Pre-filled pen 0.75mg/0.5mL, 1.5mg/0.5mL

First line GLP-1 agonist

prolonged-release suspension for injection in pre-filled pen (BCise) 2mg

Third line GLP-1 agonist

Injection 6mg/mL pre-filled pen

Second line GLP-1 agonist, if daily administration preferred.
Prescribe by brand.

Managing overweight and obesity.
Prescribe by brand.

Solution for injection - pre-filled pen 0.25mg, 0.5mg, 1mg

First line GLP-1 agonist.

Prescribe by brand.

Tablets 3mg, 7mg, 14mg

First line GLP-1 agonist.

Alternative GLP-1 receptor agonist for patients who are unable to use subcutaneous formulations or patients who prefer oral administration. 

Managing overweight and obesity.

Prescribe by brand.

Type 2 Diabetes

Preference of agent should be decided based on the clinician’s judgement about patient characteristics. Local specialists have suggested the following: 

1. Semaglutide (or other available GLP-1 RAs) may be preferred in patients with lower BMIs e.g. < BMI 35 kg/m2 or patients who have established CVD or are at high risk of CV events and require an agent with proven CV benefit. 

2. Tirzepatide may be preferred in patients with higher BMIs e.g. > BMI 40 kg/m2 or who despite optimisation of all other therapies still require further glycaemic control.

Careful consideration MUST be given to stopping tirzepatide if ineffective or not tolerated (evidence of poor tolerance as dose escalates). Tirzepatide should be reviewed after 6 months, and the deprescribing of other agents, e.g. sulfonylureas and gliptins, should be considered where possible. 

As a minimum expectation, it is recommended that tirzepatide is only continued if the adult with type 2 diabetes has had a beneficial metabolic response (a reduction of at least 11 mmol/mol [1.0%] in HbA1c and weight loss of at least 3% of initial body weight in 6 months).

 Managing overweight and obesity

100iu/mL  pre-filled pens