Mounjaro (tirzepatide) is a brand-name subcutaneous injection pen that’s prescribed for type 2 diabetes. Mounjaro has interactions with some other drugs. Examples include certain diabetes medications and oral birth control.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Mounjaro’s interactions, keep reading. For additional information about Mounjaro, including details about its uses, see this article.

Mounjaro isn’t known to interact with alcohol.

However, your doctor may advise you to limit the amount of alcohol you consume while using Mounjaro. This is because alcohol can affect blood sugar levels. Mounjaro is used to help manage blood sugar levels in adults with type 2 diabetes. So, consuming alcohol while using Mounjaro can make it hard to tell if the drug is working for your condition.

It’s also possible for Mounjaro and alcohol to cause some of the same side effects, such as:

  • nausea
  • diarrhea
  • vomiting

Drinking alcohol while using Mounjaro could raise your risk of these side effects or make them worse.

If you drink alcohol, talk with your doctor. They can tell you how much alcohol is safe to drink, if any, during Mounjaro treatment.

Before you start treatment with Mounjaro, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Mounjaro interacts with supplements, herbs, or vitamins, see the “Mounjaro and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Mounjaro. Keep in mind that this table doesn’t include all drugs that may interact with Mounjaro. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Mounjaro
insulin• insulin aspart (Fiasp, NovoLog)
• insulin degludec (Tresiba)
• insulin detemir (Levemir)
• insulin glargine (Basaglar, Lantus, Toujeo)
• insulin lispro (Admelog, Humalog, Lyumjev)
can increase the effects of Mounjaro and insulin
meglitinides• nateglinide
• repaglinide
can increase the effects of Mounjaro and meglitinides
sulfonylureas• glimepiride (Amaryl)
glyburide (Diabeta, Glynase)
• glipizide (Glucotrol XL)
can increase the effects of Mounjaro and sulfonylureas
oral birth control• drospirenone/estetrol (Nextstellis)
• ethinyl estradiol/norethindrone (Junel, Nortrel, others)
• ethinyl estradiol/norgestimate (Estarylla, Sprintec, others)
can make oral birth control less effective
any oral medication• ibuprofen (Advil)
• simvastatin (Lipitor)
• acetaminophen (Tylenol)
can make oral medications less effective
amphetamine/dextroamphetamine (Adderall)• could take longer for Adderall to begin working
• can lower the effects of Mounjaro

In some cases, factors or conditions could prevent your doctor from prescribing Mounjaro due to the risk of harm. These are known as contraindications. The contraindications for Mounjaro include:

Having multiple endocrine neoplasia syndrome type 2 (MEN2) or medullary thyroid carcinoma

Doctors typically will not prescribe Mounjaro for people with specific conditions that increase the risk of thyroid cancer. This is because Mounjaro has a boxed warning about the risk of thyroid cancer. This is the most serious warning from the Food and Drug Administration (FDA).

Specifically, your doctor will likely not prescribe Mounjaro if you have either:

  • a personal history of MEN2, which is a rare genetic (inherited) condition
  • a personal or family history of medullary thyroid carcinoma, which is a rare form of thyroid cancer

For details about the risk of thyroid cancer with Mounjaro, see the “Boxed warning” at the beginning of this article.

Having had an allergic reaction to Mounjaro or any of its ingredients

If you have had an allergic reaction to Mounjaro or any of its ingredients, your doctor will not prescribe Mounjaro. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Mounjaro, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Mounjaro.

Here’s a closer look at certain drug interactions of Mounjaro.

Insulin

Insulin is prescribed to help manage blood sugar levels in people with type 1 or type 2 diabetes.

Interaction result. Using Mounjaro in combination with insulin can increase the risk of low blood sugar with either medication.

Interaction explained. Both Mounjaro and insulin can lower blood sugar levels when used on their own. Using Mounjaro and insulin together may lower your blood sugar level even further.

Examples of insulin drugs. Here are some insulins that may interact with Mounjaro:

Steps you or your doctor may take. If your doctor prescribes Mounjaro with insulin, they may prescribe a lower dosage of insulin. Doing so will help reduce your risk of low blood sugar when these medications are used together.

