People who have type 2 diabetes have an increased amount of sugar in their blood, also called blood glucose. Increased blood sugar happens when your body’s insulin doesn’t work as well as it should. Type 2 diabetes is a common long-term (chronic) health condition. Some people with type 2 diabetes can control their blood sugar with diet and exercise. Other people need at least one medicine to control their blood sugar.
There are lots of medicines available to treat type 2 diabetes. Mounjaro was approved by the FDA in 2022. Mounjaro is approved with diet and exercise to lower blood sugar in people with type 2 diabetes. Mounjaro is also approved to lower the risk of major heart or blood vessel problems (such as heart attack and stroke) in people with type 2 diabetes who have a high risk of these problems. The active ingredient in Mounjaro, tirzepatide, is also in another medicine called Zepbound, which is approved for weight loss and to treat obstructive sleep apnea in people with obesity.
How Does Mounjaro Work for Type 2 Diabetes?
Mounjaro works to help keep your blood sugar levels from getting too high. Mounjaro acts like two hormones in your body. The hormones are glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). By acting like these hormones, Mounjaro:
- Increases your insulin levels when your blood sugar is rising
- Keeps your liver from releasing stored sugar
- Slows the movement of food through your body
Together, these things help to lower your blood sugar to manage type 2 diabetes.
How Do I Use Mounjaro?
Mounjaro is a liquid that is injected under the skin (subcutaneously) once a week. But there is some flexibility. Mounjaro doesn’t have to be used on the same day each week, if there are at least 3 days (72 hours) between doses. You also don’t have to use it at the same time of day from week to week.
Mounjaro can be injected in your stomach, upper arm, or thigh. You can self-inject it into your thigh or stomach (abdomen), or another person can give the injection into the back of your upper arm. Rotate where you inject Mounjaro from week to week, to avoid using the same spot over and over. This helps to reduce pain and irritation where you get the shot. It also helps your body absorb the Mounjaro completely so it can work to lower your blood sugar.
Mounjaro comes in a single-use pre-filled injection device (pen) or a single-use vial. The vial must be used with a syringe and needle. “Single-use” means that even if there seems to be some liquid left in the pen or in the vial after you give a dose, you should throw the pen or vial away.
Mounjaro also comes in a pre-filled, multi-dose KwikPen or a multi-dose vial that contains 4 doses. You inject one dose each week for 4 weeks, using a new pen needle or syringe each time, then throw away the KwikPen or vial, even if there is leftover medicine in it. Do not share needles, syringes, or your Mounjaro vials or pens with other people.
You can ask your health care provider to show you how to use Mounjaro before you use it for the first time. Read the instructions for use that come with your prescription, which you can also get from your pharmacist or online. There is also a video you can watch on how to use Mounjaro on the drugmaker's website.
How Was Mounjaro Studied for Type 2 Diabetes?
Studies were done to make sure Mounjaro lowers blood sugar and is safe to use in people with type 2 diabetes. The studies ranged from 40 to 52 weeks long. People in the studies had uncontrolled type 2 diabetes, and most were also obese. They looked at how well Mounjaro controls blood sugar by looking at:
- Hemoglobin A1c or HbA1c (a blood test that gives you an idea of your blood sugar levels over the past 2 to 3 months)
- Fasting blood glucose (a test that measures the amount of sugar in your blood after you haven't eaten anything for about 8 hours)
- How many people achieved an HbA1c below 7% (a common goal for many people with type 2 diabetes)
Information about changes in body weight was also collected.
Three doses of Mounjaro were studied: 5 milligrams (mg), 10 mg, and 15 mg. These were compared to a placebo (no medicine) or other medicines for type 2 diabetes.
Some people in the studies were not using any medicines for type 2 diabetes, and others were taking as many as three medicines to lower their blood sugar.
What Benefits Were Seen With Mounjaro for Type 2 Diabetes?
Better blood sugar control. After 40 to 52 weeks, the people who used Mounjaro (on any of the doses studied) lowered their blood sugar more than the people who took a placebo or used the other medicines for type 2 diabetes. At least 75% of people on any of the Mounjaro doses achieved an HbA1c lower than 7%.
On average, fasting blood glucose levels for people taking Mounjaro went down by an average of:
- 40 to 58 milligrams per deciliter (mg/dL) for the 5-mg dose
- 40 to 64 mg/dL for the 10-mg dose
- 39 to 63 mg/dL for the 15-mg dose
On average, HbA1c for people taking Mounjaro went down by about:
- 1.8% to 2.1% for the 5-mg dose
- 1.7% to 2.4% for the 10-mg dose
- 1.7% to 2.4% for the 15-mg dose
Weight loss. After 40 to 52 weeks, the people who used Mounjaro (on any of the doses studied) lost more weight than the people who took a placebo or used the other medicine for type 2 diabetes. (Note: Mounjaro is not approved for weight loss, but weight loss is often helpful in managing type 2 diabetes.)
