What are the indications, side effects, and contraindications of Mounjaro (tirzepatide) for type 2 diabetes management?

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Last updated: July 2, 2025View editorial policy

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From the Guidelines

Mounjaro (tirzepatide) is indicated for adults with type 2 diabetes to improve glycemic control, alongside diet and exercise, with a recommended starting dose of 2.5mg weekly for 4 weeks, then increasing to a maintenance dose of 5mg, 10mg, or 15mg weekly based on glycemic response and tolerability. The medication works as a dual GIP/GLP-1 receptor agonist, stimulating insulin secretion and reducing glucagon levels when blood glucose is elevated, while also slowing gastric emptying and reducing appetite, leading to improved glycemic control and potential weight loss 1.

Indications

  • Type 2 diabetes management in adults
  • Improvement of glycemic control
  • Potential weight loss

Side Effects

  • Gastrointestinal issues such as nausea, vomiting, diarrhea, decreased appetite, constipation, and abdominal pain, which typically improve over time
  • Potential increased risk of pancreatitis, severe gastrointestinal disease, or diabetic retinopathy

Contraindications

  • Personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2
  • Type 1 diabetes
  • Diabetic ketoacidosis
  • Caution advised in patients with pancreatitis history, severe gastrointestinal disease, or diabetic retinopathy

It's essential to note that while Mounjaro (tirzepatide) may improve glycemic control, SGLT2 inhibitors and GLP1 agonists (but not DPP4 inhibitors, insulin, or tirzepatide) reduce all-cause mortality and MACE compared with usual care 1. Therefore, the choice of medication should be individualized based on patient characteristics, preferences, and medical history.

From the FDA Drug Label

MOUNJARO® is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. MOUNJARO is contraindicated in patients with: A personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Known serious hypersensitivity to tirzepatide or any of the excipients in MOUNJARO. Serious hypersensitivity reactions, including anaphylaxis and angioedema, have been reported with MOUNJARO. The indications of Mounjaro (tirzepatide) are:

  • Improvement of glycemic control in adults with type 2 diabetes mellitus The side effects of Mounjaro (tirzepatide) include:
  • Risk of thyroid C-cell tumors
  • Serious hypersensitivity reactions, including anaphylaxis and angioedema The contraindications of Mounjaro (tirzepatide) are:
  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Known serious hypersensitivity to tirzepatide or any of the excipients in MOUNJARO 2 2 2

From the Research

Indications of Mounjaro (Tirzepatide)

  • Mounjaro (tirzepatide) is approved for use as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus (T2DM) in the USA, EU, Japan, and other countries 3.
  • It is used to improve glycaemic control and reduce body weight in adults with inadequately controlled T2DM 4, 5.

Side Effects of Mounjaro (Tirzepatide)

  • The most common adverse events associated with tirzepatide are gastrointestinal, including:
    • Nausea 3, 4, 5, 6
    • Diarrhea 3, 4, 5, 6
    • Decreased appetite 3
    • Vomiting 3, 4, 5, 6
  • Hypoglycemia (blood glucose level, <54 mg per deciliter) was reported in a small percentage of patients who received tirzepatide 6.
  • Serious adverse events were reported in 5 to 7% of the patients who received tirzepatide 6.

Contraindications of Mounjaro (Tirzepatide)

  • There is no specific information available on contraindications of Mounjaro (tirzepatide) in the provided studies.
  • However, it is worth noting that tirzepatide has been studied in adults with type 2 diabetes, and its use in other populations, such as those with type 1 diabetes, has been explored in observational studies 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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