Key takeaways:
Mounjaro (tirzepatide) is a once-weekly injection that’s FDA approved to treat Type 2 diabetes. It has a number of interactions with other medications to be aware of.
Key Mounjaro drug interactions include insulin, sulfonylureas, and glinides. Combining Mounjaro with these other diabetes medications can raise your risk of low blood glucose (sugar). Certain supplements, such as ginseng and chromium, also interact with Mounjaro in this way.
Mounjaro may also affect how other oral medications are absorbed. Notably, birth control pills may be less effective for preventing pregnancy, especially when first starting Mounjaro and after dose increases.
Avoid combining Mounjaro with other medications that work similarly, such as Ozempic (semaglutide). Doing so can raise your risk of side effects, such as nausea and diarrhea.
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Mounjaro (tirzepatide) is a convenient, once-a-week injectable medication for Type 2 diabetes. It works by signaling your pancreas to release insulin when you eat. It also slows down how fast your stomach empties and lowers the amount of glucose (sugar) your liver makes.
Mounjaro was the first medication FDA approved in a new class of medications called glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists. But beyond this, Mounjaro has made headlines for its ability to promote significant weight loss. With all the buzz surrounding it, your endocrinologist (diabetes specialist) may have mentioned it as an option for you.
If you’re starting Mounjaro, drug interactions might not have been the first question to come to mind. But it’s good to know if it’s safe to combine with other medications and supplements you may take or use. Many interactions involve a drop in your blood sugar (hypoglycemia). But Mounjaro can also potentially interfere with oral medications, including birth control pills.
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Mounjaro interactions
Mounjaro interacts with the following medications and supplements:
Insulin
Sulfonylureas, such as glipizide (Glucotrol XL)
Meglitinides (or “glinides”), such as repaglinide
Birth control pills
Other oral medications
Supplements that can affect blood sugar, such as ginseng and chromium
Below, we’ll review six notable Mounjaro interactions you should know about. But you should share an updated medication list with your prescriber and pharmacist so they can double-check for Mounjaro interactions.
1. Insulin
Some people with Type 2 diabetes use a combination of insulin and other diabetes medications, such as Mounjaro, to help manage their blood sugar. However, combining Mounjaro and insulin can raise the risk of low blood sugar. So extra caution is needed with this combination.
Watch for symptoms of low blood sugar when administering both Mounjaro and insulin. These can include shakiness, sweating, and a fast heart rate. Low blood sugar can be life-threatening in severe cases. So it’s important to treat it quickly if it happens to you.
To help prevent low blood sugar, your prescriber may lower your dose of insulin when you first start Mounjaro. Be sure to check your blood sugar as instructed by your prescriber and let them know if you start experiencing low sugar levels.
2. Sulfonylureas like glipizide
Sulfonylureas are a commonly prescribed group of oral diabetes medications. Examples include glipizide, glyburide (DiaBeta, Glynase), and glimepiride. Combining Mounjaro and sulfonylureas can also raise the risk of low blood sugar.
Like Mounjaro, sulfonylureas signal your pancreas to release insulin. The difference is that sulfonylureas tell your pancreas to release insulin whether you’ve eaten or not. Taking a sulfonylurea and Mounjaro together may lead to the release of too much insulin. And this can cause low blood sugar.
As with insulin, Mounjaro and sulfonylureas can still be combined, if needed. Your prescriber may lower your sulfonylurea dose before you start Mounjaro. Be sure to let them know of any notable drops in sugar that happen after starting the combination, or after dose increases.
Can you drink alcohol with Mounjaro? Learn why mixing alcohol and Mounjaro (tirzepatide) can raise the risk of digestive side effects.
What side effects can you expect? Learn about Mounjaro’s side effects — from diarrhea to hair loss — and how to manage them.
How much does it cost? Find out how much Mounjaro costs with and without insurance.
