Mary Choy, PharmD, is board-certified in geriatric pharmacotherapy and is an active leader in professional pharmacy associations.
Mounjaro carries a black box warning, the U.S. Food and Drug Administration’s (FDA) highest safety warning, for increased risk of thyroid C-cell tumors. In animal studies of both male and female rats, Mounjaro caused thyroid C-cell tumors. It is unknown whether Mounjaro will cause thyroid C-cell tumors or another type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. The connection between Mounjaro causing thyroid C-cell tumors in rats versus people has not been determined.
As a precautionary measure, Mounjaro is contraindicated in people with the following:
Mounjaro (tirzepatide) is an injectable prescription medication used along with diet and exercise to treat adults with type 2 diabetes. Tirzepatide is not insulin—people with type 1 diabetes should not use it.
Mounjaro is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. GIP receptor agonists help your body produce insulin and increase your body’s sensitivity (responsiveness) to insulin. GLP-1 stimulates insulin secretion.
It works with diet and exercise to treat adults with type 2 diabetes. Mounjaro lowers fasting (not having anything to eat or drink except water for at least eight hours) and postprandial (after-meal) blood sugar levels, decreases food intake, and reduces body weight.
Generic Name: Tirzepatide
Brand Name(s): Mounjaro
Drug Availability: Prescription
Therapeutic Classification: Glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist
Available Generically: No
Controlled Substance: No
Administration Route: Subcutaneous (under the skin) injection
Active Ingredient: Tirzepatide
Dosage Form(s): Subcutaneous injection
Mounjaro is used along with diet and exercise to treat adults with type 2 diabetes.
In the United States, type 2 diabetes is more common in people who are Black, Latinx/Hispanic, American Indian, Asian American, or Pacific Islander. According to the World Health Organization (WHO), in 2014, 422 million people had diabetes (types 1 and 2 combined) worldwide. In 2017, the financial cost of diabetes in the United States was $327 billion.
Mounjaro can be administered any time of day, with or without meals, as prescribed by your healthcare provider.
The recommended starting dosage of Mounjaro is to inject 2.5 milligrams (mg) under the skin for the first four weeks, then increase your dose to 5 milligrams once weekly. Some individuals may need additional blood sugar control for their type 2 diabetes. In this case, a healthcare provider will continue to increase the dose in 2.5 mg increments every four weeks until you find the correct dosage. The maximum dosage of Mounjaro is 15 milligrams once weekly.
A few things to keep in mind while taking Mounjaro include but aren’t limited to:
Store your Mounjaro medicine pen in its original carton in the refrigerator. Please protect it from light and do not place it in the freezer. If needed, you may store a single pen at room temperature (between 68 and 77 degrees F) for up to 21 days.
Healthcare providers may prescribe medicines for conditions not approved by the FDA. This is called “off-label” use. Robust data supporting the off-label use of Mounjaro are currently lacking.
The time it takes Mounjaro to work can vary. It may take several weeks or months to see the drug’s full impact on your blood sugar levels. Be sure to speak with your healthcare provider or pharmacist about any questions.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.
Common side effects of Mounjaro may include but not be limited to:
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.
Serious side effects of Mounjaro and their symptoms can include the following:
Data on the long-term side effects of Mounjaro is lacking.
Mounjaro may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
The following modifications (changes) should be kept in mind when using Mounjaro:
If you forget to administer your Mounjaro dose, administer it as soon as you remember, within four days (96 hours) of your missed dose. If more than four days have passed, skip the missed dose, administer the next dose on a regularly scheduled day, and resume the regular once-weekly dosing schedule. Do not use extra medicine to make up for a missed dose.
There is limited information available about Mounjaro overdose.
If you think you or someone else may have overdosed on Mounjaro, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Mounjaro, call 911 immediately.
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Tell your doctor if you are pregnant or planning to become pregnant. Do not use this medicine for at least 2 months before you plan to become pregnant.
It is very important to carefully follow any instructions from your health care team about:
In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
This medicine may increase the risk of having thyroid tumors. Tell your doctor right away if you have a lump or swelling in your neck or throat, trouble swallowing or breathing, or if your voice gets hoarse.
Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
Check with your doctor right away if you have gaseous stomach pain, indigestion, recurrent fever, severe nausea or vomiting, stomach fullness, or yellow eyes or skin. These may be symptoms of gallbladder problems (eg, cholelithiasis, cholecystitis).
This medicine may cause diabetic retinopathy. Check with your doctor if you have blurred vision or any other changes in vision.
This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use tirzepatide with other medicines, including insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.
This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.
This medicine may cause acute kidney injury. Check with your doctor right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.
If you are using birth control pills, your doctor may recommend another type of birth control for 4 weeks after you start using this medicine and after each increase in your dose.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
You should not take Mounjaro if you have one of the following:
Please let your healthcare provider know if you have the following:
Taking Mounjaro with any of the above conditions may make them worse.
Use caution when taking Mounjaro with the following medications:
Mounjaro delays stomach (gastric) emptying, so some oral medications may be affected while taking Mounjaro, especially those with a narrow therapeutic window, like warfarin. A narrow therapeutic window means a minimal difference in the dose or concentration of this medicine in the body can lead to severe adverse reactions or toxicities that can be life-threatening or disabling.
This is not a complete list of medicines that interact with Mounjaro. Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Mounjaro.
Be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC), nonprescription products, vitamins, herbs, or plant-based medicines.
There are no medications that are similar to Mounjaro. Mounjaro is the only drug approved by the FDA to work as a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and a glucagon-like peptide-1 (GLP-1) receptor agonist.
Mounjaro is used along with diet and exercise to treat type 2 diabetes in adults.
Mounjaro is typically injected under the skin once a week.
Mounjaro is injected under the skin (subcutaneous) into your abdomen, thigh, or upper arm. Be sure to change injection sites with each dose.
If you accidentally forgot to administer your Mounjaro dose, administer it as soon as you remember, within four days (96 hours) of your missed dose. If more than four days have passed, skip your missed dose, administer your next dose on the regularly scheduled day, and resume your regular once-weekly dosing schedule. Do not use extra medicine to make up for a missed dose.
Yes, you can change the day of the week you administer your Mounjaro dose as long as the time between the two doses is at least three days (72 hours) apart.
If you’re taking Mounjaro, chances are you have been navigating type 2 diabetes. While living with type 2 diabetes has its challenges, there are ways to help improve your quality of life. Below are some general tips to support your health:
Verywell Health’s drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Food and Drug Administration. Mounjaro label.
Chavda VP, Ajabiya J, Teli D, et al. Tirzepatide, a new era of dual-targeted treatment for diabetes and obesity: a mini-review. Molecules. 2022;5;27(13):4315. doi:10.3390/molecules27134315
National Institute of Diabetes and Digestive and Kidney Diseases. Type 2 diabetes.
World Health Organization. Diabetes.
Food and Drug Administration. FY2015 regulatory science research report: narrow therapeutic index drugs.
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