In these studies, the average weight loss with Mounjaro ranged from about
- 12 to 17 pounds for the 5-mg dose
- 15 to 21 pounds for the 10-mg dose
- 17 to 25 pounds for the 15-mg dose
Your results may differ from the results seen in studies.
What Other Benefits Were Seen With Mounjaro?
In a separate clinical trial, Mounjaro was studied in more than 13,000 adults with type 2 diabetes who also had heart or blood vessel (cardiovascular) disease. Participants were age 40 or older, had a body mass index (BMI) of at least 25, and had an HbA1c between 7% and 10.5%.
The average participant was 64 years old and had been living with type 2 diabetes for about 15 years. When the study began, the average BMI was 33, which is in the obesity range, and the average HbA1c was 8.4%. About 71% of the people were male and the rest were female. Most (82%) were White, 9% were Asian, 2% were Black or African American; 30% identified as Hispanic or Latino ethnicity.
Participants received either Mounjaro or dulaglutide once a week and were followed for about 4 years. Dulaglutide was used for comparison because it is another GLP-1 diabetes medicine that is approved to lower the risk of major heart-related events in certain people with type 2 diabetes.
Researchers looked at how long it took for participants to have a major heart-related event, which included death from heart or blood vessel disease, heart attack, and stroke. These events occurred in 12.1% of people who received Mounjaro and 13% of those who received dulaglutide.
The study showed that Mounjaro was no worse than dulaglutide at lowering the risk of these major heart-related events. However, Mounjaro was not proven to work better than dulaglutide for this outcome.
Both treatments also lowered blood sugar levels and body weight over 36 months.
Individual results can vary. Contact your health care provider to find out whether Mounjaro may be a good option for you.
How Can I Tell if Mounjaro Is Working?
If Mounjaro is working, you should notice your blood sugar readings are lower than they used to be. But be patient, as it may take some time. Your health care provider will likely start you on a low dose of Mounjaro. Most people are started on a dose of 2.5 mg once weekly, and then after 4 weeks, the dose will be increased to 5 mg once weekly (if you are tolerating it well). After another 4 weeks, if you are tolerating it well but your blood sugar readings are not where they need to be, your dose may be increased again.
Tell your health care provider if your blood sugar levels are not going down after being on a dose for about a month. Your health care provider may increase your dose, if you’re not already at the maximum dose of 15 mg. Or you can discuss other options to manage your type 2 diabetes.
Do not stop using Mounjaro without talking to your health care provider first, even if your blood sugar readings are looking better. Your blood sugar can go back up once you stop it.
How Can I Prevent Mounjaro Side Effects or Tell if a Side Effect Is Happening?
Side effects like nausea, vomiting, and diarrhea are possible with Mounjaro. These side effects are more common with higher doses and with dosage increases. These side effects usually decrease over time, as your body gets used to the medicine. Here are some things you can do to help with nausea, vomiting, and diarrhea if they happen to you:
- Eating smaller, more frequent meals
- Avoiding fried or spicy foods
- Eating bland, low-fat foods like crackers, toast, and rice
- Staying well-hydrated by drinking plenty of clear liquids may also help
Stop Mounjaro and call your health care provider right away if you have severe stomach pain that will not go away. The pain may radiate to your back, and you may vomit. These may be signs of inflammation of the pancreas called pancreatitis. Your health care provider will likely have you stop using Mounjaro if you get pancreatitis.
Other Mounjaro side effects are possible. Talk with your health care provider if you are having symptoms that bother you. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What Types of Drug Interactions Can Happen With Mounjaro?
Because Mounjaro slows the movement of food through your body, it may also change the way medicines taken by mouth are absorbed. You may need to make changes to those medicines. For example, if you take a birth control pill and want to avoid getting pregnant, you should use backup contraception (a non-oral contraceptive like a condom) for 4 weeks after starting Mounjaro or after increasing the dose of Mounjaro. Tell your health care provider if you feel that your other medicines are not working as well as they used to work.
Your blood sugar may get too low (hypoglycemia) if you take some other medicines for type 2 diabetes (such as insulin or a sulfonylurea) with Mounjaro. This is because your body makes more insulin after you eat or drink and your liver releases less stored sugar when you use Mounjaro. In one study, to reduce the risk of low blood sugar, people with an HbA1c of 8% or less reduced their insulin dose by 20% before starting Mounjaro. Check your blood sugar (especially if you feel like your blood sugar is low) and tell your health care provider if your level goes too low.
How Can I Get Mounjaro?
You’ll need a prescription from a health care provider to get Mounjaro. Only use a reputable pharmacy to get Mounjaro. Counterfeit versions are being sold. To report counterfeit Mounjaro, call the Lilly Answers Center (TLAC) at 800-LillyRx (800-545-5979).
There is a savings card available from the drugmaker that may allow you to pay as little as $25 for Mounjaro. Whether you are eligible for the savings card depends on whether you have prescription insurance, and what type of insurance you have. You can find out more at https://mounjaro.lilly.com/savings-resources.
For questions about cost, insurance coverage, or any other questions related to Mounjaro, you can contact the drugmaker at 833-807-MJRO (833-807-6576).