3. Glinides like repaglinide
Glinides are a less popular group of oral diabetes medications. Examples of glinides include repaglinide and nateglinide. Like sulfonylureas, they tell your pancreas to release insulin. But glinides work faster and their effects are shorter-lived than sulfonylureas.
Similar to the medications listed above, combining Mounjaro and a glinide can raise the risk of low blood sugar. If a healthcare professional prescribes both medications for you, they’ll likely adjust your glinide dose when first starting Mounjaro. Let your prescriber know if you start experiencing low sugar levels more frequently after starting both medications.
4. Birth control pills
Mounjaro can make birth control pills less effective, especially when first starting Mounjaro or after dose increases. This can lead to unintended pregnancies or a return of symptoms you’re taking birth control to help manage.
This Mounjaro interaction happens because of how the medication works. Mounjaro slows down the movement of food from your stomach to the small intestine. Food that’s delayed in the stomach prevents spikes in your blood sugar and makes you feel full faster and for longer.
A downside to slower digestion is that it can affect how your body absorbs oral birth control from your digestive tract. This could mean your body absorbs less medication than it’s supposed to, potentially causing birth control to be less effective. This interaction is most significant when first starting Mounjaro and shortly after any dose increases.
Mounjaro can also cause a number of digestive-related side effects, such as vomiting and diarrhea. Vomiting shortly after taking a birth control pill can prevent proper absorption. Diarrhea — particularly diarrhea that continues for 2 days or longer — can also prevent full absorption.
Non-oral methods of birth control, such as the patch or ring, may be better options, as they’re not affected by Mounjaro. You can also use a barrier method, such as condoms. You should use these alternative birth control options for the first 4 weeks after starting Mounjaro and for 4 weeks anytime your dose increases.
5. Other oral medications
Delayed stomach emptying can also affect the absorption of other oral medications, similar to Mounjaro’s interaction with birth control pills.
This may be concerning if you take medications that are highly sensitive to small changes in dose, like warfarin (Coumadin, Jantoven). Warfarin can cause serious side effects, like blood clots or bleeding, even when slight changes in its levels happen. Your warfarin prescriber may recommend monitoring your blood work more frequently when you start Mounjaro.
Your prescriber or pharmacist can tell you if any medications you take are sensitive to small dose changes. They can also provide you with information on the best way to manage this Mounjaro interaction.
6. Supplements that affect blood sugar
Mounjaro also interacts with a number of dietary supplements. These supplements can change your blood sugar levels. Some can raise your sugar levels, making it harder for Mounjaro to work well. Others can lower it, raising your risk of low blood sugar.
Ask your prescriber or pharmacist before combining these supplements with Mounjaro:
Ginseng
Chromium
Niacin (vitamin B3)
Oral aloe vera
Ginger
Vitamin E
Green tea extract
Keep in mind that this interaction applies to when you take these substances in supplement form. Consuming them in your diet, such as drinking ginger ale or green tea, is unlikely to cause significant problems with Mounjaro.
What medicine can you not take with Mounjaro?
You shouldn’t pair Mounjaro with other medications that work similarly. Examples include Ozempic (semaglutide) and Victoza (liraglutide). Using Mounjaro with these medications can raise your risk of side effects, such as nausea, vomiting, and diarrhea.
Other examples of medicines you shouldn’t take with Mounjaro include:
Wegovy (semaglutide)
Rybelsus (semaglutide)
Trulicity (dulaglutide)
Saxenda (liraglutide)
Byetta (exenatide)
Bydureon BCise (exenatide)
Zepbound (tirzepatide)
Talk with your prescriber if you’re not achieving your desired results with Mounjaro. They can help you explore other options.
What foods interact with Mounjaro?
There are no foods or drinks that directly interact with Mounjaro. That means they don’t change how your body absorbs, uses, or clears Mounjaro. But there are several dietary items that can contribute to high blood sugar levels. And they can make it harder for Mounjaro to do its job.
