MOUNJARO 2.5 mg Injectable Solution in a Pre-filled Pen

2. What you need to know before you use Mounjaro

Do not use Mounjaro

• if you are allergic to tirzepatide or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor, pharmacist, or nurse before you start using Mounjaro if:

• you have severe problems with digestion of food or food stays in your stomach for longer than usual (including severe gastroparesis).
• you have ever had pancreatitis (inflammation of the pancreas, which can cause severe pain in the stomach and back that does not go away).
• you have any problems with your eyes (diabetic retinopathy or macular edema).
• you are taking a sulfonylurea (another diabetes medicine) or insulin for diabetes, as you may get low blood sugar (hypoglycemia). Your doctor may need to adjust the dose of these medicines to reduce this risk.

When you start treatment with Mounjaro, you may experience fluid loss/dehydration, such as when you vomit, feel sick, and/or have diarrhea, which can cause a decrease in kidney function. To avoid dehydration, it is important to drink plenty of fluids. Contact your doctor if you have any questions or concerns.

If you are going to have surgery and will be under anesthesia (put to sleep), tell your doctor that you are taking Mounjaro.

Children and adolescents

This medicine must not be given to children and adolescents under 18 years of age because it has not been studied in this age group.

Other medicines and Mounjaro

Tell your doctor, pharmacist, or nurse if you are using, have recently used, or might use any other medicines.

Pregnancy

If you are pregnant, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medicine. This medicine must not be used during pregnancy because the effects of this medicine on the fetus are not known. Therefore, it is recommended to use contraceptive methods while using this medicine.

Breast-feeding

It is not known whether tirzepatide passes into breast milk. A risk to newborns/infants cannot be ruled out. If you are breast-feeding or plan to breast-feed, consult your doctor before using this medicine. You and your doctor must decide whether to stop breast-feeding or stop using Mounjaro.

Driving and using machines

This medicine is unlikely to affect your ability to drive or use machines. However, if you use Mounjaro with a sulfonylurea or insulin, you may get low blood sugar (hypoglycemia) that can reduce your ability to concentrate. Avoid driving or using machines if you have any signs of low blood sugar, such as headache, drowsiness, weakness, dizziness, hunger, confusion, irritability, rapid heartbeat, and sweating (see section 4). See section 2, "Warnings and precautions" for information on the increased risk of getting low blood sugar. Consult your doctor for more information.

Mounjaro contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per dose, which is essentially "sodium-free".

3. How to use Mounjaro

Follow the instructions for administration of this medicine exactly as your doctor or pharmacist has told you. If you are not sure, ask your doctor or pharmacist again.

How much to use

• The starting dose is 2.5 mg once a week for four weeks. After four weeks, your doctor will increase your dose to 5 mg once a week.

• Your doctor may increase your dose in increments of 2.5 mg up to 7.5 mg, 10 mg, 12.5 mg, or 15 mg once a week if needed. In each case, your doctor will tell you to stay on a specific dose for at least 4 weeks before moving to a higher dose.

Do not change your dose unless your doctor has told you to.

Each pen contains a dose of Mounjaro of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg.

When to use Mounjaro

You can use your pen at any time of day, with or without food. If you can, you should use it on the same day each week. To help you remember when to use Mounjaro, you can write the day of the week when you inject your first dose on the pen box or on a calendar.

If necessary, you can change the day of your weekly Mounjaro injection, as long as at least 3 days have passed since your last injection. After selecting a new dosing day, continue with once-weekly administration on that new day.

How to inject Mounjaro

Mounjaro is injected under the skin (subcutaneous injection) in the abdominal area at least 5 cm away from the navel or in the upper thigh or upper arm. You may need help from another person if you want to inject into the upper arm.

If you want, you can inject into the same area of your body each week. But in this case, make sure to choose different injection sites within the same area. If you also inject insulin, choose a different injection site for that injection.

Before using Mounjaro, read the "Instructions for use" of the pen carefully.

Monitoring of blood sugar levels

If you are using Mounjaro with a sulfonylurea or insulin, it is important that you monitor your blood sugar levels as instructed by your doctor, nurse, or pharmacist (see section 2, "Warnings and precautions").

If you use more Mounjaro than you should

If you use more Mounjaro than you should, talk to your doctor immediately. Too much medicine can cause your blood sugar levels to drop too low (hypoglycemia) and can also cause nausea or vomiting.

