Tirzepatide Forte Flex-Dose 4 mL

Tirzepatide Flex-Dose 60 mg vial is a prescriber- and patient-driven compound designed to allow fully customizable dosing based on the provider’s clinical judgment. It is administered subcutaneously and supports flexible dosing frequencies, including micro-dosing, multiple weekly injections, or a once-weekly flex titration schedule.

Directions

Directions MUST be prescribed in UNITS.

• • • Example: Inject 10 units on insulin syringe subcutaneously twice weekly.

Clinical Reason Statement

A Clinical Reason Statement is required when prescribing Tirzepatide. If a Clinical Difference Statement is not provided, the prescription will be cancelled and the patient will be referred to the commercially available product, if available.

i.e. Prescribed For Flexible Dosing/Titration Not Achievable With Commercial Product.

To ensure proper submission, please follow the instructions below:

• • • LifeFile eRx Portal: Enter the clinical reason in the “Clinical Statement” field when submitting your order.
    • API Integrations: A new Clinical Statement field is now available for practices sending prescriptions through integrated systems.
    • Faxed Prescriptions: The clinical reason must be clearly written out on the prescription itself.