Can You Take Insulin With Mounjaro? Yes, and Here’s Why You Might Combine Them

Type 2 diabetes is a common health condition that affects about 30 million people in the U.S. Most people with this condition don’t respond well to their natural insulin. But some people’s bodies don’t make enough insulin either. Both situations cause blood glucose (sugar) levels to rise.

Insulin is one of many injectable diabetes medications. It’s been a mainstay of diabetes treatment for over 100 years. And it works well for lowering glucose levels.

In the recent past, several noninsulin injections have been FDA approved for Type 2 diabetes. Mounjaro (tirzepatide) is one example. Mounjaro also works well for reducing blood glucose. But it works differently from insulin.

For many people, one diabetes medication isn’t enough to help them reach their treatment goals. In some cases, people may be prescribed both insulin and Mounjaro.

If this is the case for you, it’s common to wonder if it’s safe to combine them. In short, yes, it’s safe for many people to use insulin with Mounjaro. But there are some risks and side effects to know about with the combination.

How do insulin and Mounjaro work?

Both insulin and Mounjaro lower blood glucose and hemoglobin A1C (HbA1C or A1C). Your A1C represents your average glucose levels over the past 3 months. But the two medications work in different ways.

EXPERT PICKS: WHAT TO READ NEXT

• Diabetes injections guide: Insulin and Mounjaro (tirzepatide) are two of several injectable diabetes medications.

• What Mounjaro feels like: Three people share their experiences with Mounjaro, which can be beneficial for many people living with Type 2 diabetes.

• Managing low glucose (sugar): Low blood glucose (hypoglycemia) is a potential side effect of combining insulin and Mounjaro. Read about how to treat hypoglycemia quickly.

Insulin acts like natural insulin would. It helps lower glucose and A1C by:

• Moving excess glucose from your blood into your cells for energy

• Decreasing the amount of new glucose your liver makes

• Telling your liver to store extra glucose that your cells don’t need for later use

Mounjaro acts like two gut hormones in your body. It works by:

• Stimulating your pancreas to release natural insulin after you eat

• Decreasing the amount of new glucose your liver makes

• Slowing the movement of food out of your stomach. This helps reduce your body’s absorption of carbohydrates from food.

Because injectable insulin works like natural insulin, it can be helpful for all types of diabetes. But Mounjaro works only if your body makes its own insulin. This is why it’s FDA approved to treat Type 2 diabetes. You shouldn’t use it if you have Type 1 diabetes.

Can you take insulin with Mounjaro?

Yes. It’s safe to use insulin with Mounjaro to help manage Type 2 diabetes. In fact, the American Diabetes Association supports this combination. But it recommends most people try Mounjaro (or another similar medication) before adding insulin. This is because it works well and has a lower risk of hypoglycemia (low blood glucose) than insulin.

Why are insulin and Mounjaro sometimes prescribed together?

Your prescriber may suggest using insulin and Mounjaro together if one of them isn’t lowering your A1C enough. Both are very effective at reducing blood glucose levels. But when combined, the effects are even greater.

One clinical trial looked at adding Mounjaro to insulin glargine (Lantus, Basaglar, Semglee). Participants using the combination had double the A1C reduction compared with those who used insulin alone. What’s more, close to 70% of those using Mounjaro and insulin glargine reached an A1C level of less than 7%. This is a common A1C goal for many people with Type 2 diabetes.

Beyond A1C reduction, Mounjaro offers potential weight-loss benefits. In the study mentioned above, people lost an average of 20 lbs 1 year after adding Mounjaro to insulin glargine. Given that weight gain is a common side effect of insulin, this added benefit could help combat that.

Good to know: Scientists are finding tirzepatide (Mounjaro’s active ingredient) may have other benefits beyond A1C reduction and weight loss. Other benefits being studied include cardiovascular risk reduction and kidney protection. Your prescriber may also take this information into account when recommending Mounjaro for you.

How do you use insulin and Mounjaro?

There are differences when it comes to using insulin and Mounjaro. Both are injectable medications that you can give yourself. But where and when to inject them varies.

You can inject insulin and Mounjaro into the skin of your abdomen (stomach), your thigh, or the back of your upper arm. With insulin, there’s also the option to give doses in the buttocks.

Insulin and Mounjaro also have different dosage schedules. Insulin is usually injected 1 to 3 times daily, depending on the type you use. Mounjaro is administered only once a week.

Tips for successful injections

If you’re using insulin and Mounjaro, these tips can help make your injections as safe and smooth as possible:

• Check which medication you’re injecting at each dose. It’s possible to accidentally grab the wrong medication when preparing for injection. Always read the label on your medication before injecting a dose.

• Don’t mix the medications in a single syringe. Both medications may come as vials with syringes to draw them up. Always use separate syringes for injecting insulin and Mounjaro. Don’t draw them both into one syringe.

• Clean your hands and skin. Before giving yourself doses, be sure to wash your hands with soap and water. And right before injecting, be sure to wipe your injection site with an alcohol pad.

• Don’t inject the two medications in the same spot. You can use a single body area for insulin and Mounjaro. But don’t inject both into the same location. For instance, you can use your stomach for both injections. But you should inject Mounjaro on one side of the stomach and insulin on the other.

• Rotate your injection sites for each medication. Make sure to choose a different location for each dose. Rotating injection sites is a good way to make sure you get your full doses. It also reduces your risk of skin irritation or injection-site reactions.

Are there risks in using insulin and Mounjaro together?

Both insulin and Mounjaro have potential side effects when used separately. These are generally distinct for each medication. But there’s a shared side effect that’s crucial to know about if you’re using both.

When used alone, Mounjaro carries a low risk of hypoglycemia (low blood glucose). But if you’re using both insulin and Mounjaro, the risk goes up. If you’re already using insulin, your prescriber will likely lower your dosage after you start Mounjaro. This helps reduce the risk of hypoglycemia.

Be sure to discuss how to treat low blood glucose with your healthcare team when first starting this combination. Severe hypoglycemia can become dangerous if left untreated. If you notice more frequent glucose lows after starting the combination, tell your prescriber. They may need to make further dosage adjustments.

Keep in mind that insulin and Mounjaro have other side effects. Your prescriber or pharmacist can give you detailed information about each medication’s risks.

How to save on insulin and Mounjaro

There are many ways to save on insulin. Savings tips include using GoodRx, using manufacturer copay cards, and applying for patient assistance programs. If available, a biosimilar (“generic”) insulin may also help lower your costs. With a free GoodRx discount, you may be able to find insulin prices as low as $35 at certain pharmacies.

There are also ways to save on Mounjaro, which is available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $25 per prescription through the manufacturer’s copay savings program.

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Written by:

Kristina D. Carter, PharmD, MBA, MHA

Kristina D. Carter, PharmD, MBA, MHA, has over 25 years of experience working in healthcare. She is registered as a licensed pharmacist in Georgia, Indiana, and Tennessee.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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