to deliver four fixed doses of medication. The extra liquid left in the pen, known as a “buffer,” ensures that each dose is properly administered.

This buffer liquid may not have the correct concentration of the active ingredient, leading to an inaccurate dose.

The amount of active ingredient  could be higher or lower than standard doses which could result in under-dosing or overdosing, which can impact the medication’s effectiveness.

The Mounjaro fifth dose and the risk of overdose

By taking more than the licensed amount of Mounjaro exposes you to an increased risk of side effects.

Taking more Mounjaro than prescribed can increase the likelihood of experiencing side effects, such as nausea, vomiting, diarrhoea, constipation, or indigestion.

The gradual dose escalation is designed to allow your body to adjust to the medication safely, and using an extra dose could overwhelm your system and increase the risk of unwanted effects.

What the Mounjaro KwikPen contains

The active ingredient in Mounjaro is tirzepatide.

• Mounjaro 2.5 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 2.5 mg of tirzepatide.
• Mounjaro 5 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 5 mg of tirzepatide.
• Mounjaro 7.5 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 7.5 mg of tirzepatide.
• Mounjaro 10 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 10 mg of tirzepatide.
• Mounjaro 12.5 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 12.5 mg of tirzepatide.
• Mounjaro 15 mg KwikPen: Each pre-filled pen contains 4 doses of 0.6 ml solution, with each dose delivering 15 mg of tirzepatide.

The correct Mounjaro dosing

Each Mounjaro pen has 4 pre measured doses which have been calibrated to give a precise dose. So, the first thing is to stick to four doses per pen, no more. It may be tempting to try and squeeze more out of the pen given their costs, but in the long run this could potentially unravel your weight loss plans.

Mounjaro has a gradual dose escalation plan to allow your body to adjust to it gradually so you don’t experience overwhelming side effects. In fact during the SURMOUNT 1 trial most the side effects were experienced with lower doses as the body became accustomed to Mounjaro.

The table below summarises the Mounjaro dose escalation.

To learn more, read our blog, Mounjaro dosing.

What strengths of Mounjaro are available?

Mounjaro is available as a KwikPen, which contains four pre-measured doses. Mounjaro is available in the following various strengths:

• Mounjaro 2.5mg
• Mounjaro 5mg
• Mounjaro 7.5mg
• Mounjaro 10mg
• Mounjaro 12.5mg
• Mounjaro 15mg

Starting Mounjaro

You will always start with Mounjaro 2.5mg and gradually increase your dose after four weeks.

For a more detailed review of the Mounjaro starting dose have a read of our Mounjaro 2.5mg product overview.

Mounjaro dose progression explained

Mounjaro doses typically increase every 4 weeks, but you may stay on a lower dose longer if you experience severe side effects, are happy with the results at a lower dose, or prefer to progress slowly. You can adjust your dose at any time, as long as you’ve been on the current dose for at least 4 weeks.

The maximum recommended dose is Mounjaro 15 mg per week, as exceeding this can lead to serious side effects. To ensure effective and safe weight loss, it’s important to follow the prescribed dosing schedule. If you have concerns or questions, feel free to contact us for a FREE Mounjaro weight loss consultation.

When to transition to a maintenance dose of Mounjaro

During your Mounjaro treatment, your dosage will gradually increase to help your body adjust. This period typically includes reduced appetite and weight loss. If you experience side effects, it’s best to stay on the lower dose for longer.

For optimal results, combine Mounjaro with regular exercise and a balanced diet. If you’re unsure when to transition to a maintenance dose or have any concerns, get in touch with us for a FREE consultation.

Choosing the right Mounjaro maintenance dose

The ideal maintenance dose of Mounjaro varies for each individual based on factors like how well you tolerate the medication and your overall health. Common Mounjaro maintenance doses are:

• Mounjaro 5mg
• Mounjaro 10mg
• Mounjaro 15mg

A healthcare professional will help determine the best option for you. If you need guidance or have any questions, contact us for your FREE Mounjaro weight loss consultation.

Mounjaro fifth dose summary

We can know bury this urban myth about the hidden Mounjaro fifth dose. It doesn’t exist.

What remains in the Mounjaro Kwikpen after 4 dose is simply a buffer to make sure your four doses contain exactly the right amount of the active ingredient tirzepatide.

Stick to the Mounjaro dose escalation program for long lasting weight loss results with the minimum side effects.

Have questions about Mounjaro?

Get a FREE telephone consultation with one of our pharmacists, who will call you and help you understand what the right options are for you.

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Frequently asked questions about Mounjaro

Who should not take Mounjaro?

Mounjaro should not be used by individuals who:

• Are allergic to tirzepatide or any of the other ingredients in Mounjaro.
• Are pregnant or breastfeeding.
• Are under 18 years of age.
• Have a history of medullary thyroid cancer (MTC) or Multiple Endocrine Neoplasia type 2 (MEN 2).
• Have experienced severe gastrointestinal issues, such as:
• Gastroparesis (delayed stomach emptying)
• Pancreatitis (inflammation of the pancreas)
• Have severe kidney or liver problems.
• Have diabetic retinopathy.
• Any history or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia (MEN)

For a more detailed review, please read our blog: Who should not take Mounjaro.

