We are offering Saxenda (a GLP-1 injection) at a special price of ¥15,180 per pen, as it will be discontinued once our current stock runs out. As of September 7th, we have 7 pens available at the Koenji location and 6 pens at the Kojimachi location. For more details on Saxenda, please refer to the link below.
Medical weight loss treatment at HADA NO CLINIC
At our clinic, we offer weight loss treatments using medications such as Mounjaro, Ozempic, Rybelsus, Lusefi, and Metformin, all under the supervision of a doctor and with regular check-ups.
Medication | Effect | Dosage | Features |
---|---|---|---|
Mounjaro | ![]() | Weekly injection | Targets GIP/GLP-1 receptors to suppress appetite and increase energy expenditure |
Ozempic | Weekly injection | Targets GLP-1 receptors to suppress appetite and increase energy expenditure | |
Rybelsus | Oral, once daily | ||
Lusefi | Oral, once daily | Inhibits glucose reabsorption in the kidneys, promoting glucose excretion through urine | |
Metformin | Oral, twice daily | Inhibits glucose production in the liver and reduces glucose absorption in the digestive tract Promotes GLP-1 secretion from the intestines to suppress appetite |
Mounjaro (Tirzepatide)
![](https://koenji.clinic/wp-content/uploads/mounjaro.png)
Mounjaro (Tirzepatide) is a once-weekly injection that helps suppress appetite and increase energy expenditure, aiding in weight loss. It works on both GLP-1 and GIP receptors, offering potentially greater weight loss effects compared to medications that target only the GLP-1 receptor.
While Mounjaro is approved as a treatment for diabetes, it has not yet been approved as a weight loss medication in Japan, meaning it is not covered by the Pharmaceutical Side Effect Relief System.
Mounjaro Prices (incl. tax)
Drug | Price / pen (1 week) | Price / 4 pens (4 weeks) |
---|---|---|
Mounjaro 2.5mg | ¥5,500 | ¥22,000 |
Mounjaro 5mg | ¥9,900 | ¥39,600 |
Mounjaro 7.5mg | ¥14,300 | ¥57,200 |
Mounjaro 10mg | ¥18,700 | ¥74,800 |
Mounjaro 12.5mg | ¥23,100 | ¥92,400 |
Mounjaro 15mg | ¥26,400 | ¥105,600 |
Item | Price |
---|---|
Alcohol swabs (20 pieces) | ¥165 |
Anti-nausea medication (10-day supply) | ¥660 |
- A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,982) is needed at the initial visit and every three months to monitor for side effects.
- After use, the needle retracts automatically into the pen for safety. Dispose of the pen in a sturdy container (like a milk carton), seal it with tape, and discard it as burnable trash. If you wish to dispose of items at our clinic, a medical waste fee of ¥440 will be charged.
Dosage and Administration
How to use Mounjaro
Storage:
Store in the refrigerator (2–8°C) and avoid freezing. It can also be stored at room temperature (below 30°C) for up to 3 weeks.
Injection Method:
Inject subcutaneously (into the fat) in the abdomen or thigh once a week, on the same day each week. It can be taken regardless of meals. Do not inject into muscles or veins. Follow the “Instructions for Use” provided during your consultation to use it correctly.
Dosage Schedule:
Period | Dosage |
---|---|
Weeks 1–4 | 2.5 mg / week |
Weeks 5–8 | 5 mg / week |
Weeks 9–12 | 7.5mg / week |
Weeks 13–16 | 10mg / week |
Weeks 17–20 | 12.5mg / week |
Week 21+ | 15mg / week |
Since nausea and discomfort may occur initially, start with 2.5 mg once a week and gradually increase the dose every 4 weeks according to the table, up to a maximum of 15 mg.
- If the effect is strong or side effects persist, maintain the current dosage without increasing it.
