Can oral contraceptive pills (OCPs) be less effective when taking Mounjaro (tirzepatide)?

From the Guidelines

Oral contraceptive pills (OCPs) are not directly affected by Mounjaro (tirzepatide) in terms of effectiveness, but gastrointestinal side effects from Mounjaro could potentially interfere with OCP absorption. When considering the use of Mounjaro alongside OCPs, it's essential to understand that the primary concern is not a pharmacological interaction between the two medications but rather the potential physical interference with OCP absorption due to gastrointestinal side effects like nausea, vomiting, or diarrhea 1. The evidence provided does not directly address the interaction between Mounjaro and OCPs but discusses the general principles of contraceptive effectiveness and potential interactions with other medications 1. Key points to consider include:

• The mechanism of potential interaction is physical, related to reduced absorption of contraceptive hormones, rather than pharmacological.
• Severe gastrointestinal side effects could necessitate the use of a backup contraception method.
• Alternative contraceptive methods, such as long-acting reversible contraceptives (LARCs), may be considered to avoid potential issues with absorption. Given the information available and prioritizing morbidity, mortality, and quality of life, it is recommended to discuss alternative contraceptive methods with a healthcare provider if starting or already on Mounjaro, especially if experiencing severe gastrointestinal side effects. This approach ensures that the effectiveness of the chosen contraceptive method is not compromised, thereby prioritizing the prevention of unintended pregnancies and maintaining the quality of life for individuals using Mounjaro.

From the FDA Drug Label

Contraception Use of MOUNJARO may reduce the efficacy of oral hormonal contraceptives. Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with MOUNJARO [see Drug Interactions (7.2), Use in Specific Populations (8. 3), and Clinical Pharmacology (12.3)].

1. 2 Oral Medications MOUNJARO delays gastric emptying, and thereby has the potential to impact the absorption of concomitantly administered oral medications. ... Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with MOUNJARO.

Yes, oral contraceptive pills (OCPs) can be less effective when taking Mounjaro (tirzepatide) because Mounjaro delays gastric emptying, which may impact the absorption of oral medications, including oral hormonal contraceptives 2. It is recommended that patients using oral hormonal contraceptives switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with Mounjaro.

From the Research

Effectiveness of Oral Contraceptive Pills (OCPs)

• The effectiveness of OCPs can be influenced by various factors, including drug interactions 3
• Certain medications, such as rifampin, anticonvulsants, and certain antibiotics, can decrease the efficacy of OCPs 3
• However, there is no direct evidence to suggest that Mounjaro (tirzepatide) interacts with OCPs, as none of the provided studies mention this specific medication

Contraception and Medical Conditions

• Women with certain medical conditions, such as diabetes, hypertension, and depression, can safely use OCPs, but require careful consideration and monitoring 4, 5
• Progestin-only contraceptives are recommended for women with contraindications to estrogen, such as those with a history of venous thromboembolism or cardiovascular disease 5

Contraceptive Options and Effectiveness

• OCPs are a commonly used reversible method of contraception, with a failure rate of 4-7% per year 6
• Other contraceptive options, such as intrauterine devices and subdermal implants, have higher effectiveness and lower failure rates 6
• The choice of contraceptive method depends on individual factors, including medical history, personal preferences, and lifestyle 6, 5