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You could possibly de-escalate and go to a smaller maintenance dose

The middle-aged man with metabolic syndrome Men in their 40s and 50s with the classic pattern of elevated blood sugar, high triglycerides, low HDL cholesterol, high blood pressure, and central obesity represent a significant portion of tirzepatide users

Overall, initial combination therapy with sitagliptin/metformin resulted in greater reductions of HbA 1c and FPG levels, possibly aiding in attaining target HbA 1c more quickly than metformin alone

While absolute lean mass decreased by about 9.7%, the proportion of lean mass relative to total body mass actually increased by 3 percentage points