If you use Mounjaro with insulin, watch for symptoms of low blood sugar. Examples include dizziness, shaking, headache, and sweating.

If you have symptoms of low blood sugar, your doctor may advise you to eat at least 15 grams of carbohydrates to increase your blood sugar level. Sources of carbohydrates include hard candies, fruit juice, and glucose tablets. It’s important to remember that sugar-free candies or diet soda will not help manage low blood sugar.

If your blood sugar becomes severely low, you may lose consciousness. If you have symptoms of low blood sugar that seem life threatening or severe, you or a caretaker should call 911 or a local emergency number right away.

If you have questions about using Mounjaro with insulin, talk with your doctor.

Sulfonylureas

Sulfonylureas are a type of diabetes medication. Like Mounjaro, they’re used to help manage blood sugar levels in people with type 2 diabetes.

Interaction result. Using Mounjaro in combination with a sulfonylurea can increase the risk of low blood sugar levels with either drug.

Interaction explained. When used individually, Mounjaro and sulfonylureas can lower blood sugar levels. Using Mounjaro and sulfonylureas together may further lower your blood sugar level.

Examples of sulfonylurea drugs. Here are some sulfonylureas that may interact with Mounjaro:

Steps you or your doctor may take. If your doctor tells you it’s safe, you may use Mounjaro while taking a sulfonylurea. In this case, your doctor may prescribe a lower dosage of the sulfonylurea. This will help lessen your risk of low blood sugar when using these drugs together.

If you use Mounjaro with a sulfonylurea, watch for symptoms of low blood sugar. Examples include dizziness, shaking, headache, and sweating.

To treat symptoms of low blood sugar, your doctor may recommend eating at least 15 grams of carbohydrates. This may include hard candies, fruit juice, or glucose tablets. Keep in mind that diet sodas and sugar-free candies will not treat low blood sugar.

If your blood sugar is severely low, you may lose consciousness. If you have symptoms of low blood sugar that seem severe or life threatening, you or a caretaker should call 911 or a local emergency number immediately.

If you have questions about using Mounjaro with sulfonylureas, talk with your doctor.

Oral birth control

Oral birth control refers to medications that are taken by mouth to help prevent pregnancy.

Interaction result. Using Mounjaro in combination with oral birth control can make oral birth control less effective.

Interaction explained. Mounjaro may affect your body’s ability to absorb oral birth control. This can lead to lower levels of oral birth control in your system, which may make these drugs less effective at preventing pregnancy.

The risk of this effect is highest when you first start treatment with Mounjaro and after your doctor increases your Mounjaro dosage.

Examples of oral birth control drugs. Below are examples of oral birth control drugs that may interact with Mounjaro:

  • drospirenone/estetrol (Nextstellis)
  • ethinyl estradiol/norethindrone (Junel, Nortrel, others)
  • ethinyl estradiol/norgestimate (Estarylla, Sprintec, others)

Steps you or your doctor may take. Before starting Mounjaro treatment, be sure your doctor knows if you’re taking oral birth control.

You can keep taking your oral birth control as your doctor has instructed. In addition, your doctor may recommend that you use a backup method of birth control for 4 weeks after starting Mounjaro treatment. They may also recommend using a backup method of birth control for at least 4 weeks after your Mounjaro dosage is increased. Examples of backup birth control methods include using a condom or diaphragm.

Your doctor can also recommend other birth control options that do not interact with Mounjaro. An example is an intrauterine device (IUD), such as levonorgestrel (Kyleena, Mirena, others). IUDs are plastic, T-shaped devices that are inserted into your uterus by a healthcare professional.

If you have questions about using Mounjaro with oral birth control, talk with your doctor.

Mounjaro may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Mounjaro.

Mounjaro and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Mounjaro and herbs

There are no specific reports of herbs interacting with Mounjaro. However, certain herbs could possibly increase the risk of having low blood sugar if they’re taken with Mounjaro. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Mounjaro treatment.

