Mounjaro side effects and how to avoid them

In this article:

• Common side effects of Mounjaro

In this article

• Common side effects of Mounjaro

Mounjaro (tirzepatide) is approved by the U.S. Food and Drug Administration (FDA) for adults 18 years and older to treat Type 2 diabetes mellitus as an adjunct to diet and exercise. Mounjaro is a prescription-only injectable drug in a class of medicines known as GIP/GLP-1 receptor agonists. The following information highlights potential Mounjaro side effects and how to avoid them.

RELATED: How to save on Mounjaro

Common side effects of Mounjaro

The most common side effects of Mounjaro are gastrointestinal (GI) related and include:

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Constipation
• Indigestion
• Stomach pain
• Burping
• Gastroesophageal reflux disease (GERD)

In clinical trials, most nausea, vomiting, and diarrhea events occurred while the dose of Mounjaro was being increased. These events tend to decrease over time, as your body adjusts to the medicine.

Additional side effects may include:

• Heart rate increase (tachycardia)
• Injection site reactions
• Increased blood levels of pancreatic enzymes amylase and lipase

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Serious side effects of Mounjaro

Although not common, Mounjaro may cause serious side effects, including:

• Severe stomach problems 
• Risk of thyroid cancer 
• Pancreatitis (inflamed pancreas)
• Hypoglycemia (low blood sugar) 
• Serious allergic reactions 
• Acute kidney injury 
• Changes in vision
• Acute gallbladder problems

Severe stomach problems

GI side effects are the most common adverse events associated with the use of Mounjaro. Most GI side effects occur when therapy begins, are mild or moderate in severity, and decrease with continued treatment. GI side effects tend to be dose-dependent, i.e., the higher the strength of the dose, the greater the incidence of GI side effects. 

Risk of thyroid cancer

In animal studies, tirzepatide (as well as similar drugs, like Ozempic and Wegovy), led to the formation of thyroid tumors in mice and rats. It is not clear whether this risk applies to humans. However, Mounjaro has a mandated “boxed warning,” also called a black box warning, from the FDA. Mounjaro is contraindicated (should never be used) in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). People who use Mounjaro should be alert to symptoms of a thyroid tumor, such as difficulty swallowing or breathing, hoarseness, or a lump in the neck.

Inflammation of the pancreas (pancreatitis)

Acute pancreatitis has been reported in patients treated with Mounjaro. The signs and symptoms of pancreatitis include severe pain in the stomach or abdomen (with or without vomiting), and should they occur, Mounjaro should be discontinued and the healthcare professional should be contacted right away.

Weight loss

In clinical studies, Mounjaro patients had significant weight loss. People who used tirzepatide (the active ingredient in Mounjaro and Zepbound) lost an average of 15% to 21% of their starting body weight, depending on the dose used. This effect is important for those with Type 2 diabetes, where excess weight often contributes to health complications. Mounjaro is often prescribed off-label for weight loss.

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Low blood sugar (hypoglycemia)

The risk of getting hypoglycemia (low blood sugar) may be higher if Mounjaro is combined with another diabetes medicine that may also cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or lightheadedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood changes, hunger, weakness, and feeling jittery.

Serious allergic reactions

There have been reports of serious hypersensitivity reactions, including anaphylactic reactions, in people using Mounjaro. Symptoms of a serious allergic reaction include: swelling of the face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and rapid heartbeat. Should any of these symptoms occur while taking Mounjaro, you should get emergency medical attention right away.

Acute kidney injury

In those people who have existing kidney problems, Mounjaro’s possible side effects of diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to worsen. Healthcare professionals may need to closely monitor kidney function when patients use Mounjaro, especially in those who experience severe GI side effects leading to dehydration.

Changes in vision

People with diabetes may develop an eye condition called diabetic retinopathy. If you use Mounjaro and notice any changes in vision, call your healthcare provider right away. 

How soon do Mounjaro side effects start?

Many of the most commonly experienced GI side effects of Mounjaro occur when initiating treatment: nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, and abdominal pain. These symptoms may worsen during the first few weeks or months, especially when the dose is increased, but should begin to lessen once your body gets used to the medicine. Less common, but more serious side effects, such as gallbladder problems or pancreatitis, may take months or years of drug use to occur.

How long do Mounjaro side effects last?

Common side effects typically go away within a few days or weeks after initiating therapy or following dose adjustments, or once the body has adjusted to the medicine. Injection site reactions can be minimized by routinely changing the location of the injections. More serious side effects, such as kidney problems or pancreatitis, will likely require the discontinuation of Mounjaro.

Mounjaro contraindications and warnings

Restrictions

Mounjaro is only FDA-approved for use in adults and should not be used with any of the following conditions:

• Personal or family history of medullary thyroid carcinoma (MTC)
• History of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Allergy to any ingredients in Mounjaro

Overdose

In the event of an overdose, notify the healthcare professional or Poison Control Center. A few days of observation and treatment for symptoms such as nausea and vomiting or mild hypoglycemia may be necessary due to the half-life (the time it takes for about half of the drug to be removed from the body) of Mounjaro of approximately 5 days, which can make overdose effects last longer.

Pregnancy and breastfeeding

There is limited data regarding the use of Mounjaro in pregnant or breastfeeding women. A woman’s healthcare provider is the best source of medical advice when managing Mounjaro and other diabetes treatments while pregnant or breastfeeding. If you are using Mounjaro and find out that you are pregnant, notify your healthcare provider right away. 

It’s also important to know that Mounjaro can affect birth control pills. If you take birth control pills, you will need an effective backup method of birth control, such as condoms, for four weeks after you start using Mounjaro, and for four weeks after each dose increase. Check with your doctor for medical advice about birth control that is appropriate for you. 

Abuse and dependence

Mounjaro is not habit-forming or addictive; however, abrupt discontinuation may result in higher blood sugar levels. Always consult with a healthcare professional before discontinuing Mounjaro or switching to another diabetes medicine.

Mounjaro drug interactions

Mounjaro may affect the rate of absorption of other oral medications. This may be important for those drugs where small differences in absorption and blood levels can have an impact on their effectiveness, such as the blood thinner warfarin. When taking other medicines to treat diabetes, there is an increased risk of hypoglycemia. Birth control pills taken by mouth may not work as well while using Mounjaro (see section above). It is important to discuss other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements a person takes with a healthcare professional.

How to avoid Mounjaro side effects

Talk to a doctor about your health history

Discuss the following with your healthcare provider before beginning Mounjaro therapy:

• Do you have any other medical conditions, such as problems with your pancreas, kidneys, liver, or stomach, or have a history of diabetic retinopathy (vision problems related to diabetes)?
• Do you have GI problems, such as slowed gastric emptying or problems with digesting food?
• Do you take any other diabetes medications, e.g., insulin or sulfonylureas?
• Do you take any other prescription drugs or over-the-counter drugs, vitamins, or herbs?
• Are you pregnant or plan to become pregnant?
• Are you breastfeeding or plan to breastfeed?

How to treat side effects of Mounjaro

GI side effects are the most common side effects of Mounjaro, particularly when initiating therapy or adjusting the dose. If you experience nausea:

• Eat more frequent, smaller meals instead of less frequent, larger meals
• Stop eating when you feel full
• Eat bland foods and avoid fried, fatty, or sugary foods

People with Type 2 diabetes that take other medicines for diabetes are at higher risk for low blood sugar. If you experience hypoglycemia (low blood sugar), eat or drink something with a high sugar content such as a non-diet soda, fruit juice, or hard candy. Your healthcare provider may prescribe a glucagon injection or nasal spray that may be used for severe hypoglycemia.

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