Many people prescribed Mounjaro (tirzepatide) and they also take other medicines for conditions such as high blood pressure, thyroid problems, depression, chronic pain or infections.
If you are thinking about beta blockers and Mounjaro, there is no known clinically significant direct interaction between them. However, your healthcare professional may want to monitor your blood pressure, heart rate or other aspects of your treatment, ehich depends on your health and the other medicines you take.
It is also very common to have questions about taking Mounjaro along with antibiotics, pain relief such as paracetamol or ibuprofen, blood thinners, antidepressants, oral contraceptives, thyroid medicines, vitamins and supplements.
Many medicines can be taken alongside Mounjaro, but some need a little more information. Tirzepatide can slow down the movement of food through your stomach. This can also affect how quickly some medicines taken by mouth are absorbed by your body.
For most oral medicines, this does not mean that the dose needs to be changed. However, your healthcare professional may want to monitor you more closely for some weeks if you take a medicine with a narrow therapeutic index or one that needs to work quickly.
How Does Mounjaro Affect Other Medicines?
Mounjaro works by activating GIP and GLP 1 receptors.
One of its effects is to slow the rate at which food leaves your stomach. This means that some medicines taken by mouth may be absorbed more slowly.
According to the UK Summary of Product Characteristics:
- Gastric emptying can be slower, particularly when you first start treatment.
- This may delay the absorption of medicines taken by mouth.
- Most oral medicines do not need a dose adjustment because of this.
- Extra monitoring may be needed for medicines with a narrow therapeutic index, such as warfarin or digoxin, particularly when starting Mounjaro or increasing the dose.
This is why your prescriber will ask about all the medicines, vitamins and supplements you take before prescribing Mounjaro.
What Medicines Should Not Be Taken With Mounjaro?
There is no general list of medicines that everyone must avoid while taking Mounjaro.
However, some medicines may need closer review because Mounjaro can affect stomach emptying, blood glucose levels or the way some medicines are absorbed.
Examples include:
- Oral contraceptives
- Warfarin
- Digoxin
- Sulfonylureas
- Insulin
- Medicines with a narrow therapeutic index
These are examples of medicines your healthcare professional may want to review before or during Mounjaro treatment.
Depending on the medicine and your individual situation, they may recommend additional monitoring or changes to your treatment.
Mounjaro Drug Interaction Risk Overview
| Medicine Group | Interaction Summary |
|---|---|
| Paracetamol | No dose adjustment is generally required. Mounjaro may delay absorption at first, but the overall amount absorbed is not expected to change. |
| Ibuprofen | There is no known clinically significant direct interaction, but ibuprofen can cause stomach and kidney problems in some people. |
| Antibiotics | Most can be taken when prescribed, but the specific antibiotic and your illness should be considered. |
| Blood pressure medicines | Often used alongside Mounjaro, but your blood pressure may change during treatment, so your medicines may need to be reviewed. |
| Beta blockers | There is no known clinically significant direct interaction, but your healthcare professional may monitor your blood pressure and heart rate depending on your treatment. |
| Antidepressants | Many can be used alongside Mounjaro, but individual medicines should be reviewed. |
| Blood thinners | Some may need closer monitoring, particularly medicines where changes in absorption could be important. |
| Levothyroxine | Usually used alongside Mounjaro, but your thyroid treatment should be reviewed if your health or other medicines change. |
Can You Take Paracetamol with Mounjaro?
Yes, paracetamol can generally be taken with Mounjaro when used as directed.
Paracetamol has also been used in studies looking at how tirzepatide affects medicines taken by mouth. After the first dose of tirzepatide, the peak level of paracetamol in the blood was lower and reached later. However, the overall amount absorbed was unchanged.
This means a dose adjustment is generally not needed for paracetamol because of Mounjaro alone.
As with any medicine, follow the instructions on the packaging or the advice given by your healthcare professional. If you are taking other medicines or have another health condition, check with your pharmacist if you are unsure whether paracetamol is suitable for you.
Can You Take Ibuprofen with Mounjaro?
There is no known clinically significant direct interaction between ibuprofen and Mounjaro.
However, ibuprofen is an NSAID and can cause stomach irritation and other side effects. This may be more important if Mounjaro is already causing nausea, vomiting or other stomach problems.
There are a few things to keep in mind:
- Vomiting or diarrhoea can cause dehydration, which may increase the risk of kidney problems when taking ibuprofen.