Foods and drinks you may want to limit while using Mounjaro include:
Sugary foods and beverages, such as soda, juices, and candy
Refined carbohydrates, such as white bread and white rice
Fruits and vegetables that raise blood sugar, such as pineapple and sweet corn
Fatty or fried foods, such as french fries, ice cream, and pizza
Now, this doesn’t mean that you have to avoid these foods and drinks completely. But it’s a good idea to cut back on how much or how often you consume them. What’s more, some of these dietary items, such as fried and fatty foods, can worsen common Mounjaro side effects, such as heartburn and diarrhea. So limiting them can also help you manage these side effects.
Can you drink alcohol while taking Mounjaro?
It’s not the best idea. Alcohol doesn’t directly interact with Mounjaro. But it can make the medication’s digestive side effects worse. Drinking alcohol while using Mounjaro also raises your risk of low blood sugar.
In severe cases, drinking alcohol can raise your risk of pancreatitis (inflammation of the pancreas) and kidney damage. These complications are very rare with Mounjaro. But alcohol can make them more likely to happen.
Frequently asked questions
Yes, when used as prescribed, Mounjaro is safe for most people. Mounjaro commonly causes digestive side effects. These include nausea, constipation, and heartburn. Starting with a low dose and raising it gradually over several weeks can help lessen these side effects. In rare cases, people have reported pancreatitis and gallbladder problems while using Mounjaro. If you have a history of these conditions, let your prescriber know before starting the medication.
There are many foods that are good to eat while using Mounjaro, including:
Fruits and vegetables that don’t meaningfully raise blood sugar, such as apples and avocado
Whole grains, such as brown rice and whole-wheat bread
Lean meats and proteins, such as chicken, eggs, and fish
Low-fat dairy products, such as cottage cheese
These foods don’t usually cause sugar highs or lows, and they shouldn’t worsen Mounjaro’s side effects.
Mounjaro’s side effects are most noticeable when you first start it or right after a dose increase. They usually improve or go away after a few weeks of using the same dose. If you’re experiencing side effects that are excessive or persistent, tell your prescriber.
Yes, when used as prescribed, Mounjaro is safe for most people. Mounjaro commonly causes digestive side effects. These include nausea, constipation, and heartburn. Starting with a low dose and raising it gradually over several weeks can help lessen these side effects. In rare cases, people have reported pancreatitis and gallbladder problems while using Mounjaro. If you have a history of these conditions, let your prescriber know before starting the medication.
There are many foods that are good to eat while using Mounjaro, including:
Fruits and vegetables that don’t meaningfully raise blood sugar, such as apples and avocado
Whole grains, such as brown rice and whole-wheat bread
Lean meats and proteins, such as chicken, eggs, and fish
Low-fat dairy products, such as cottage cheese
These foods don’t usually cause sugar highs or lows, and they shouldn’t worsen Mounjaro’s side effects.
Mounjaro’s side effects are most noticeable when you first start it or right after a dose increase. They usually improve or go away after a few weeks of using the same dose. If you’re experiencing side effects that are excessive or persistent, tell your prescriber.
The bottom line
Key Mounjaro (tirzepatide) drug interactions include insulin, sulfonylureas, and glinides. Taking them together can cause your blood glucose (sugar) to drop too low. Certain supplements, such as ginseng and chromium, can also cause blood sugar changes when combined with Mounjaro. Mounjaro can also make birth control pills less effective and may affect how your body absorbs other oral medications.
You shouldn’t pair Mounjaro with other medications that work similarly to it, such as Ozempic (semaglutide) or Victoza (liraglutide). Combining them raises the risk of side effects, such as nausea and diarrhea.
Contact your prescriber if you have any questions about potential Mounjaro interactions. They can adjust your medication dosages if needed and help you limit interactions.
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References
Eli Lilly and Company. (2025). Mounjaro- tirzepatide injection, solution [package insert].
MedlinePlus. (2025). Tirzepatide injection.
Razzaki, T. S., et al. (2022). Tirzepatide: Does the evidence to date show potential for the treatment of early stage Type 2 diabetes? Therapeutics and Clinical Risk Management.
