Does Mounjaro (tirzepatide) cause pancreatitis?

From the Guidelines

Mounjaro may cause pancreatitis, although causality has not been established, and it is recommended to discontinue the medication if pancreatitis is suspected. According to the most recent study published in 2025 in the journal Diabetes Care 1, pancreatitis has been reported in clinical trials, but the exact relationship between Mounjaro and pancreatitis is still unclear. The study advises to use caution when prescribing Mounjaro, especially in individuals with a history of kidney disease, as they may be at a higher risk of gastrointestinal side effects and potential acute kidney injury from dehydration.

Some key points to consider when prescribing Mounjaro include:

• Monitoring patients for signs of pancreatic inflammation, especially during the initial treatment period
• Discontinuing the medication if pancreatitis is suspected
• Using caution in people with kidney disease when initiating or increasing the dose
• Being aware of other possible safety concerns, such as severe liver injury and cardiovascular disease

It is essential to weigh the potential benefits of Mounjaro, including improved blood sugar control and potential weight loss, against the small risk of developing pancreatitis 1. Healthcare providers should carefully evaluate each patient's individual risk factors and medical history before prescribing Mounjaro. If symptoms of pancreatitis occur, such as severe abdominal pain, nausea, vomiting, and fever, medical attention should be sought immediately.

From the FDA Drug Label

5.2 Pancreatitis Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists. In clinical studies, 14 events of acute pancreatitis were confirmed by adjudication in 13 MOUNJARO-treated patients (0.23 patients per 100 years of exposure) versus 3 events in 3 comparator-treated patients (0.11 patients per 100 years of exposure). MOUNJARO has not been studied in patients with a prior history of pancreatitis. It is unknown if patients with a history of pancreatitis are at higher risk for development of pancreatitis on MOUNJARO After initiation of MOUNJARO, observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, discontinue MOUNJARO and initiate appropriate management.

Mounjaro may cause pancreatitis. The drug label reports that acute pancreatitis has been observed in patients treated with GLP-1 receptor agonists, including Mounjaro. Patients should be carefully observed for signs and symptoms of pancreatitis after initiation of Mounjaro, and the drug should be discontinued if pancreatitis is suspected 2.

From the Research

Mounjaro and Pancreatitis

• Mounjaro (tirzepatide) is a dual incretin agonist used to manage type 2 diabetes mellitus (T2DM) and obesity 3, 4, 5.
• There have been reports of acute pancreatitis associated with the use of GLP-1 receptor agonists, including tirzepatide 3.
• A case study reported a 59-year-old male with T2DM who developed acute pancreatitis after switching from semaglutide to tirzepatide 3.
• However, a systematic review and meta-analysis found that tirzepatide was not significantly associated with an increased risk of pancreatitis compared to control groups 6.
• Another study found that tirzepatide was associated with a decreased risk of recurrent acute pancreatitis in people with T2D or obesity 7.

Safety Profile of Tirzepatide

• Tirzepatide has a safety profile consistent with that of GLP-1 receptor agonists, with common adverse events including gastrointestinal events such as nausea, diarrhea, and vomiting 4, 5.
• A systematic review and meta-analysis found that tirzepatide was associated with an increased risk of the composite outcome of gallbladder or biliary diseases, but not with an increased risk of pancreatitis 6.
• The use of tirzepatide requires careful dose adjustments and vigilant monitoring to optimize patient safety 3, 4, 5.

Clinical Implications

• Clinicians should be aware of the potential risk of acute pancreatitis associated with the use of tirzepatide, particularly when switching between GLP-1 receptor agonists 3.
• Tirzepatide may be a valuable addition to the treatment options for T2DM, offering significant therapeutic benefits and a favorable safety profile 4, 5.
• Further research is needed to elucidate the safety profile of switching between GLP-1 receptor agonists and to guide clinical practice 3, 7, 6.