Mounjaro and vitamins

There are no specific reports of vitamins interacting with Mounjaro. However, certain vitamins or minerals could possibly increase the risk of having low blood sugar if they’re taken with Mounjaro. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Mounjaro.

Mounjaro and food

There were no reports of food interactions with Mounjaro. If you’d like to learn more about eating certain foods during treatment with Mounjaro, talk with your doctor.

Mounjaro and vaccines

There were no reports of vaccine interactions with Mounjaro. If you’d like to learn more about getting certain vaccines while using Mounjaro, talk with your doctor.

Mounjaro and lab tests

There were no reports of lab tests interacting with Mounjaro. If you’d like to learn more about getting certain vaccines while using Mounjaro, talk with your doctor.

MOUNJARO AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Mounjaro. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Mounjaro. The impact of cannabis may affect how well you stick to your Mounjaro treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Mounjaro. Before you take this drug, be sure to talk with your doctor about your health history. Mounjaro may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Mounjaro include:

  • Diabetic retinopathy. Mounjaro may worsen a vision problem called diabetic retinopathy. If you have this condition, your doctor will watch for changes in your vision during Mounjaro treatment. Your doctor may also recommend that you visit an eye doctor to closely monitor this condition.
  • Digestive system problems. Before using Mounjaro, tell your doctor if you have a digestive system problem such as gastroparesis (slowed stomach emptying). The drug can cause severe digestive problems as a side effect and may not be safe for people who have digestive problems. Your doctor may prescribe a drug other than Mounjaro if you have a digestive system problem.
  • Kidney problems. If you have a kidney problem, such as kidney failure, be sure to tell your doctor before using Mounjaro. The drug may cause severe digestive problems that lead to dehydration, which can worsen your condition. If you have a kidney problem, your doctor can recommend whether it’s safe to use Mounjaro.
  • Pancreatitis. If you’ve had pancreatitis in the past, be sure to tell your doctor before using Mounjaro. You may have a higher risk of pancreatitis as a side effect of the drug. If you’ve had pancreatitis, your doctor can recommend whether it’s safe for you to use Mounjaro.
  • Pregnancy. It’s not known whether Mounjaro is safe to use while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor before using Mounjaro.
  • Breastfeeding. It isn’t known whether Mounjaro passes into breast milk during breastfeeding or if the drug causes side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor before using Mounjaro.
  • Allergic reaction. If you’ve had an allergic reaction to Mounjaro or any of its ingredients, your doctor will not prescribe Mounjaro. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Here is a frequently asked question about Mounjaro and possible interactions.

Can I take oral medications while using Mounjaro?

Yes, if your doctor tells you it’s safe, you can take oral medications while using Mounjaro. These include any capsule, tablet, or liquid solution that’s taken by mouth.

That said, Mounjaro may affect your body’s ability to absorb oral medications. The risk of this effect is highest when you first start treatment with Mounjaro and after your doctor increases your Mounjaro dosage.

If you’re taking any oral medications, your doctor may closely monitor the effects of these drugs while you’re using Mounjaro. Warfarin (Jantoven) is an example of an oral medication your doctor may monitor closely during Mounjaro treatment.

Keep in mind that Mounjaro is known to interact with specific oral medications. These include oral birth control and certain diabetes medications called meglitinides and sulfonylureas. To learn more, see the “Mounjaro drug interactions” and “Drug interactions in depth” sections above.

If you have other questions about taking Mounjaro with oral medications, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Mounjaro. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Mounjaro label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Mounjaro doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Mounjaro by using it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Mounjaro. These resources might help:

  • Overview of Mounjaro. For a general overview of Mounjaro, you can see this article.
  • Dosage specifics. To learn about the dosage of Mounjaro, see this article.
  • Cost. If you’d like to learn about Mounjaro and cost, see this article.
  • Reproductive health. For information about Mounjaro and pregnancy, breastfeeding, and birth control, you can see this article.
  • Facts about type 2 diabetes. To learn more about type 2 diabetes, see our diabetes hub.

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Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.