Can I drink alcohol while using Mounjaro?

It’s recommended to limit alcohol intake when using Mounjaro, as it can increase the risk of side effects like nausea and dizziness. For more information, check out our blog, Can you drink alcohol while taking Mounjaro?.

Can I take Mounjaro with levothyroxine?

Currently, there are no confirmed interactions between Mounjaro and levothyroxine, but it is essential to keep an eye on your thyroid levels. For more details, visit our blog, Mounjaro and levothyroxine.

Does Mounjaro cause thyroid cancer?

While early studies in rodents raised concerns, there is little evidence suggesting Mounjaro causes thyroid cancer in humans. For more information, see our blog, Does Mounjaro cause thyroid cancer?.

How much weight can I lose with Mounjaro?

In the SURMOUNT 1 trial, the following weight loss results were observed:

• Tirzepatide 5mg: 16.4 kg (36.1 lbs)
• Tirzepatide 10mg: 22.4 kg (49.4 lbs)
• Tirzepatide 15mg: 23.8 kg (52.5 lbs)

Does Mounjaro help with sleep apnoea?

Studies suggest that Mounjaro may help improve symptoms of sleep apnoea. For more details, visit our blog, Mounjaro and sleep apnoea.

Does Mounjaro cause hair loss?

Mounjaro has been linked to hair loss in about 5% of users, although it’s not clear whether this is due to the medication or rapid weight loss. For more information, check out our blog, Does Mounjaro cause hair loss?

How long do the side effects of Mounjaro last?

Side effects like nausea, bloating, and constipation typically improve within a few days or weeks as your body adjusts. For more details, visit our blog: How loing do the side effects of Mounjaro last? Also, learn more about Mounjaro’s side effects and how to manage them in our blog on Mounjaro side effects.

Should I stop taking Mounjaro once I’ve reached my target weight?

Stopping Mounjaro after reaching your target weight may make it more challenging to maintain weight loss, potentially leading to weight regain due to increased appetite and unhealthy eating habits.

Can I start Mounjaro at 5 mg?

No, the starting dose of Mounjaro is 2.5 mg. It’s crucial to follow the prescribed dosing schedule to minimize side effects and allow your body to adjust.

Can I stay on 2.5 mg of Mounjaro?

It’s generally not recommended to stay on Mounjaro 2.5 mg long-term. After about 4 weeks, the dose should be increased to Mounjaro 5 mg. If you experience severe side effects, contact us to discuss alternatives or adjustments.

Can you lose weight on 2.5 mg of Mounjaro?

While some weight loss may occur at Mounjaro 2.5 mg, more significant results are typically seen at higher doses.

When do you move from 2.5 mg to 5 mg of Mounjaro?

After 4 weeks on Mounjaro 2.5 mg, you will typically increase to Mounjaro 5 mg. If you experience any side effects, consult us to discuss how to proceed with your dosage.

Can you take Mounjaro every 10 days?

No, Mounjaro should be taken weekly, on the same day and time each week. Taking it every 10 days could result in hunger between doses. You can stay on a lower maintenance dose while keeping the weekly schedule.

Which maintenance dose of Mounjaro produces the most weight loss?

The SURMOUNT 1 trial showed that the Mounjaro 15mg dose produced the most weight loss (23.8 kg over 72 weeks), followed by 10mg (22.4 kg) and 5mg (16.4 kg).

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Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice.

References:

• ClinicalTrials.gov. (2021). SURMOUNT-1: Tirzepatide for Weight Loss in Non-Diabetic Obese Individuals. Retrieved from https://clinicaltrials.gov.
• ClinicalTrials.gov. (2021). A Study of Tirzepatide (LY3298176) in Participants with Obesity or Overweight for the Maintenance of Weight Loss (SURMOUNT-4). ClinicalTrials.gov Identifier: NCT04660643. Retrieved from https://clinicaltrials.gov/study/NCT04660643
• Jastreboff, A.M., Aronne, L.J., Ahmad, N.N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M.C. and Stefanski, A., 2022. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, 387(3), pp.205-216.
• Medicines.org.uk. (n.d.). Mounjaro 2.5 mg solution for injection in pre-filled pen [Summary of Product Characteristics]. Retrieved from https://www.medicines.org.uk/emc/product/15481/smpc#about-medicine
• MHRA, 2023. MHRA authorises diabetes drug Mounjaro (tirzepatide) for weight management and weight loss. GOV.UK. Available at: https://www.gov.uk/government/news/mhra-authorises-diabetes-drug-mounjaro-tirzepatide-for-weight-management-and-weight-loss [Accessed 30 Nov. 2024].
• Sinha R, Papamargaritis D, Sargeant JA, Davies MJ. Efficacy and Safety of Tirzepatide in Type 2 Diabetes and Obesity Management. J Obes Metab Syndr. 2023 Mar 30;32(1):25-45.
• UK Medicines Information. (2023). Mounjaro (tirzepatide) Patient Information Leaflet. Retrieved from https://www.medicines.org.uk/emc/files/pil.15481.pdf