Who Should Not Receive Treatment
You may not be eligible for weight loss treatment if you meet any of the following criteria:
A. All Drugs (Mounjaro / Ozempic / Rybelsus / Lusefi / Metformin)
- Pregnant or breastfeeding women
- People with diabetes (consult at an insurance-covered facility)
- Those with severe kidney or liver issues
- Those allergic to similar drugs
- Those at risk of hypoglycemia due to extreme exercise, excessive alcohol intake, pituitary/adrenal insufficiency
- Those who are underweight (BMI <18.5), have low body fat (<15% men, <20% women), or have eating disorders
In addition to the criteria in section A, you may not be eligible for treatment if:
Mounjaro / Ozempic / Rybelsus
- You meet any of the criteria in “A”
- You have severe gastrointestinal issues or a history of pancreatitis
- You have depression or suicidal tendencies
- You have thyroid issues or a family history of medullary thyroid cancer or MEN2
Side Effects
Mounjaro / Ozempic / Rybelsus
- 1. Gastrointestinal symptoms
-
Nausea, vomiting, diarrhea, constipation, abdominal discomfort, bloating. Usually temporary and improves with continued use.
- 2. Injection site reactions (excl. Rybelsus)
-
Redness, swelling, lumps. Usually temporary. Rotate injection sites.
- 3. Kidney issues
-
Dehydration from diarrhea/vomiting may cause kidney problems. Stay hydrated.
- 4. Increased heart rate
-
If sustained, stop the medication and consult a doctor.
- 5. Hypoglycemia
-
Symptoms include cold sweats, shaking, palpitations, hunger, headaches, drowsiness, seizures. Take 20g of sugar or 200ml juice and rest. Avoid driving or using machinery until symptoms pass.
- 6. Pancreatitis, gallstones, cholecystitis, cholangitis, jaundice
-
Rare but seek immediate medical attention for severe abdominal pain, back pain, vomiting, or fever. Rapid weight loss increases the risk of gallstones; keep weight loss under 5% per month.
- 7. Anaphylaxis, angioedema
-
Rare but seek emergency help for itching, hives, facial/throat swelling, difficulty breathing, dizziness.
- 8. Thyroid C-cell tumors (medullary thyroid cancer)
-
Cases in rats/mice, but human relevance is unclear. Report any neck swelling or lumps. Regular calcitonin blood tests will be conducted.
Pregnancy, Breastfeeding, and Fertility planning
These drugs are not for use during pregnancy or breastfeeding. Discontinue Mounjaro, Ozempic, or Rybelsus 2 months before trying to conceive, and Lusefi or Metformin 1 month before trying to conceive. No reported effects on male fertility.
Drug Interactions
Mounjaro / Ozempic / Rybelsus (Caution)
Oral Contraceptives | May reduce the effectiveness of birth control pills. |
---|---|
Warfarin | May increase or decrease its effects. |
Other Diabetes Medications | Higher risk of hypoglycemia. |
Alcohol Interaction
Moderate drinking is generally safe, but avoid heavy drinking as it can cause hypoglycemia.
【Recommended Limit】Up to 500ml of beer, 1 cup of sake, or 200ml of wine per day.
Interactions Between Diet Medications (Diabetes Drugs)
GLP-1 receptor agonists (Mounjaro, Ozempic, Rybelsus), SGLT2 inhibitors (Lusefi), and Metformin have a low risk of hypoglycemia alone but increase the risk when combined. Follow your doctor’s instructions and get regular check-ups and tests. If you are prescribed diet or diabetes drugs from other clinics, inform your doctor.
References & Website List
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- Gabery S, Salinas CG, Paulsen SJ, Ahnfelt-Rønne J, Alanentalo T, Baquero AF, Buckley ST, Farkas E, Fekete C, Frederiksen KS, Helms HCC, Jeppesen JF, John LM, Pyke C, Nøhr J, Lu TT, Polex-Wolf J, Prevot V, Raun K, Simonsen L, Sun G, Szilvásy-Szabó A, Willenbrock H, Secher A, Knudsen LB, Hogendorf WFJ. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight. 2020 Mar 26;5(6):e133429. doi: 10.1172/jci.insight.133429. PMID: 32213703; PMCID: PMC7213778.
- US Food and Drug Administration . Wegovy prescribing information. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=215256 最終アクセス2020.12.02.
- Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT; STEP 8 Investigators. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022 Jan 11;327(2):138-150. doi: 10.1001/jama.2021.23619. PMID: 35015037; PMCID: PMC8753508.
