tirzepatide   Click here for help

GtoPdb Ligand ID: 11429

Synonyms: LY-3298176 | LY3298176 | Mounjaro® | Zepbound®
Approved drug
tirzepatide is an approved drug (EMA & FDA (2022))
Compound class: Peptide
Comment: Tirzepatide (LY3298176) is a clinical stage dual GIP/GLP-1 agonist ('twincretin'), that was developed to help manage type 2 diabetes mellitus (T2DM) [1,4] and as a novel anti-obesity medication. Structurally it is 39 amino acid linear peptide that is conjugated to a C20 fatty diacid moiety by a linker connected to the lysine20 residue. The dual agonist approach produces a synergistic effect on the insulin and glucagonostatic responses compared to a GLP-1 agonist (semaglutide) alone [1,10]. It was the first dual-targeting single agent to be approved for T2DM management.
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Ligand Activity Visualisation Charts

These are box plot that provide a unique visualisation, summarising all the activity data for a ligand taken from ChEMBL and GtoPdb across multiple targets and species. Click on a plot to see the median, interquartile range, low and high data points. A value of zero indicates that no data are available. A separate chart is created for each target, and where possible the algorithm tries to merge ChEMBL and GtoPdb targets by matching them on name and UniProt accession, for each available species. However, please note that inconsistency in naming of targets may lead to data for the same target being reported across multiple charts.

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2D Structure
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2D Structure

An image of the ligand's 2D structure. For small molecules with SMILES these are drawn using the NCI/CADD Chemical Identifier Resolver. Click on the image to access the chemical structure search tool with the ligand pre-loaded in the structure editor. For other types of ligands, e.g. longer nucleotides and peptides, a manually drawn representation of the molecule may be provided.

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SMILES / InChI / InChIKey
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SMILES / InChI / InChIKey

SMILES (Simplified Molecular Input Line Entry Specification) A specification for unambiguously describing the structure of chemical molecules using short ASCII strings. Canonical SMILES specify a unique representation of the 2D structure without chiral or isotopic specifications. Isomeric SMILES include chiral specification and isotopes.

Standard InChI (IUPAC International Chemical Identifier) and InChIKey InChI is a non-proprietary, standard, textual identifier for chemical substances designed to facilitate linking of information and database searching. An InChIKey is a simplified version of a full InChI, designed for easier web searching.

Generated using the Chemistry Development Kit (CDK) (Willighagen EL et al. Journal of Cheminformatics vol. 9:33. 2017, doi:10.1186/s13321-017-0220-4; https://cdk.github.io/)

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Canonical SMILES NCCCC[C@@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)NCC(=O)NCC(=O)N1CCC[C@H]1C(=O)N[C@H](C(=O)N[C@H](C(=O)NCC(=O)N[C@H](C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(=O)N[C@H](C(=O)N)CO)C)CO)CO)C)[C@H](CC)C)CC(C)C)Cc1c[nH]c2c1cccc2)CCC(=O)N)C(C)C)Cc1ccccc1)C)NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@H]([C@H](CC)C)NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)C(NC(=O)[C@H]([C@H](CC)C)NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@H]([C@H](O)C)NC(=O)[C@@H](NC(=O)[C@H]([C@H](O)C)NC(=O)CNC(=O)[C@@H](NC(=O)C(NC(=O)[C@H](Cc1ccc(cc1)O)N)(C)C)CCC(=O)O)Cc1ccccc1)CO)CC(=O)O)Cc1ccc(cc1)O)CO)(C)C)CC(C)C)CC(=O)O)CCCCNC(=O)CCCCCCCCCCCCCCCCCCC(=O)N[C@H](C(=O)O)CCC(=O)NCCOCCOCC(=O)NCCOCCOCC(=O)O)C)CCC(=O)N
Isomeric SMILES CC[C@H](C)[C@@H](C(=O)N[C@@H](C)C(=O)N[C@@H](CCC(=O)N)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](C)C(=O)N[C@@H](Cc1ccccc1)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCC(=O)N)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H](C)C(=O)NCC(=O)NCC(=O)N1CCC[C@H]1C(=O)N[C@@H](CO)C(=O)N[C@@H](CO)C(=O)NCC(=O)N[C@@H](C)C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(=O)N[C@@H](CO)C(=O)N)NC(=O)[C@H](CCCCNC(=O)CCCCCCCCCCCCCCCCCCC(=O)N[C@@H](CCC(=O)NCCOCCOCC(=O)NCCOCCOCC(=O)O)C(=O)O)NC(=O)[C@H](CC(=O)O)NC(=O)[C@H](CC(C)C)NC(=O)C(C)(C)NC(=O)[C@H]([C@@H](C)CC)NC(=O)[C@H](CO)NC(=O)[C@H](Cc1ccc(cc1)O)NC(=O)[C@H](CC(=O)O)NC(=O)[C@H](CO)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](Cc1ccccc1)NC(=O)[C@H]([C@@H](C)O)NC(=O)CNC(=O)[C@H](CCC(=O)O)NC(=O)C(C)(C)NC(=O)[C@H](Cc1ccc(cc1)O)N
InChI InChI=1S/C225H348N48O68/c1-23-126(10)183(214(327)242-131(15)190(303)244-148(80-84-168(228)283)196(309)245-145(64-50-52-88-226)195(308)240-130(14)191(304)248-154(105-135-58-42-40-43-59-135)205(318)263-182(125(8)9)212(325)247-149(81-85-169(229)284)197(310)251-156(108-139-111-234-144-63-49-48-62-142(139)144)201(314)249-151(102-123(4)5)204(317)265-184(127(11)24-2)213(326)241-129(13)189(302)236-112-173(288)235-115-177(292)270-92-54-66-164(270)210(323)258-161(118-276)208(321)256-160(117-275)194(307)238-113-174(289)239-132(16)218(331)272-94-56-68-166(272)220(333)273-95-57-69-167(273)219(332)271-93-55-67-165(271)211(324)255-159(116-274)188(230)301)264-198(311)146(65-51-53-89-231-170(285)70-46-38-36-34-32-30-28-26-27-29-31-33-35-37-39-47-71-172(287)243-150(221(334)335)82-86-171(286)232-90-96-338-98-100-340-121-176(291)233-91-97-339-99-101-341-122-181(299)300)246-202(315)157(109-179(295)296)252-199(312)152(103-124(6)7)261-223(337)225(21,22)269-217(330)185(128(12)25-3)266-209(322)163(120-278)257-200(313)153(107-138-74-78-141(282)79-75-138)250-203(316)158(110-180(297)298)253-207(320)162(119-277)259-216(329)187(134(18)280)267-206(319)155(106-136-60-44-41-45-61-136)254-215(328)186(133(17)279)262-175(290)114-237-193(306)147(83-87-178(293)294)260-222(336)224(19,20)268-192(305)143(227)104-137-72-76-140(281)77-73-137/h40-45,48-49,58-63,72-79,111,123-134,143,145-167,182-187,234,274-282H,23-39,46-47,50-57,64-71,80-110,112-122,226-227H2,1-22H3,(H2,228,283)(H2,229,284)(H2,230,301)(H,231,285)(H,232,286)(H,233,291)(H,235,288)(H,236,302)(H,237,306)(H,238,307)(H,239,289)(H,240,308)(H,241,326)(H,242,327)(H,243,287)(H,244,303)(H,245,309)(H,246,315)(H,247,325)(H,248,304)(H,249,314)(H,250,316)(H,251,310)(H,252,312)(H,253,320)(H,254,328)(H,255,324)(H,256,321)(H,257,313)(H,258,323)(H,259,329)(H,260,336)(H,261,337)(H,262,290)(H,263,318)(H,264,311)(H,265,317)(H,266,322)(H,267,319)(H,268,305)(H,269,330)(H,293,294)(H,295,296)(H,297,298)(H,299,300)(H,334,335)/t126-,127-,128-,129-,130-,131-,132-,133+,134+,143-,145-,146-,147-,148-,149-,150-,151-,152-,153-,154-,155-,156-,157-,158-,159-,160-,161-,162-,163-,164-,165-,166-,167-,182-,183-,184-,185-,186-,187-/m0/s1
InChI Key AAPYRSPHYSKGIS-MCNPHUAVSA-N

