Mounjaro side effects

Mounjaro (tirzepatide) is a popular and effective weight loss treatment currently available from online clinics such as Quick Meds. As a dual action therapy (GLP-1 and GIP receptor agonist), Mounjaro helps to reduce appetite, leading to earlier feelings of fullness, for longer, and regulates blood sugars more effectively. 

As with all medication, including other weight loss medications, Mounjaro can cause side effects though not everyone gets them. They most likely affect the gastrointestinal tract (i.e stomach and digestion) and are temporary. 

Side effects are more likely upon treatment initiation and after each dose escalation. For most, these side effects settle soon after the body has adjusted to treatment. 

Most common side effects include nausea, headaches, constipation, acid reflux, bloating and sulfur burps.

Higher doses tend to carry higher risk of side effects. This can be managed through gradual dose titration, remaining hydrated, and reducing trigger foods. Working with your provider is important in assuring safety and effectiveness. 

Read on to learn more about the side effects and what you can do to manage them. 

Nausea

Perhaps the most common side effect reported on Mounjaro treatment is nausea, found to affect 12–18% of patients in clinical trials (SURPASS-2). Not everyone experiences it but for those who do, it usually starts within the first few days of treatment or after a dose increase. This tends to be mild to moderate and improves within 1–2 weeks.

Nausea occurs as a direct result of how Mounjaro works. By delaying gastric emptying, food stays in the stomach for longer, prolonging feelings of fullness which can be uncomfortable

Some patients may be put off treatment due to this, but it's important to note this is an expected side effect which generally passes quickly and is a sign the treatment has started to work.

Tips to manage Nausea

• Listen to your body - only eating in response to hunger cues can help ensure you get the nutrition you need without overwhelming the stomach, 

• Consume ‘easier to digest’ foods - avoid oily/greasy or spicy foods or meals high in carbohydrates, easing the digestive process.

• Eat slower - known as Mindful Eating, this helps make more conscious eating decisions and avoids binge eating.

• Hydration - keep sipping water or alternatively try herbal teas, such as ginger, to help settle the stomach. 

• Posture - avoid lying down immediately after eating. 

• Treatment - persistent nausea can be treated with simple antacids.

For persistent side effects, contact your prescribing team for appropriate advice.

Sulphur Burps

Sulphur burps (egg-smelling belches) are another common side effect of Mounjaro caused by delayed gastric emptying. Slower stomach emptying means food sits in the stomach longer, giving gut bacteria more time to ferment sulphur-containing foods and produce hydrogen sulphide gas (sulphur burps).

Tips to manage sulphur burps

Sulphur-rich foods

Keeping a food diary can help you track which foods are contributing to your symptoms. Once you've worked out the culprits, you can reduce consumption or eliminate them completely.

Common food items such as: eggs, red meat, garlic, onions, legumes & cruciferous vegetables (leafy greens, sprouts, broccoli) can play a role, but ensure to not cut them out entirely. Moderation is key when reducing a certain food item. 

Smaller meals

Consuming smaller meals more slowly may also help, as you'll limit how much air you swallow and how much food sits in the stomach fermenting. Additionally, limiting carbonated drinks can help reduce the amount of gas in the stomach.

Avoid lying down after eating as by staying upright for at least 30 minutes can help to reduce reflux and burping.

Hydration

Try to aim for 6-8 glasses of water daily. This will help the movement of food through the digestive system.

Medication

If symptoms persist, medication used on a short-term basis like simethicone or bismuth subsalicylate can help bind the odour-causing gas in the stomach. 

Peppermint or ginger tea both have evidence for reducing bloating and GI discomfort. Ginger may also help promote gastric motility.

Speak to a healthcare professional if you notice difficulty swallowing, chest pain, weight loss, a fever, or other concerning symptoms alongside sulphur burps. 

Diarrhoea and Constipation

Diarrhoea and constipation are common and expected as the treatment is intentionally affecting how the stomach/intestines handle digestion. 

Slower gastric motility makes it more likely that digested food will ‘stick’, causing constipation. Ensuring adequate hydration and sufficient fibre intake can help keep things moving, helping with symptoms. 

Tips to manage diarrhoea

• Hydration - ensure to drink plenty of fluids. Electrolytes can also help aid hydration.

• Easy-to-digest foods - avoiding spicy and greasy foods can help ease symptoms. Opt for lean proteins with plenty of fruit and vegetables.

• Laxative effect - avoid excessive caffeine, pure fruit juices, or alcohol, as these could have laxative effects.

• Medication - over-the-counter medicines, like loperamide can help. Limit use for 1-2 days. Do not use it for longer than 48 hours without speaking to your doctor.

