Does Mounjaro (Tirzepatide) Cause Gout?
No, Mounjaro (tirzepatide) does not cause gout based on available evidence. There is no documented association between tirzepatide and gout development or hyperuricemia in the medical literature.
Understanding the Evidence Gap
The provided evidence extensively discusses medications that do cause gout—specifically diuretics, pyrazinamide, and other agents that interfere with renal uric acid excretion 1, 2. However, tirzepatide is notably absent from any discussion of gout-inducing medications.
- The clinical trial comparing tirzepatide to semaglutide in 1,879 patients over 40 weeks reported gastrointestinal side effects (nausea, diarrhea, vomiting) and hypoglycemia as the primary adverse events, with no mention of gout or hyperuricemia 3
- Known drug-induced gout typically results from medications that interfere with renal tubular urate excretion (diuretics, pyrazinamide, ethambutol, cyclosporin) or increase uric acid formation (cytotoxic agents, fructose) 2
- Tirzepatide's mechanism as a dual GIP/GLP-1 receptor agonist does not involve pathways that would affect uric acid metabolism 3
Actual Risk Factors for Gout to Consider
When evaluating gout risk in patients on tirzepatide, focus on these established factors 4:
- Diuretic use (odds ratio 1.72) - the most common medication-related cause 1, 5
- Obesity - which tirzepatide actually helps reduce 3
- Diet rich in meat, seafood, and fructose-containing beverages 1, 4
- Alcohol consumption, particularly beer and spirits 1
- Chronic kidney disease 4
Clinical Implications
If a patient on tirzepatide develops gout, investigate other causes rather than attributing it to the medication. The substantial weight loss achieved with tirzepatide (1.9-5.5 kg greater than semaglutide) 3 may actually reduce gout risk long-term, as weight loss is recommended for gout management 1.
Common Pitfall to Avoid
Do not confuse tirzepatide with medications that genuinely cause hyperuricemia. The rare case report of euglycemic ketoacidosis with tirzepatide 6 represents a different metabolic complication entirely unrelated to uric acid metabolism or gout.