Tirzepatide / Niacinamide

(Ship Cold) Injection

16.6 mg / 2 mg / mL

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Product Overview

Tirzepatide / Niacinamide Injection Description1-4

Tirzepatide / Niacinamide Injection is a combination of tirzepatide and niacinamide. Tirzepatide acts as a dual incretin receptor agonist, targeting both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Niacinamide (vitamin B3) supports mitochondrial function by aiding cellular energy conversion and provides antioxidant activity.

Tirzepatide1-3

Tirzepatide is administered as a once-weekly subcutaneous injection and is used alongside diet and exercise to support glycemic control in adults with type 2 diabetes mellitus. It is also FDA approved for chronic weight management under the brand name Zepbound in specific populations. Tirzepatide is a novel dual agonist of GIP and GLP-1 receptors.

Niacinamide(vitamin B3)5-7

Niacinamide, also known as niacin or nicotinic acid, is an essential nutrient in the vitamin B3 family. It occurs naturally in foods such as bran, yeast, eggs, peanuts, poultry, red meat, fish, whole-grain cereals, legumes, and seeds. Niacinamide contributes to the conversion of food into energy and helps protect against oxidative stress by regulating oxidative enzymes and acting as an antioxidant. It is used in the management of dermatological conditions, central nervous system disorders, and elevated cholesterol levels.

Mechanism of Action1-4

Tirzepatide exerts its effects through dual incretin receptor agonism, targeting both:

  1. GIP (Glucose-dependent Insulinotropic Polypeptide) Receptor:
  • Enhances insulin secretion
  • Reduces glucagon secretion
  • Promotes lipid metabolism and may contribute to weight loss
  1. GLP-1 (Glucagon-Like Peptide-1) Receptor:
  • Delays gastric emptying
  • Reduces appetite
  • Stimulates insulin release in a glucose-dependent manner
  • Inhibits glucagon release during hyperglycemia

 

Niacinamide 5-7

Niacinamide contributes to supporting mitochondrial function and metabolic pathways through its conversion to NAD⁺/NADP⁺.It is a vital component in the oxidized state of nicotinamide adenine dinucleotide (NAD, or coenzyme 1) and the reduced form of nicotinamide adenine dinucleotide phosphate (NADP, or coenzyme 2). The coenzymes, NAD and NADP) facilitate essential oxidation-reduction reactions. These coenzymes play key roles in glycolysis, pyruvate metabolism, protein and amino acid metabolism, pentose biosynthesis, glycerol metabolism, synthesis of high-energy phosphate bonds, and fatty acid metabolism.

Common 1-4

Most adverse reactions are gastrointestinal in nature and dose-dependent:

  • Gastrointestinal: Nausea, vomiting, diarrhea, constipation, dyspepsia, decreased appetite, abdominal pain
  • Headache, dizziness, and injection site reactions

Contraindications & Precautions1-4

Contraindications:

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • History of serious hypersensitivity to tirzepatide or any component of the formulation

Precautions:

  • Pancreatitis risk: Monitor patients for signs/symptoms (serious abdominal pain)
  • Severe gastrointestinal disease: Use with caution; only if benefit outweighs potential risk.
  • Acute kidney injury: Especially in those with dehydration, vomiting, or diarrhea.
  • Diabetic retinopathy: Rapid improvement in glucose may worsen retinopathy.
  • Use with insulin or secretagogues: Dose adjustment may be necessary to reduce hypoglycemia risk.
  • Pregnancy & Lactation:
- No adequate data; use only if the benefit outweighs potential risk.
 Discontinue at least 1 month prior to a planned pregnancy due to long half-life

Store refrigerated at 36°F to 46°F (2°C – 8°C). Discard within 28 days of puncture or according to the beyond-use date. Do not freeze. Keep out of reach of children.

  1. Clinical Pharmacology powered by Elsevier (ClinicalKey) – Tirzepatide Monograph. https://www.clinicalkey.com

  2. FDA Prescribing Information – Mounjaro® (tirzepatide): https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215866s000lbl.pdf

  3. Jastreboff AM, et al. “Tirzepatide Once Weekly for the Treatment of Obesity.” NEJM. 2022; 387(3):205–216. https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

  4. Drucker DJ. “Mechanisms of Action and Therapeutic Application of GLP-1 and GIP.” Cell Metabolism. 2018. https://doi.org/10.1016/j.cmet.2018.06.015
  5. Niacinamide – Professional Monograph; NatMed Pro ; 2025 ; https://naturalmedicines.therapeuticresearch.com/Data/ProMonographs/Niacinamide
  6. Vitamin B3 StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526107/ February 29, 2024. Accessed June 26, 2025
  7. Clinical Pharmacology powered by Elsevier (ClinicalKey) – Niacinamide Monograph. https://www.clinicalkey.com


This information is for educational purposes only. This compounded product has not been reviewed, approved, or evaluated by the Food and Drug Administration for safety and effectiveness. This product is not intended to diagnose, treat, cure, or prevent any disease. No claims are made regarding treatment, cure, or prevention of any disease or condition.

This information may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088.  A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.

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