Mounjaro
Mounjaro (tirzepatide) is a prescription injection used to improve blood sugar control in people 10 years and older with Type 2 diabetes. It works best when you also follow a nutritious diet and exercise regularly. Mounjaro (tirzepatide) belongs to the drug class called GIP and GLP-1 agonists. The dosage is convenient because it's injected under the skin once a week. Some common side effects of Mounjaro (tirzepatide) include nausea and diarrhea. It can also lower your appetite, which might lead to some weight loss.
What is Mounjaro (tirzepatide)?
What is Mounjaro (tirzepatide) used for?
- Type 2 diabetes in adults and children 10 years of age and older
How Mounjaro (tirzepatide) works
Mounjaro (tirzepatide) is a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist. For short, it's called a GIP and GLP-1 agonist.
This medication works by acting like GLP-1 and GIP, two hormones that your gut releases into the body. These hormones raise your insulin levels after you eat. They also help lower the amount of glucose (sugar) that's released in the body. And they help slow down digestion. All of these actions help lower blood sugar levels.
Drug facts
Side effects of Mounjaro (tirzepatide)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (12-18%)
- Diarrhea (12-17%)
- Low appetite (5-11%)
- Vomiting (5-9%)
- Indigestion (5-8%)
- Constipation (6-7%)
- Stomach pain (5-6%)
Less Common Side Effects
- Faster heart rate
- Injection site reaction
Note: Side effect percentages are for adults. They might be slightly different for children.
Mounjaro (tirzepatide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Inflammation of the pancreas (pancreatitis): severe stomach pain that might spread to your back, nausea, vomiting, fever
- Dangerously low blood sugar: feeling hungry, fast heartbeat, shakiness, anxiety, sweating, tingling, dizziness, weakness, drowsiness, confusion
- Kidney damage: nausea, vomiting, trouble urinating, muscle cramps, feeling confused, swelling in the ankles or feet, trouble breathing
- Gallbladder problems: pain in the upper right side of the stomach, nausea, vomiting
- Serious allergic reaction: hives; trouble breathing; swelling of your lips, tongue, throat, or face
More on Mounjaro (tirzepatide) side effects
The following Mounjaro (tirzepatide) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Change in vision
- Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Fast or irregular heartbeat
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Constipation
- Diarrhea
- Loss of appetite
- Nausea
- Upset stomach
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Pros and cons of Mounjaro (tirzepatide)
Pros
- Given once weekly
- Can lower A1C by an average of up to 2.3% in about 9 months
- Comes in vials and ready-to-use injectable pens
- Can use if you have liver or kidney problems
Cons
- Only available as an injection given under the skin
- Can cause unpleasant side effects like nausea, vomiting, and diarrhea
- Takes time to reach a dose that works well
- Might not be safe during pregnancy
Pharmacist tips for Mounjaro (tirzepatide)
- You can inject Mounjaro (tirzepatide) at any time of the day, with or without food. It's helpful to choose the same day of every week to inject. If needed, set reminders for your injections to help you remember.
- If needed, you can change the day of the week that you inject Mounjaro (tirzepatide). Just make sure that there are at least 3 days (or 72 hours) between the injections.
- If you miss a Mounjaro (tirzepatide) dose by 4 days or less, inject as soon as possible. If it's been more than 4 days, skip the missed dose and wait for your next scheduled dose. For both cases, you can continue your regular weekly schedule afterwards. Call your care team if you're not sure what to do.
- It's common to have stomach upset as a side effect of Mounjaro (tirzepatide). You can have stomach pain, nausea, vomiting, or diarrhea. For most people, side effects get better over time. Be sure to stay hydrated, especially if you vomit or have diarrhea. Tell your care team if you have these side effects and they bother you a lot or they don't get better.
- Mounjaro (tirzepatide) can make birth control pills not work as well. This can raise the risk of an unplanned pregnancy. Talk to your gynecologist or primary care provider about switching to the patch or ring. Another option is to add a barrier method like condoms. Take these precautions for a month after you start Mounjaro (tirzepatide) and a month after your dose gets raised.
- Tell your prescriber if you take a medication that's very sensitive to dose changes. One example is warfarin (Coumadin). Your prescriber might need to monitor you more closely while you're taking Mounjaro (tirzepatide). This is because Mounjaro (tirzepatide) can change how your body absorbs other medications.