- Take ibuprofen with plenty of fluid unless your healthcare professional has advised you to restrict fluids.
- Follow the recommended dose and do not use it for longer than advised.
- Speak to your healthcare professional before taking ibuprofen if you have kidney problems, a stomach ulcer or ongoing stomach symptoms.
If you are unsure whether ibuprofen is suitable for you, a pharmacist can help you choose an appropriate pain relief option.
Can You Take Antibiotics with Mounjaro?
In most cases, antibiotics can be taken while using Mounjaro. There is no general recommendation to stop Mounjaro simply because you have been prescribed an antibiotic.
However, it is important to tell your prescriber or pharmacist that you are taking Mounjaro. They may need to consider:
- Which antibiotic you have been prescribed.
- Why you need the antibiotic.
- Whether you have vomiting or diarrhoea.
- Whether you are able to eat and drink normally.
If an infection makes you very unwell or causes significant dehydration, your healthcare professional may need to review your medicines and advise you on what to do next.
Do not stop or change your prescribed medicines without speaking to your healthcare professional first.
Mounjaro and Blood Pressure Medicines
Many people taking Mounjaro also use medicines for high blood pressure.
Common examples include:
- ACE inhibitors
- ARBs
- Calcium channel blockers
- Diuretics
- Beta blockers
There is no known clinically significant direct interaction between tirzepatide and most blood pressure medicines. However, your blood pressure may change during weight management treatment.
Some blood pressure medicines can also lower blood pressure. If your blood pressure becomes lower than expected, your healthcare professional may need to review your treatment.
Do not stop or reduce your blood pressure medicine on your own. If you notice dizziness, fainting or other symptoms that concern you, speak to your healthcare professional.
Mounjaro and Beta Blockers
People often search for:
- Mounjaro and bisoprolol
- Mounjaro and propranolol
- Beta blockers and Mounjaro
Beta blockers are not generally listed as medicines that must be avoided with Mounjaro. There is no known clinically significant direct interaction between tirzepatide and beta blockers.
Beta blockers may be prescribed for:
- High blood pressure
- Heart rhythm problems
- Angina
- Migraine prevention
- Anxiety, in the case of propranolol
Your healthcare professional may look at your blood pressure and heart rate as part of your usual care. This is especially important if you take other medicines that affect your blood pressure or blood glucose.
If you take a beta blocker and are starting Mounjaro, continue your usual medicine unless your prescriber tells you otherwise.
Bisoprolol and Mounjaro
Bisoprolol is a beta blocker used for conditions such as high blood pressure and some heart conditions.
There is no known clinically significant direct interaction between bisoprolol and tirzepatide. In most cases, the two medicines can be used together when prescribed by a healthcare professional.
If your blood pressure changes while taking Mounjaro, your healthcare professional may review your medicines and check whether any changes are needed.
Do not stop taking bisoprolol without speaking to your prescriber first.
Propranolol and Mounjaro
Propranolol is a beta blocker that may be prescribed for:
- High blood pressure
- Migraine prevention
- Essential tremor
- Anxiety
There is no known clinically significant direct interaction between propranolol and Mounjaro.
If you have diabetes, there is another point to be aware of. Beta blockers such as propranolol can sometimes make it harder to notice some of the usual warning signs of low blood sugar, particularly a fast heartbeat.
This can be more important if you are taking Mounjaro with insulin or a sulfonylurea, as these medicines can increase the risk of hypoglycaemia.
Your healthcare professional can advise you on what symptoms to look out for and whether you need to monitor your blood glucose more closely.
Key Takeaways
- Mounjaro can slow stomach emptying, which may affect how quickly some medicines taken by mouth are absorbed.
- Paracetamol can generally be taken with Mounjaro when used as directed.
- Ibuprofen does not have a known clinically significant direct interaction with Mounjaro, but it may not be suitable for everyone.
- Antibiotics and blood pressure medicines can often be used alongside Mounjaro when prescribed.
- Some medicines, including warfarin, lithium, insulin and sulfonylureas, may need closer monitoring.
- Always tell your prescriber or pharmacist about all prescription medicines, over the counter medicines, vitamins and herbal supplements you take.
Mounjaro and Antidepressants
Some people taking Mounjaro also take antidepressants for conditions such as depression, anxiety or certain types of pain.