- novo nordisk “Wegovy semaglutide injection 2.4mg” https://www.wegovy.com/
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- Buse JB, Bode BW, Mertens A, Cho YM, Christiansen E, Hertz CL, Nielsen MA, Pieber TR; PIONEER 7 investigators. Long-term efficacy and safety of oral semaglutide and the effect of switching from sitagliptin to oral semaglutide in patients with type 2 diabetes: a 52-week, randomized, open-label extension of the PIONEER 7 trial. BMJ Open Diabetes Res Care. 2020 Dec;8(2):e001649. doi: 10.1136/bmjdrc-2020-001649. PMID: 33318068; PMCID: PMC7737050.
- Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D; STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414-1425. doi: 10.1001/jama.2021.3224. PMID: 33755728; PMCID: PMC7988425.
- Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.
- Lingvay I, Hansen T, Macura S, Marre M, Nauck MA, de la Rosa R, Woo V, Yildirim E, Wilding J. Superior weight loss with once-weekly semaglutide versus other glucagon-like peptide-1 receptor agonists is independent of gastrointestinal adverse events. BMJ Open Diabetes Res Care. 2020 Oct;8(2):e001706. doi: 10.1136/bmjdrc-2020-001706. PMID: 33115821; PMCID: PMC7594204.
- Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. doi: 10.1111/dom.14725. Epub 2022 May 19. PMID: 35441470; PMCID: PMC9542252.
- Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. doi: 10.3389/fendo.2021.645563. Erratum in: Front Endocrinol (Lausanne). 2021 Nov 10;12:786732. PMID: 34305810; PMCID: PMC8294388.
- ノボノルディスクファーマ 「ウゴービ® 肥満症治療剤 持続性GLP-1 受容体作動薬」https://pro.novonordisk.co.jp/products/wegovy.html 最終アクセス:2023.05.03
- ノボノルディスクファーマ 「ウゴービ® 添付文書」 chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://pro.novonordisk.co.jp/content/dam/hcpexperience/jp/ja/documents/products/wegovy/Wegovy_PI_latest.pdf.coredownload.inline.pdf 最終アクセス:2023.05.03
- O’Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, Carson CG, Jepsen CH, Kabisch M, Wilding JPH. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet. 2018 Aug 25;392(10148):637-649. doi: 10.1016/S0140-6736(18)31773-2. Epub 2018 Aug 16. PMID: 30122305.
- Davies M, Pieber TR, Hartoft-Nielsen ML, Hansen OKH, Jabbour S, Rosenstock J. Effect of Oral Semaglutide Compared With Placebo and Subcutaneous Semaglutide on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA. 2017 Oct 17;318(15):1460-1470. doi: 10.1001/jama.2017.14752. PMID: 29049653; PMCID: PMC5817971.
- M.S. Capehorn, A.-M. Catarig, J.K. Furberg, A. Janez, H.C. Price, S. Tadayon, B. Vergès, M. Marre, Efficacy and safety of once-weekly semaglutide 1.0mg vs once-daily liraglutide 1.2mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10), Diabetes & Metabolism, Volume 46, Issue 2, 2020, Pages 100-109, ISSN 1262-3636, https://doi.org/10.1016/j.diabet.2019.101117. (https://www.sciencedirect.com/science/article/pii/S1262363619301326)
- ノボノルディスクファーマ株式会社 2型糖尿病治療剤 経口GLP-1受容体作動薬 セマグルチド(遺伝子組換え)リベルサス錠3mg リベルサス錠7mg リベルサス錠14mg 2021年9月改定(第2版)
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- Aroda VR, Rosenstock J, Terauchi Y, Altuntas Y, Lalic NM, Morales Villegas EC, Jeppesen OK, Christiansen E, Hertz CL, Haluzík M; PIONEER 1 Investigators. PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes. Diabetes Care. 2019 Sep;42(9):1724-1732. doi: 10.2337/dc19-0749.
- Gibbons C, Blundell J, Tetens Hoff S, Dahl K, Bauer R, Baekdal T. Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes. Diabetes Obes Metab. 2021 Feb;23(2):581-588. doi: 10.1111/dom.14255. Epub 2020 Nov 27. PMID: 33184979; PMCID: PMC7839771.
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- Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, Jeppesen OK, Lingvay I, Mosenzon O, Pedersen SD, Tack CJ, Thomsen M, Vilsbøll T, Warren ML, Bain SC; PIONEER 6 Investigators. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2019 Aug 29;381(9):841-851. doi: 10.1056/NEJMoa1901118. Epub 2019 Jun 11. PMID: 31185157.