- If you're pregnant or thinking of becoming pregnant, talk to your prescriber about safe ways to manage your blood sugar. We don't know if Mounjaro (tirzepatide) is safe during pregnancy. But animal studies showed that it might harm an unborn baby. Mounjaro (tirzepatide) should only be used during pregnancy if the benefits are greater than the risks.
How to use Mounjaro (tirzepatide):
- Your care team will show you how to inject Mounjaro (tirzepatide). They'll make sure you know how before you can do it on your own at home. Read the instructions for the pen or vial, and ask your care team if you have any questions.
- How to store Mounjaro (tirzepatide): Store the medication in the refrigerator in its original container until you're ready to use it. Don't let the medication freeze, and don't use it if it freezes. If needed, you can leave the medication at room temperature (up to 86ºF) for up to 21 days (or 3 weeks).
- If you accidentally drop the Mounjaro (tirzepatide) pen on a hard surface, don't use it to be safe. Use a new pen for your injection.
- Before injecting Mounjaro (tirzepatide): Check the medication inside the pen or vial. Make sure it isn't cloudy and doesn't have particles (solid chunks). It should be clear, colorless to slightly yellow. If it looks different, don't use it and get a new pen or vial for the injection.
- Where to inject Mounjaro (tirzepatide): Inject the medication under the skin of your stomach or thigh. You can also ask someone to help inject it under the skin at the back of your upper arm. Remember to choose a different area to inject each week. Don't inject into areas of skin that are tender, red, bruised, hard, or cut. This helps lower your chances of skin irritation or damage.
- How to inject using the Mounjaro (tirzepatide) pen: Clean the injection site with an alcohol wipe. Pull off the gray base cap without touching the needle. Then, place the clear base flat on your skin and unlock the pen. To start the injection, press and hold the purple button for up to 10 second. You'll hear a click that tells you the injection has started and then another click when it's done.
- How to inject using the Mounjaro (tirzepatide) vial: Follow your care team's instructions to draw up your dose. Use the recommended syringes and needles (e.g., a 1-mL syringe and needle). Clean the injection site with an alcohol swab. Then, insert the needle into your skin and push the plunger down all the way to inject the full dose. The needle should stay in your skin for at least 5 seconds to make sure you get all the medication. Then, quickly and carefully pull the needle out.
- After each Mounjaro (tirzepatide) injection: Place your used pen or syringe in a sharps container. You can also use some other puncture-resistant container, like an empty laundry detergent bottle. This helps prevent you and other people from getting hurt from a needle stick.
Common questions about Mounjaro
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Risks and warnings for Mounjaro (tirzepatide)
Mounjaro (tirzepatide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of thyroid cancer
It's not known if Mounjaro (tirzepatide) can cause certain thyroid cancers in people. But in studies on rats, those that were given the medication had a higher risk of thyroid cancer. It was more likely to happen when higher doses were used or when the medication was given for a long time.
To be safe, don't take Mounjaro (tirzepatide) if you or someone in your family has medullary thyroid cancer (MTC). Also don't take this medication if you have multiple endocrine neoplasia syndrome type 2 (MEN 2). Talk to your prescriber so they can find a different way to help with your high blood sugar.
If you notice a lump on your neck while taking Mounjaro (tirzepatide), call your care team right away. Also get help right away if you have trouble breathing, trouble swallowing, or hoarseness that won't go away. These could be signs of thyroid cancer. Your care team can check what's going on.
Inflammation of the pancreas (pancreatitis)
Some people taking Mounjaro (tirzepatide) had swelling or inflammation in their pancreas. This problem is called pancreatitis. It can sometimes cause serious damage to the pancreas or bleeding.
Call your care team right away if you have symptoms of pancreatitis. This can include severe stomach pain that can go to your back, nausea, vomiting, and fever. You might need to stop taking Mounjaro (tirzepatide).
Low blood sugar (hypoglycemia) when used with other diabetes medications
- Risk factors: Using insulin | Taking medications that raise the amount of insulin in your body (e.g., sulfonylureas like glipizide)
Your blood sugar can get too low if you take Mounjaro (tirzepatide) with medications that raise the amount of insulin in your body. Examples include insulins or sulfonylureas like glipizide. If you're taking one of these medications, tell your prescriber. They might need to make changes to them to prevent low blood sugar.
Very low blood sugar (hypoglycemia) can be dangerous. Make sure you know how to tell and what to do when you have low blood sugar. Keep glucose tablets or hard candy with you at all times so you can get your blood sugar back up quickly. Get medical help right away if you still feel shaky, nervous, dizzy, weak, or confused, even after you've treated yourself for low blood sugar.