Common examples include:
- Amitriptyline
- Sertraline
- Citalopram
- Fluoxetine
- Venlafaxine
- Duloxetine
- Escitalopram
There is no known clinically significant direct interaction between tirzepatide and most antidepressants.
However, Mounjaro slows stomach emptying, so it may change how quickly some oral medicines are absorbed. This does not mean that your antidepressant will stop working, but your healthcare professional should know about all the medicines you take.
If you notice new or worsening symptoms after starting Mounjaro, speak to your prescriber rather than stopping your antidepressant yourself.
Amitriptyline and Mounjaro
Amitriptyline may be prescribed for:
- Depression
- Nerve pain
- Migraine prevention
- Certain long term pain conditions
There is no known clinically significant direct interaction between amitriptyline and tirzepatide.
Both medicines can cause some gastrointestinal side effects. For example, amitriptyline can cause constipation, while Mounjaro can cause nausea, diarrhoea or constipation.
If constipation or other stomach symptoms become difficult to manage, speak to your pharmacist or prescriber. Do not stop either medicine without medical advice.
Lithium and Mounjaro
Lithium needs careful monitoring because the amount of lithium in your blood can be affected by changes in your fluid levels.
There is no established direct interaction showing that tirzepatide itself changes lithium levels. However, vomiting or diarrhoea while taking Mounjaro can lead to dehydration, which may increase the risk of lithium toxicity.
If you take lithium:
- Try to maintain your usual fluid intake.
- Tell your healthcare professional if you have ongoing vomiting or diarrhoea.
- Attend your regular lithium blood tests.
- Do not change your lithium dose unless your prescriber tells you to.
If you cannot keep fluids down or become significantly dehydrated, seek medical advice promptly.
Mounjaro and Blood Thinners
If you take an anticoagulant such as warfarin, your healthcare professional should know before you start Mounjaro.
Tirzepatide can slow stomach emptying, which may affect how quickly some oral medicines are absorbed. The UK product information specifically advises monitoring the effect of warfarin when tirzepatide treatment is started or the dose is changed.
If you take warfarin, your healthcare professional may therefore arrange additional INR checks when starting or increasing Mounjaro.
Other blood thinners work differently, so your individual medicine should be checked rather than assuming that the same advice applies to all anticoagulants.
Do not stop taking a blood thinner unless your prescriber tells you to.
Mounjaro and Levothyroxine
Levothyroxine is used to replace thyroid hormone and is commonly taken by people who also use Mounjaro.
There is no known clinically significant direct interaction between levothyroxine and tirzepatide. However, there are a couple of things worth knowing:
- Mounjaro can slow stomach emptying, which may affect how quickly some oral medicines are absorbed.
- Changes in body weight can affect the amount of thyroid hormone some people need.
Continue taking levothyroxine as prescribed, usually on an empty stomach. Your healthcare professional may check your thyroid function through blood tests and adjust your dose if needed.
If you take calcium or iron supplements, ask your pharmacist or prescriber about when to take them, as they can affect levothyroxine absorption.
Cosentyx and Mounjaro
Cosentyx (secukinumab) is an injectable medicine used to treat several inflammatory conditions, including psoriasis and psoriatic arthritis.
There is no known clinically significant direct interaction between Cosentyx and Mounjaro.
If you use both medicines:
- Follow the injection instructions for each medicine.
- Follow the storage instructions for each medicine.
- Use the recommended injection sites and rotate sites as advised.
- Keep track of when each medicine is due.
Make sure your healthcare team knows about all the medicines you use, including injectable medicines.
Vitamins and Supplements
Many people taking Mounjaro also use vitamins or supplements and wonder whether they need to stop them.
For most vitamins and mineral supplements, there is no known direct interaction with Mounjaro.
Examples include:
- Vitamin D
- Vitamin B12
- Folic acid
- Magnesium
- Zinc
- Omega 3 supplements
However, Mounjaro can slow stomach emptying, which may affect how quickly some medicines and supplements taken by mouth are absorbed.
If you take several supplements or medicines, tell your pharmacist or prescriber about them. This is particularly important if you take calcium or iron with levothyroxine, as these supplements can affect how levothyroxine is absorbed.
Herbal Medicines
Remember to tell your healthcare professional about herbal medicines and supplements too. They can interact with medicines or affect your blood glucose levels.