Headache, Dizziness, and Fatigue

Headaches, dizziness and fatigue are all linked and usually occur as a result of dehydration or the body adjusting to a reduced food intake. These symptoms usually resolve within the first few weeks of starting treatment or on a dose increase. 

Tips to manage headaches, dizziness & fatigue

• Hydration - is essential in the prevention of these side effects but also ensures a holistic healthy lifestyle.

• Smaller, nutrient rich meals - a reduced appetite will lead to a reduced food intake. When hunger strikes, it's best to focus on nutrient dense foods like lean protein and fibre, providing the nutrition your body needs to keep going. 

• Complex carbohydrates - carbohydrates should be limited to avoid blood sugar spikes. Focus on consuming complex carbs like whole grains or legumes to keep blood sugar levels steady. 

Hair Thinning on Mounjaro

A less common side effect reported by some is hair thinning. Though not a known direct side effect of Mounjaro, it’s more likely due to rapid weight loss and calorie restriction. 

Rapid weight loss can affect the hair's natural phases of growth (telogen effluvium) and possibly lead to hair shedding within 2-3 months thereafter. This is usually temporary, if it occurs, and resolves as the body's weight stabilises and nutritional intake improves. 

Tips to manage hair thinning:

• Protein - protein rich foods can help keep hair strong and prevent thinning.

• Multivitamins - containing iron, zinc and biotin can aid hair health, providing nutrients which may be missed from a now reduced diet. 

• Calorie control - avoid extreme calorie reduction and maintain a wide variety in your nutritional intake.

Injection Site Reactions

Rarely, patients find irritation or mild swelling at the injection site. This usually presents with: swelling, redness, itching or mild pain/discomfort. These symptoms are not common, usually mild and resolve themselves within a few days.

Tips to manage injection site reactions

• Rotate injection site - don't inject into the same space each week. Inject into different areas of the abdomen, thigh or upper arm.

• Clean - the injection area before injecting. 

• Room temperature medication - take the injection out of the fridge for 30 mins prior to using it to reduce discomfort. 

If symptoms persist or deteriorate you should contact your GP or call NHS 111. Concerning symptoms to look out for include: severe swelling, area is red & hot to touch, if the swelling spreads, severe pain, fever/night sweats or shivers, open wound or discoloration of the skin. 

Serious Side Effects: When to Seek Urgent Help

Whilst rare, a known serious risk associated with Mounjaro is pancreatitis- inflammation of the pancreas. The pancreas is an organ which helps release enzymes and hormones to aid digestion. 

Symptoms to look out for include:

• A sudden, severe stomach pain which spreads to the back

• A high temperature

• Nausea and vomiting

Another concern involves the gallbladder (also involved in digestion) and the presence of gallstones or inflammation of the gallbladder itself (cholecystitis).

Symptoms to look out for include:

• A sudden, severe abdominal pain

• Nausea and vomiting

• Fever

• Yellowing of the eyes or skin

If any of these symptoms occur, you should stop using Mounjaro and seek immediate medical attention, by either calling 999 or going to A&E.

During trials in animal studies it was found that GLP-1 agonists (Wegovy, Mounjaro, Saxenda) were linked to thyroid C-cell tumours, however this has not been confirmed in humans.

Tips to ensure safety at all times

• Honesty - ensure you complete your questionnaire honestly and openly. This helps ensure the clinical team can provide accurate information based on your individual circumstances.

• Information leaflet - read carefully through the information pack sent with your treatment prior to starting treatment. 

• Dose - always follow the licensed dosing regimen as agreed with our clinicians.

• Consistency - avoid breaks in treatment, particularly at higher doses. In the event of an unavoidable break, contact the pharmacy before restarting to do so safely and appropriately. 

• Contact - the pharmacy at any time during your treatment for any concerns, we are always here to help. 

• Lifestyle - adhere to the lifestyle changes advised by your clinician. Generally speaking, ensure adequate hydration, reduce alcohol, practice mindful eating 

Are Mounjaro Side Effects Dose-Dependent?

Yes, side effects can be dose dependent and are more likely to occur at higher doses. The dose titration schedule has been designed to stay at each dose for a minimum of 4 weeks before increasing further. This 

Further to this, there is no need to increase the dose every month. If you are obtaining benefits of treatment at the current dose, you may continue on this dose until you feel ready to move up a dose. 

Most side effects occur in the first 1-2 weeks of a new dose, after which they usually settle. If side effects persist, it is recommended to stay on the lower doses for longer until they settle. 

Do not hesitate to contact the team for tailored advice before moving up a dose.