Generated using the Chemistry Development Kit (CDK) (Willighagen EL et al. Journal of Cheminformatics vol. 9:33. 2017, doi:10.1186/s13321-017-0220-4; https://cdk.github.io/)
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Summary of Clinical Use Click here for help
An overview of the SURPASS phase 3 clinical studies of tirzepatide for the treatment of T2DM has been published [8]. Based on results from this global program full FDA approval was granted in May 2022, with administration being intended to improve glycemic control in T2DM patients (as an adjunct to diet and exercise). It is not indicated for use in patients with type 1 diabetes. Tirzepatide is administered by subcutaneous injection, one weekly. This once-weekly regimen has also demonstrated significant and sustained weight reduction in obese patients with BMI ≥30 (in the Phase 3 SURMOUNT-1 study; final results published in June 2022) [6]. Patients who received tirzepatide achieved 15-20% reduction in body weight, depending on weekly drug dose. Based on results arising from SURMOUNT-1 and SURMOUNT-2 trials, in November 2023, the FDA issued authorisation for tirzepatide to be used for weight management in obese patients and overweight patients with weight-related medical conditions (hypertension, dyslipidemia, T2DM, obstructive sleep apnea, cardiovascular disease).
Clinical Trials
Clinical Trial ID Title Type Source Comment References
NCT04657016 A Study of Tirzepatide (LY3298176) In Participants After A Lifestyle Weight Loss Program Phase 3 Interventional Eli Lilly and Company
NCT03861052 A Study of Tirzepatide (LY3298176) Compared to Dulaglutide in Participants With Type 2 Diabetes Phase 3 Interventional Eli Lilly and Company
NCT02759107 A Study of LY3298176 in Healthy Participants and Participants With Type 2 Diabetes (T2DM) Phase 1 Interventional Eli Lilly and Company 1
NCT03882970 A Study of Tirzepatide (LY3298176) Versus Insulin Degludec in Participants With Type 2 Diabetes Phase 3 Interventional Eli Lilly and Company 7
NCT04039503 A Study of Tirzepatide (LY3298176) Versus Placebo in Participants With Type 2 Diabetes Inadequately Controlled on Insulin Glargine With or Without Metformin Phase 3 Interventional Eli Lilly and Company 2
NCT03987919 A Study of Tirzepatide (LY3298176) Versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Participants With Type 2 Diabetes Phase 3 Interventional Eli Lilly and Company 5
NCT03954834 A Study of Tirzepatide (LY3298176) in Participants With Type 2 Diabetes Not Controlled With Diet and Exercise Alone Phase 3 Interventional Eli Lilly and Company 5,9
NCT03730662 A Study of Tirzepatide (LY3298176) Once a Week Versus Insulin Glargine Once a Day in Participants With Type 2 Diabetes and Increased Cardiovascular Risk Phase 3 Interventional Eli Lilly and Company 3
NCT04184622 A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight Phase 3 Interventional Eli Lilly and Company Known as the SURMOUNT-1 study, data from this trial demonstrated that once weekly tirzepatide resulted in significant and sustained reductions in body weight in people with obesity. 6