Mounjaro (Tirzepatide) - Subcutaneous

Warning:

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:

What Is Mounjaro?

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.

Drug Facts

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

What Is Mounjaro Used For?

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.

How to Take Mounjaro 

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:

  • Mounjaro is injected under the skin (subcutaneous) into the abdomen, thigh, or upper arm.
  • Rotate your injection sites with each dose.
  • Inspect and check the liquid in the pen before administering your dose. It should be clear and colorless. Do not use it if it's discolored or has particles in it.
  • Use a new needle and syringe each time you inject your medicine.
  • Never share medicine pens or needles with others under any circumstances. Sharing needles or pens can result in infection transmission (passing on infections).
  • You can change the day of weekly administration, if necessary, as long as the time between the two doses is at least three days (72 hours).
  • If you use Mounjaro with insulin, administer it as separate injections and never mix the two medicines.
  • It is OK to inject Mounjaro and insulin in the same body region, but the injections should not be right next to each other.

Storage

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.

Off-Label Uses

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.

How Long Does Mounjaro Take to Work?

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.

What Are the Side Effects of Mounjaro?

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

Common side effects of Mounjaro may include but not be limited to:

Severe Side Effects

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:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness or trouble breathing
  • Angioedema: Swelling of the lower layer of skin tissue or mucous membranes due to fluid build-up and widening vessels
  • Changes in thyroid gland or cells (C-cell hyperplasia of the thyroid): Pain in the front of the neck, difficulty swallowing or breathing, persistent cough, and hoarseness
  • Hypoglycemia (low blood sugar): Shaking, trembling, sweating, fast or pounding heartbeat, lightheadedness, hunger, and confusion
  • Gallbladder disorder or pancreatitis: Sudden and severe stomach pain, nausea, vomiting, fever, passing gas, stomach upset or bloating, and yellow eyes or skin
  • Diabetic retinopathy (damage to blood vessels in the retina, the light-sensitive layer of tissue at the back of the eye): Blurred vision or any other change in vision
  • Acute kidney injury: Change in how much or how often you urinate, lower back or side pain, or blood in your urine

Long-Term Side Effects

Data on the long-term side effects of Mounjaro is lacking.

Report Side Effects

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).

Dosage: How Much Mounjaro Should I Take?

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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.

  • For type 2 diabetes:
    • For injection dosage form (solution):
      • Adults—At first, 2.5 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose as needed. However, the dose is usually not more than 15 mg once a week.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Mounjaro:

  • Pregnancy: In animal studies, Mounjaro negatively affected the fetus (fetal growth abnormalities). Not enough data is available to determine the exact risk of significant congenital (present at birth) disabilities, miscarriage, or other adverse outcomes during pregnancy for pregnant people taking Mounjaro. If you are or plan to become pregnant, speak with your healthcare provider to weigh the benefits and risks of taking Mounjaro during your pregnancy.
  • Breastfeeding: There's not enough scientific evidence available to tell whether there would be a risk to your breastfeeding child. Talk with your healthcare provider if you plan to breastfeed, to weigh the benefits and risks of taking Mounjaro while nursing, and the different ways to feed your baby.
  • Adults over 65: Based on clinical studies of Mounjaro, no overall differences in safety or effectiveness were found between adults over 65 years and adults less than 65. However, some adults over 65 may be more sensitive to Mounjaro than others.
  • Children: The safety and effectiveness of Mounjaro have not been established in people younger than 18 years of age. Therefore, children under 18 should not take Mounjaro.

Missed Dose

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.

Overdose: What Happens If I Take Too Much Mounjaro?

There is limited information available about Mounjaro overdose.

What Happens If I Overdose on Mounjaro?

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.

Precautions

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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:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are using tirzepatide unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, diabetic patients may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur during pregnancy in patients with diabetes.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

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.

  • Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
  • If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms including seizures or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family should also know how to use it.

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.

What Are Reasons I Shouldn’t Take Mounjaro?

You should not take Mounjaro if you have one of the following:

  • An allergy to Mounjaro or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.
  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple endocrine neoplasia syndrome type 2 (MEN 2) 

Please let your healthcare provider know if you have the following:

Taking Mounjaro with any of the above conditions may make them worse.

What Other Medications Interact With Mounjaro?

Use caution when taking Mounjaro with the following medications:

  • Insulin or drugs that stimulate insulin release in your body (insulin secretagogues) such as a sulfonylurea: When starting Mounjaro, your healthcare provider may consider reducing the dose of your insulin or insulin secretagogues to reduce your risk of hypoglycemia (low blood sugar).
  • Hormonal birth control pills: Mounjaro may affect how well your hormonal birth control pills work. When starting Mounjaro, you should switch to a non-oral birth control method or add a barrier method of birth control, like condoms, for four weeks after the initial dose and four weeks after any dosage increase. Non-oral hormonal contraceptives should not be affected.

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.

What Medications Are Similar?

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.

Frequently Asked Questions

  • What is Mounjaro (tirzepatide) used for?

    Mounjaro is used along with diet and exercise to treat type 2 diabetes in adults.

  • How is Mounjaro administered?

    Mounjaro is typically injected under the skin once a week.

  • Where do I inject my Mounjaro dose?

    Mounjaro is injected under the skin (subcutaneous) into your abdomen, thigh, or upper arm. Be sure to change injection sites with each dose.

  • What should I do if I miss my Mounjaro 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.

  • Can I change the day of the week I administer my Mounjaro 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.

How Can I Stay Healthy While Taking Mounjaro?

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:

  • Take all type 2 diabetes-related medications as recommended by your healthcare provider.
  • Exercise regularly.
  • Follow a balanced healthy diet. Consider working with a registered dietitian nutritionist (RD or RDN) to cultivate and meet your diet and movement goals.
  • Test your blood sugar levels regularly as directed by your healthcare provider.
  • Drink plenty of water; avoid dehydration.

Medical Disclaimer

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.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Mounjaro label.

  2. 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

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Type 2 diabetes.

  4. World Health Organization. Diabetes.

  5. Food and Drug Administration. FY2015 regulatory science research report: narrow therapeutic index drugs.