If you forget to use Mounjaro

If you miss an injection and,

• it has been 4days or lesssince you should have used Mounjaro, use it as soon as you remember. Then inject your next dose as usual on your scheduled day.
• it has been more than 4dayssince you should have used Mounjaro, skip the missed dose. Then inject your next dose as usual on your scheduled day.

Do not inject a double dose to make up for a missed dose. The minimum time between two doses must be at least 3 days.

If you stop using Mounjaro

Do not stop using Mounjaro without talking to your doctor. If you stop using Mounjaro and have type 2 diabetes, your blood sugar levels may increase.

If you have any other questions about the use of this medicine, ask your doctor, pharmacist, or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects

Uncommon(may affect up to 1 in 100 people)

• Pancreatitis (inflammation of the pancreas) that can cause severe stomach and back pain that does not go away. See your doctor immediately if you experience these symptoms.

Rare(may affect up to 1 in 1,000 people)

• Severe allergic reactions (e.g., anaphylactic reaction, angioedema). You must get medical help immediately and tell your doctor if you experience symptoms such as breathing problems, rapid swelling of the lips, tongue, and/or throat with difficulty swallowing and rapid heartbeat.

Other side effects

Very common(may affect more than 1 in 10 people)

• Nausea
• Diarrhea
• Stomach pain (abdominal pain) reported in patients treated for weight control
• Vomiting reported in patients treated for weight control
• Constipation reported in patients treated for weight control

These side effects are usually not serious. Nausea, diarrhea, and vomiting are more common when you start using tirzepatide but decrease over time in most patients.

• Low blood sugar (hypoglycemia) is very common when tirzepatide is used with sulfonylurea and/or insulin. If you are taking a sulfonylurea or insulin for type 2 diabetes, you may need to have your dose reduced while using tirzepatide (see section 2, "Warnings and precautions"). Symptoms of low blood sugar can include headache, drowsiness, weakness, dizziness, hunger, confusion, irritability, rapid heartbeat, and sweating. Your doctor should tell you how to treat low blood sugar levels.

Common(may affect up to 1 in 10 people)

• Low blood sugar (hypoglycemia) when tirzepatide is used for type 2 diabetes with metformin and a sodium-glucose cotransporter 2 inhibitor (another diabetes medicine)
• Allergic reaction (hypersensitivity) (e.g., rash, itching, and eczema)
• Dizziness reported in patients treated for weight control
• Low blood pressure reported in patients treated for weight control

• Decreased appetite reported in patients treated for type 2 diabetes
• Stomach pain (abdominal pain) reported in patients treated for type 2 diabetes
• Vomiting reported in patients treated for type 2 diabetes – usually decreases over time
• Indigestion (dyspepsia)
• Constipation reported in patients treated for type 2 diabetes
• Bloating
• Belching
• Gas (flatulence)
• Acid reflux or heartburn (also called gastroesophageal reflux disease – GERD) – a disease caused by stomach acid flowing back up into the tube that connects the stomach to the mouth

• Hair loss reported in patients treated for weight control
• Fatigue
• Injection site reactions (e.g., itching or redness)
• Rapid heartbeat
• Increased levels of pancreatic enzymes (such as lipase and amylase) in the blood
• Increased levels of calcitonin in the blood in patients treated for weight control.

Uncommon(may affect up to 1 in 100 people)

• Low blood sugar (hypoglycemia) when tirzepatide is used with metformin for type 2 diabetes
• Gallstones
• Gallbladder inflammation
• Weight loss reported in patients treated for type 2 diabetes
• Pain at the injection site
• Increased levels of calcitonin in the blood in patients treated for type 2 diabetes or for OSA with obesity
• Altered sense of taste
• Altered skin sensation
• Delayed emptying of the stomach

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly through the Spanish Medicines Monitoring System for Human Use: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Mounjaro

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the label of the pen and on the carton after EXP. The expiry date is the last day of the month shown.

Store in a refrigerator (2°C to 8°C). Do not freeze. If the pen has been frozen, DO NOT USE IT.

Store in the original package to protect from light.

Mounjaro can be stored without refrigeration below 30°C for up to 21 consecutive days, after which the pen must be discarded.

Do not use this medicine if you notice that the pen is damaged or the medicine is cloudy, has color, or contains particles.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Container Contents and Additional Information

Mounjaro Composition

The active ingredient is tirzepatida.

