From the FDA Drug Label
MOUNJARO delays gastric emptying [see Clinical Pharmacology (12. 2)]. MOUNJARO has not been studied in patients with severe gastrointestinal disease, including severe gastroparesis, and is therefore not recommended in these patients.
The risk of permanent gastroparesis associated with tirzepatide (Mounjaro) is not directly stated in the FDA drug label. However, it is mentioned that Mounjaro delays gastric emptying and has not been studied in patients with severe gastroparesis, suggesting a potential risk.
- Key points:
From the Research
The risk of permanent gastroparesis with tirzepatide appears to be very low based on current evidence. Tirzepatide, a GLP-1/GIP receptor agonist used for type 2 diabetes and weight management, does cause delayed gastric emptying as part of its mechanism of action, but this effect is typically transient and dose-dependent 2. Most gastrointestinal side effects, including nausea, vomiting, and slowed digestion, tend to diminish over time as patients continue treatment. The medication is started at a low dose (2.5mg weekly) and gradually increased to minimize these effects. If gastroparesis-like symptoms occur, they generally resolve with dose reduction or discontinuation of the medication.
Key Considerations
- Patients with pre-existing gastroparesis or severe gastrointestinal motility disorders should use tirzepatide cautiously, as the drug may exacerbate these conditions 3.
- The delayed gastric emptying effect of tirzepatide is considered a therapeutic mechanism that contributes to increased satiety and reduced food intake, rather than a pathological process that leads to permanent damage to gastric motility 4.
- Regular monitoring for persistent digestive symptoms is recommended during treatment 5.
- The safety profile of tirzepatide is generally acceptable, similar to GLP-1 RAs, with a low risk of hypoglycaemia when used without insulin or insulin secretagogues 6.
Recommendations
- Tirzepatide can be used safely in patients with type 2 diabetes, with careful monitoring for gastrointestinal side effects.
- Patients should be educated on the potential gastrointestinal side effects of tirzepatide and the importance of reporting any persistent or severe symptoms.
- Healthcare providers should regularly assess patients for signs of gastroparesis or other gastrointestinal motility disorders and adjust the treatment plan as needed.