Allergic reactions
- Risk factors: Allergy to GLP-1 agonist medications
Although rare, Mounjaro (tirzepatide) can cause a serious allergic reaction. If you've had a severe reaction to a GLP-1 agonist like Ozempic (semaglutide), you might have a higher risk of an allergic reaction to Mounjaro (tirzepatide).
If you have an allergic reaction to Mounjaro (tirzepatide), get emergency medical help. Signs of an allergic reaction can be trouble breathing; swelling of your lips, tongue, throat, or face; rash; or hives.
Stomach side effects
Mounjaro (tirzepatide) can cause side effects like stomach upset. This includes stomach pain, nausea, vomiting, and diarrhea. Sometimes, these problems can be severe. Because of this, Mounjaro (tirzepatide) isn't the best choice for people with severe stomach issues, like gastroparesis (slowed emptying of your stomach).
Kidney damage due to dehydration
- Risk factors: History of kidney problems | Dehydration due to nausea, vomiting, or diarrhea
Some people who took Mounjaro (tirzepatide) had gotten kidney problems. Most times, this happened in people who had nausea, vomiting, or diarrhea as side effects. These side effects can lead to dehydration. And if dehydration is severe enough, it could cause kidney damage.
Be sure to drink plenty of fluids and stay hydrated if you have nausea, vomiting, or diarrhea while taking Mounjaro (tirzepatide). Let your care team know if you have these side effects. And tell them if you don't urinate or if you're not urinating normally. You might need to get blood work to make sure your kidneys are okay.
Eye problems in people with diabetic retinopathy
If you have an eye problem called diabetic retinopathy, Mounjaro (tirzepatide) might make it worse for a short time. This might happen when you first start the medication or when your prescriber raises your dose.
Tell your prescriber if you have diabetic retinopathy. Remember to get your vision checked regularly while you're taking Mounjaro (tirzepatide). This helps check if your eye problem gets worse during treatment. Let your prescriber and eye specialist know if you notice any changes in your vision.
Gallbladder problems
It's rare, but some people who took Mounjaro (tirzepatide) have had gallbladder problems. This can include gallstones. Call your prescriber right away if you have severe pain in the upper stomach, nausea, vomiting, or fever. These can be signs of gallbladder issues.
Lung problems during general anesthesia or deep sedation
Some people taking GLP-1 medications like Mounjaro (tirzepatide) who are put under deep sleep for surgery have had a serious lung problem. This happens when food or liquid from the stomach gets into the lungs by mistake.
This lung problem is rare. But it can happen with Mounjaro (tirzepatide) because the medication slows down digestion. This means that even if you didn't eat before your surgery like you're told, some food could still be in your stomach.
Tell your prescriber if you have any surgery or procedure requiring anesthesia planned. And make sure you tell the surgery team that you're taking Mounjaro (tirzepatide). It helps the medical team watch out for this lung problem and keep you safe.
Mounjaro (tirzepatide) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 pens of 2.5mg/0.5ml | 1 carton | $1,058.75 | $1,058.75 |
| 4 pens of 5mg/0.5ml | 1 carton | $1,058.55 | $1,058.55 |
| 4 pens of 7.5mg/0.5ml | 1 carton | $1,052.00 | $1,052.00 |
| 4 pens of 10mg/0.5ml | 1 carton | $1,051.79 | $1,051.79 |
| 4 pens of 12.5mg/0.5ml | 1 carton | $1,057.76 | $1,057.76 |
| 4 pens of 15mg/0.5ml | 1 carton | $1,058.34 | $1,058.34 |
Typical dosage for Mounjaro (tirzepatide)
The typical starting dose is 2.5 mg injected under the skin once weekly. Inject into the stomach, thigh, or back of the upper arm.
After 4 weeks, your prescriber will raise your dose to 5 mg injected under the skin once weekly.
Depending on how well the medication works, your prescriber might keep raising your dose every 4 weeks or so until you're at a dose that works best for you.
For adults, the maximum recommended dose is 15 mg injected once weekly. For children, the maximum dose is 10 mg injected once weekly.
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How much does Mounjaro (tirzepatide) cost?
$1,051.79
Mounjaro (tirzepatide) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Mounjaro (tirzepatide) will not be safe for you to take.
- Personal or family history of medullary thyroid cancer (MTC)
- Multiple endocrine neoplasia type 2 (MEN 2)
- Allergy to Zepbound (tirzepatide)
What are alternatives to Mounjaro (tirzepatide)?
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