How does Mounjaro (tirzepatide) work to manage diabetes, and what happens if a patient stops taking it?

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Last updated: April 30, 2025View editorial policy

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From the Guidelines

Mounjaro works by mimicking a hormone in your body called GLP-1 and adding another hormone action called GIP, which together help control blood sugar, and stopping it can lead to a rise in blood sugar levels, potentially causing symptoms like increased thirst, frequent urination, fatigue, and blurry vision. When you eat, Mounjaro slows down how quickly food leaves your stomach, making you feel full longer, as seen in its pharmacokinetics profile with a total dose range of 15 mg weekly and an elimination half-life of 5 days 1. It also tells your pancreas to release insulin when blood sugar is high and reduces the amount of sugar your liver produces. This combination helps lower blood sugar levels in people with type 2 diabetes. If someone stops taking Mounjaro, their blood sugar levels will likely rise again, potentially returning to pre-treatment levels within days to weeks, which is consistent with the general understanding of diabetes management, where good management is important for microvascular and macrovascular complications, treatment of hyperglycemia, and minimization of cardiovascular and other long-term risk factors 1. This happens because the medication's effects are temporary and only work while it's in your system. Without Mounjaro, the body returns to its previous state where it struggles to manage blood sugar effectively. Some key points to consider when managing type 2 diabetes include:

  • Metformin (unless contraindicated) and lifestyle modifications are the first steps in managing type 2 diabetes in most patients 1
  • When selecting an additional therapy, clinicians should consider the evidence of benefits, harms, patient burden, and cost of medications in addition to performing an individualized assessment of each patient’s preferences, glycemic control target, comorbid conditions, and risk for symptomatic hypoglycemia 1 This could lead to symptoms of high blood sugar like increased thirst, frequent urination, fatigue, and blurry vision. Over time, uncontrolled diabetes can cause serious complications affecting the heart, kidneys, eyes, and nerves. It's essential to never stop Mounjaro without consulting a healthcare provider, who might need to adjust other medications or recommend alternatives to keep blood sugar controlled, as part of a comprehensive approach to managing type 2 diabetes, including patient education, evaluation, and self-management 1.

From the Research

How Mounjaro Works

  • Mounjaro, also known as tirzepatide, is a medication used to treat type 2 diabetes 2.
  • It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a natural hormone in the body that helps to lower blood sugar levels.
  • GLP-1 receptor agonists, such as Mounjaro, have been shown to have cardiovascular and renal protective effects, independently of glucose control 3, 2.

Stopping Mounjaro Treatment

  • If a person with diabetes stops taking Mounjaro, their blood sugar levels may increase, which can lead to a range of complications, including cardiovascular and renal disease 3, 4.
  • Stopping Mounjaro treatment may also lead to a loss of the cardiovascular and renal protective effects associated with GLP-1 receptor agonists 2.
  • It is essential to consult with a healthcare provider before stopping any medication, including Mounjaro, as they can provide guidance on the best course of action and help to minimize any potential risks.

Potential Risks of Stopping Mounjaro

  • Stopping Mounjaro treatment may increase the risk of heart failure hospitalization, particularly in patients with reduced kidney function 5.
  • The risk of cardiovascular events, such as coronary events and progression to heart failure, may also increase if Mounjaro treatment is stopped 6.
  • It is crucial to weigh the potential benefits and risks of stopping Mounjaro treatment with a healthcare provider, taking into account individual factors and medical history.

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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