Mounjaro and Heartburn: What’s the Connection?

Mounjaro (tirzepatide) is a weekly injectable medication that’s FDA-approved to treat Type 2 diabetes. It’s similar to glucagon-like peptide-1 (GLP-1) receptor agonist medications, like Ozempic (semaglutide) and Trulicity (dulaglutide). But in addition to working on GLP-1 receptors, Mounjaro also acts as a gastric inhibitory polypeptide (GIP). 

Mounjaro is also effective for helping people with diabetes lower their blood sugar. But it can also cause side effects like heartburn. Let’s look at the connection between Mounjaro and heartburn. 

Does Mounjaro cause heartburn?

Yes, Mounjaro can cause heartburn. In clinical studies, up to 8% of people who started taking Mounjaro had heartburn. 

People also experienced several other gut-related side effects including:

• Nausea

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Abdominal Pain

Research suggests that people are more likely to have these side effects when taking higher doses of Mounjaro. People taking lower doses may still have these side effects, but it seems to be less common. 

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Research also shows that people are more likely to have side effects when they first start taking a higher dose of Mounjaro. Side effects seem to get better as you adjust to a higher dose. 

Why does Mounjaro cause heartburn?

It’s not clear why Mounjaro causes heartburn. But it may be related to two things.

1. Acid back up

Mounjaro delays gastric emptying, which means it takes longer for food to move out of your stomach and into your intestine. When your stomach is overly full, it can cause heartburn.

Normally, the stomach stretches and shrinks to make room for food. But when food sits in your stomach for long periods, your stomach remains stretched (or distended). This puts pressure on the muscle band that separates your stomach from your esophagus (food pipe). This increased pressure can stop the muscle band from working as well as it should. This lets acid from your stomach escape into your esophagus, causing heartburn. 

2. Mounjaro-related vomiting

About 5% of people taking Mounjaro have vomiting as a side effect. Repeated vomiting can also trigger heartburn. 

When you vomit, acid from your stomach moves up into your esophagus. This acid can burn the lining of your esophagus, causing pain and discomfort. 

EXPERT PICKS: WHAT TO READ NEXT

• What’s it like to take Mounjaro? These three people share their experiences.

• Mounjaro vs. Ozempic for Type 2 diabetes: Five key differences to know about. 

• Diet and heartburn: We break down the best — and worst — foods and drinks for reflux.

How can you treat heartburn caused by Mounjaro?

Heartburn can feel uncomfortable and painful. But there are ways to manage Mounjaro-related heartburn. Here are some things to try.

Change how you eat 

Try eating smaller, more frequent meals. Mounjaro slows gastric emptying, which means it is easier for your stomach to fill up. Eating smaller meals helps keep your stomach less full. This makes it less likely for acid to travel into your esophagus. 

It also helps to avoid foods that tend to trigger heartburn, like: 

• Foods that are high in fat

• Spicy foods

• Alcohol

• Citrus fruits and tomatoes

Many people find that lying down at night is a trigger for heartburn. That’s because the change in position makes it easier for food and acid to travel up your throat. Try to eat dinner at least 3 hours before bedtime. This gives your stomach time to empty before you lie down.

Try over-the-counter heartburn medications

Antacids work to quickly neutralize the acid in your stomach. You may feel a difference in 5 to 15 minutes. Over-the-counter (OTC) antacids include:

• Tums (calcium carbonate) 

• Rolaids (calcium carbonate / magnesium hydroxide)

• Mylanta or Maalox (aluminum hydroxide / magnesium hydroxide / simethicone)

• Pepto-Bismol (bismuth subsalicylate)

Histamine-2 antagonists, also called H2 blockers, work by blocking binding to sites in your stomach called histamine-2 receptors. This lowers the amount of acid your stomach makes. H2 blockers take longer to work than antacids — usually about 30 minutes to 1 hour. But the relief can last for 8 to 12 hours. OTC H2 blockers include:

• Pepcid (famotidine)

• Zantac (ranitidine)

Talk to your healthcare team

Your healthcare team may recommend other medications to help treat your heartburn, like proton pump inhibitors (PPIs).

Proton pump inhibitors work inside the cells of your stomach lining. They block an enzyme that makes stomach acid. This lowers acid levels in your stomach over time, which relieves symptoms of heartburn. These medications are the strongest heartburn medicines. They take the longest to work — usually 1 to 4 days. You also usually need to take them daily for them to work well.

Common PPIs include:

• Prilosec (omeprazole)

• Nexium (esomeprazole)

• Prevacid (lansoprazole)

• Protonix (pantoprazole)

Can you prevent heartburn while taking Mounjaro?

There’s no way to guarantee that you won’t have heartburn while taking Mounjaro. But there are ways to make it less likely to happen.

Side effects are usually worse when you first start taking Mounjaro. That’s why most people begin with a low dose of Mounjaro. Give yourself a few weeks to adjust to your medication before increasing your dose. Starting Mounjaro slowly can help reduce the risk of side effects. 

It can also help to change how you eat — before you develop symptoms. Try eating smaller, more frequent meals and avoiding foods that can trigger heartburn. 

When should you seek care for heartburn while taking Mounjaro?

Talk with your healthcare team if you’re struggling with heartburn. They may have options to help make taking Mounjaro more comfortable. 

Seek medical care right away if you have any concerning symptoms, like:

• Hoarseness

• Difficulty swallowing

• Vomiting

• Unexplained weight loss

• Dark or bloody stools

• Symptoms that wake you up at night

• Trouble breathing

• Vomiting blood

• Severe pain

Why trust our experts?

Written by:

Tracy Norfleet, MD, FACP

Dr. Tracy Norfleet is a board-certified Internal Medicine physician, health expert, and physician leader with over 20 years of experience practicing adult medicine. Dual-certified by the American Board of Obesity Medicine and the American Board of Lifestyle Medicine, Dr. Tracy possesses a wealth of knowledge and expertise in both traditional medical practices and innovative lifestyle interventions for chronic disease management and reversal.

Edited 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.

Reviewed by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

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