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Key takeaways
Mounjaro can cause constipation in up to 17% of those who take it.
Most side effects, including constipation, resolve as your body gets used to the medication.
Increasing water intake, adding more fiber to your diet, and exercising more can help reduce constipation while taking Mounjaro.
Mounjaro, a brand-name version of tirzepatide, is a once-weekly injectable medication that targets both GIP and GLP-1 receptors. It’s designed to help manage blood sugar in adults with Type 2 diabetes when combined with diet and exercise. While many users report weight loss, it’s important to note that Mounjaro is FDA approved only for diabetes treatment. For weight management, Zepbound—another form of tirzepatide—is the approved option for those who are overweight or obese.
People with diabetes may be more susceptible to constipation due to nerve damage, diet restrictions, or the medications prescribed to treat it. Is Mounjaro one of the treatments you need to worry about slowing things down? While constipation is one of the most common side effects of Mounjaro, it doesn’t impact everyone who takes it, and there are simple ways to manage this side effect.
Can Mounjaro cause constipation?
Yes, “Mounjaro constipation” is definitely a thing that some people experience. For example, a study in the New England Journal of Medicine found that 11% to 17% of people taking tirzepatide, the active ingredient in Mounjaro, experienced constipation. “Constipation is a fairly common side effect I see in patients who are taking Mounjaro,” says Ehsan Ali, MD, board-certified internist based in Beverly Hills, California. “It doesn’t happen to everyone, but it’s definitely something I bring up when discussing potential side effects.”
“In my practice, I frequently hear patients report changes in their bowel habits, and constipation is one of the more prevalent digestive issues,” agrees Annika Kariniemi, CNP, a family nurse practitioner and founder of ProHealth Medical Weight Loss. This symptom is most noticeable during the first month or two of starting Mounjaro, as their bodies adjust. Constipation may also show up when the dose of Mounjaro is increased, she says.
When compared to other similar medications that control blood sugar, Mounjaro is typically slightly more constipating, according to Dr. Ali. “When you look at other drugs in the GLP-1 receptor agonist family, like Ozempic or Wegovy, constipation tends to be a shared side effect, but Mounjaro does seem to hit the GI system a little harder in some people,” Dr. Ali says. “That’s likely because Mounjaro targets both GLP-1 and GIP receptors, which can slow down digestion even more than the others.”
The silver lining, Dr. Ali explains, is that people who struggle with nausea or bloating while taking Ozempic actually often do better on Mounjaro. “It’s really about how each person’s body responds; there’s no one-size-fits-all answer, but constipation is something we keep a close eye on,” Dr. Ali says.
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Why does Mounjaro cause constipation?
Mounjaro works by mimicking two key hormones—GLP-1 and GIP—both of which play a role in blood sugar control and appetite regulation. “One of the ways these hormones work is by slowing down gastric emptying, meaning food moves through your stomach and intestines more slowly,” Kariniemi explains. “While this helps you feel fuller for longer and aids in weight loss, it can also lead to constipation because the slower transit time allows more water to be absorbed from your stool, making it harder and more difficult to pass.”
Not only that, but some people on Mounjaro experience decreased appetites and end up drinking less water, which can further contribute to constipation, Kariniemi adds.
What are the most common side effects of Mounjaro?
The most common short-term side effects of the Mounjaro are:
- Nausea
- Diarrhea
- Decreased appetite
- Vomiting
- Constipation
- Indigestion
- Stomach pain
Mounjaro doesn’t typically have long-term side effects, but it can have some longer-term risks, such as an increased risk of gallstones, inflammation of the gallbladder (cholecystitis), and pancreatitis. People with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) shouldn’t take Mounjaro due to a possible increased risk of thyroid cancer. If you have signs of pancreatitis, such as severe stomach pain with or without vomiting, you should stop taking Mounjaro and visit a healthcare professional right away. It is important to know that Mounjaro can make birth control pills less effective. Alternative methods of birth control are recommended for four weeks after beginning treatment and with each increase in dose of the medication to reduce the chances of unintended pregnancy.
How to prevent constipation from Mounjaro
Not everyone will experience constipation while taking Mounjaro, but if you do, there are several ways to treat it.
- Drink plenty of water: Hydration is crucial when you’re taking Mounjaro. “Many people aren’t drinking enough water throughout the day, and that alone can make constipation worse,” Dr. Ali says. “I tell patients to aim for at least 8–10 glasses of water daily, especially when starting Mounjaro.”
- Make dietary changes: Eating high-fiber foods like prunes or whole grains can help alleviate constipation.
- Exercise regularly: Working out can help your bowels work more effectively. “Even light walking after dinner can help get your digestive system moving,” says Dr. Ali.
- Try an over-the-counter treatment: Try a fiber supplement or a probiotic. “If those steps aren’t enough, a gentle stool softener like docusate can help,” he says. Your healthcare provider can help you determine if a supplement or laxative is right for you.
- Ask your provider about a dose adjustment: Most of the time, symptoms like constipation decrease as your body gets used to Mounjaro. But sometimes, the dose needs to be adjusted. At times, looking at Mounjaro alternatives may be necessary, says Kariniemi.
When to see a healthcare provider
You should seek medical advice from a healthcare provider for constipation that is severe, such as having no bowel movements for several days, says Akhil Shenoy, MD, board-certified internist and medical adviser at Aeroflow Diabetes. Additionally, you should contact a healthcare professional if you’re experiencing other severe gastrointestinal symptoms in addition to constipation, such as bloody stool or abdominal pain.
The good news is that Mounjaro constipation is largely treatable with simple lifestyle changes like increased water intake, dietary changes, and exercise. Usually, stopping the medication completely isn’t necessary. “There’s a lot we can try in terms of solving the problem before giving up on medication if it will improve someone’s health,” Dr. Ali assures.
- FDA approves new medication for chronic weight management, U.S. Food and Drug Administration (2023)
- Mounjaro (tirzepatide) injection, for subcutaneous use, U.S. Food and Drug Administration (2022)
- Tirzepatide once weekly for the treatment of obesity, New England Journal of Medicine (2022)