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Examples include anticholinergic medications and opioid pain medications (e.g., hydrocodone, morphine) Metabolism and clearance Tirzepatide is metabolized by proteolytic cleavage of the peptide backbone, beta-oxidation of the C20 fatty diacid moiety and amide hydrolysis DOSING Dosage forms Single-dose pen 2.5 mg/0.5 ml 5 mg/0.5 ml 7.5 mg/0.5 ml 10 mg/0.5 ml 12.5 mg/0.5 ml 15 mg/0.5 ml Comes in carton with 4 pens Single-dose vials 2.5 mg/0.5 ml 5 mg/0.5 ml 7.5 mg/0.5 ml 10 mg/0.5 ml 12.5 mg/0.5 ml 15 mg/0.5 ml Kwikpen (each pen contains 4 doses) 4 doses of 2.5 mg: 10 mg/2.4 mL (4.17 mg/mL) 4 doses of 5 mg: 20 mg/2.4 mL (8.33 mg/mL) 4 doses of 7.5 mg: 30 mg/2.4 mL (12.5 mg/mL) 4 doses of 10 mg: 40 mg/2.4 mL (16.7 mg/mL) 4 doses of 12.5 mg: 50 mg/2.4 mL (20.8 mg/mL) 4 doses of 15 mg: 60 mg/2.4 mL (25 mg/mL) Multi-dose vial (each vial contains 4 doses) 4 doses of 2.5 mg/0.6 mL: 10 mg/2.4 mL (4.17 mg/mL) 4 doses of 5 mg/0.6 mL: 20 mg/2.4 mL (8.33 mg/mL) 4 doses of 7.5 mg/0.6 mL: 30 mg/2.4 mL (12.5 mg/mL) 4 doses of 10 mg/0.6 mL: 40 mg/2.4 mL (16.7 mg/mL) 4 doses of 12.5 mg/0.6 mL: 50 mg/2.4 mL (20.8 mg/mL) 4 doses of 15 mg/0.6 mL: 60 mg/2.4 mL (25 mg/mL) Dosing Starting: 2.5 mg subcutaneously once weekly

Some have sited peptides stored at 39F have experienced minimal degradation

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Nutr Metab Cardiovasc Dis (2020) 30:70916

Then the surgeon separates the intestine just past the stomach and reconnects it lower down