• Mounjaro 2.5mg:Each pre-filled pen contains 2.5 mg of tirzepatida in 0.5 ml of solution (5 mg/ml).
• Mounjaro 5mg:Each pre-filled pen contains 5 mg of tirzepatida in 0.5 ml of solution (10 mg/ml).
• Mounjaro 7.5mg:Each pre-filled pen contains 7.5 mg of tirzepatida in 0.5 ml of solution (15 mg/ml).
• Mounjaro 10mg:Each pre-filled pen contains 10 mg of tirzepatida in 0.5 ml of solution (20 mg/ml).
• Mounjaro 12.5mg:Each pre-filled pen contains 12.5 mg of tirzepatida in 0.5 ml of solution (25 mg/ml).
• Mounjaro 15mg:Each pre-filled pen contains 15 mg of tirzepatida in 0.5 ml of solution (30 mg/ml).

The other components are disodium hydrogen phosphate heptahydrate (E339), sodium chloride, sodium hydroxide (for more information, see section 2 "Mounjaro contains sodium"), concentrated hydrochloric acid, and water for injectable preparations.

Product Appearance and Container Contents

Mounjaro is a clear, colorless to slightly yellowish injectable solution in a pre-filled pen.

The pre-filled pen has a hidden needle that will automatically be inserted into the skin when the injection button is pressed. The pre-filled pen will retract the needle when the injection is complete.

Each pre-filled pen contains 0.5 ml of solution.

The pre-filled pen is for single use.

Container sizes are 2 pre-filled pens, 4 pre-filled pens, or a multiple pack of 12 (3 packs of 4) pre-filled pens. Not all pack sizes may be marketed.

Marketing Authorization Holder

Eli Lilly Nederland B.V., Papendorpseweg 83, 3528 BJ Utrecht, Netherlands.

Manufacturer

Eli Lilly Italia S.p.A., Via Gramsci 731/733, 50019, Sesto Fiorentino, Florence (FI), Italy.

Lilly France, 2, rue du Colonel Lilly, 67640 Fegersheim, France

You can request more information about this medication by contacting the local representative of the marketing authorization holder:

Date of Last Revision of this Prospectus:

Other Sources of Information

Detailed information on this medication is available on the European Medicines Agency website: http://www.ema.europa.eu, and on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/).

Important Information You Should Know Before Injecting Mounjaro.

Read these instructions for use and the prospectus before using your Mounjaro pre-filled pen (pen) and each time you get a new pen.There may be new information. This information does not replace the conversation with your doctor, nurse, or pharmacist about your medical condition or treatment.

Consult your doctor, nurse, or pharmacist about how to properly inject Mounjaro.

• Mounjaro is a single-dose pre-filled pen.
• The pen has a hidden needle that will automatically be inserted into your skin when you press the injection button. The pre-filled pen will retract the needle when the injection is complete.
• Mounjaro is used once a week.
• It is injected only under the skin (subcutaneously).
• You or another person can inject the medication into the abdominal area, the top of the thigh, or the top of the arm.
• You may need the help of another person if you want to inject yourself in the top of the arm.

Parts of the Pen

Preparation for Injecting Mounjaro

Choose Your Injection Site

Your doctor, nurse, or pharmacist can help you choose the best injection site for you.

Storage and Handling

• For storage instructions, see section 5 of the prospectus.
• The pen has glass parts. Handle it carefully. If you drop the pen on a hard surface, do notuse it. Use a new pen for your injection.

Frequently Asked Questions

What happens if I see air bubbles in my pen?

Air bubbles are normal.

What happens if my pen is not at room temperature?

It is not necessary to bring the pen to room temperature.

What happens if I unlock the pen and press the purple injection button before removing the gray base cap?

Do notremove the gray base cap. Throw away the pen and get a new one.

What happens if there is a drop of liquid on the tip of the needle when I remove the gray base cap?

A drop of liquid on the tip of the needle is normal. Do nottouch the needle.

Do I need to keep the injection button pressed until the injection is complete?

It is not necessary, but it can help you keep the pen stable on your skin.

I heard more than two clicks during the injection – two high clicks and one low click. Is the injection complete?

Some people may hear a low click just before the second high click. This is due to the normal operation of the pen. Do notremove the pen from your skin until you hear the second higher click.

I am not sure if my pen has workedcorrectly.

What happens if there is a drop of liquid or blood on my skin after the injection?

This is normal. Press a cotton ball or gauze on the injection site. Do notrub the injection site.

Other Information

• If you have vision problems, do not use your pen without the help of another trained person in the use of the Mounjaro pen.

Where to Get More Information

• If you have any questions or problems with your Mounjaro pen, contact Lilly or your doctor, nurse, or pharmacist.

Last Revision