Can Mounjaro Cause Anemia?
Mounjaro (tirzepatide) does not cause anemia based on available clinical trial data and systematic reviews. Anemia is not listed as a recognized adverse effect of this medication in major clinical trials or guideline reviews.
Evidence from Clinical Trials
The most comprehensive systematic review and network meta-analysis for the American College of Physicians examined serious adverse events across multiple diabetes medication classes, including tirzepatide 1. In this analysis:
- Tirzepatide showed no significant difference from usual care for serious adverse events (RR, 0.79 [CI, 0.51 to 1.22]; high certainty of evidence) 1
- The most common adverse events with tirzepatide were gastrointestinal in nature, not hematologic 2, 3
Established Adverse Event Profile
The safety profile of tirzepatide is well-characterized from the SURPASS clinical trial program 2, 4:
- Primary adverse events are gastrointestinal: nausea (17-22%), diarrhea (13-16%), decreased appetite, and vomiting (6-10%) 3
- These events are typically mild to moderate in severity 2, 3
- Hypoglycemia risk is low (0.2-1.7% experienced blood glucose <54 mg/dL) 3
- No hematologic adverse effects, including anemia, are reported as common or characteristic side effects 2, 4
Important Clinical Context
While tirzepatide itself does not cause anemia, patients with type 2 diabetes may develop anemia from other causes that should be considered 1:
- Chronic kidney disease (common in diabetes patients)
- Concomitant medications such as ACE inhibitors/ARBs, which are frequently used in diabetic patients and can be associated with anemia 1
- Other diabetes medications if used in combination
Clinical Recommendation
If a patient on Mounjaro develops anemia, investigate alternative causes rather than attributing it to tirzepatide. The medication's established safety profile across multiple large-scale trials does not support anemia as a drug-related adverse effect 1, 2, 3.