Examples include:
- St John's wort
- Turmeric supplements
- Ginseng
- Garcinia cambogia
- Berberine
- Weight loss supplements
The fact that a product is labelled as natural does not automatically mean that it is suitable to take with your medicines.
If you regularly use a herbal product or supplement, check with your pharmacist or prescriber before starting Mounjaro or adding another medicine.
Medicines That May Need Extra Monitoring
Most medicines do not need special monitoring simply because you are taking Mounjaro. However, some medicines or situations may need closer attention.
| Medicine | Why Monitoring May Be Needed |
|---|---|
| Warfarin | Tirzepatide can slow gastric emptying, so your healthcare professional may monitor your INR when starting Mounjaro or changing the dose. |
| Levothyroxine | Changes in weight or other factors may mean that thyroid function needs to be checked from time to time. |
| Lithium | Vomiting, diarrhoea or dehydration can increase the risk of lithium toxicity. |
| Insulin | Taking Mounjaro with insulin can increase the risk of low blood glucose, so your treatment may need monitoring. |
| Sulfonylureas | Taking Mounjaro with a sulfonylurea can increase the risk of hypoglycaemia. |
| Oral contraceptives | Tirzepatide can affect the absorption of oral contraceptives, particularly when starting treatment or increasing the dose. Follow the contraception advice in the product information or from your healthcare professional. |
Needing monitoring does not mean that these medicines cannot be used with Mounjaro. It simply means that your healthcare professional may want to check your treatment more closely.
When Should You Speak to Your Prescriber?
It is a good idea to have your medicines reviewed if you:
- Start a new prescription medicine.
- Stop a long term medicine.
- Have ongoing vomiting or diarrhoea.
- Have repeated episodes of low blood sugar.
- Notice unexpected changes in your blood pressure.
- Develop new or worsening thyroid symptoms.
- Take a medicine that needs regular blood tests, such as warfarin or lithium.
- Are unsure whether an over the counter medicine, vitamin or supplement is suitable with Mounjaro.
If you are unsure about a medicine, do not stop it on your own. Your pharmacist or prescriber can check whether it is suitable to take alongside Mounjaro and advise you on what to do.
Key Takeaways
- Many medicines can be used alongside Mounjaro, but your individual medicines should always be reviewed.
- Mounjaro can slow stomach emptying, which may affect how quickly some oral medicines are absorbed.
- Medicines such as warfarin, lithium, insulin and sulfonylureas may need closer monitoring in some people.
- Beta blockers such as bisoprolol and propranolol do not have a known clinically significant direct interaction with Mounjaro, but your healthcare professional may monitor your treatment based on your individual circumstances.
- Always tell your prescriber or pharmacist about prescription medicines, over the counter medicines, vitamins and herbal supplements before starting Mounjaro or changing your treatment.
Medicines That Deserve Extra Attention
Many medicines can be used alongside Mounjaro, but some need a little more care and monitoring. Your prescriber will look at your medicines, health conditions and other factors before deciding whether Mounjaro is suitable for you.
| Medicine/Condition | Why Review Is Important |
|---|---|
| Warfarin | Your INR may need closer monitoring when starting Mounjaro or increasing the dose. Tirzepatide can slow gastric emptying, which may affect the absorption of oral medicines. |
| Oral contraceptives | Tirzepatide can affect the absorption of oral hormonal contraceptives. Follow the contraception advice provided with your medicine and by your healthcare professional. |
| Insulin | Using Mounjaro with insulin can increase the risk of low blood sugar. Your prescriber may need to review your insulin dose. |
| Sulfonylureas | Taking Mounjaro with a sulfonylurea can increase the risk of low blood sugar, so your treatment may need monitoring. |
| Levothyroxine | Your thyroid function may need to be checked regularly, particularly if your weight or treatment changes. |
| Lithium | Vomiting, diarrhoea or dehydration can increase the risk of lithium toxicity, so extra care may be needed if these symptoms occur. |
| Previous pancreatitis | If you have had pancreatitis before, tell your prescriber. Mounjaro should be used with caution in people with a history of pancreatitis, and your prescriber will decide whether it is appropriate. |
| Previous allergic reaction | Mounjaro should not be used if you have previously had a serious allergic reaction to tirzepatide or any of its ingredients. |
| Heart rate | Mounjaro can cause a small increase in heart rate in some people. Your healthcare professional can decide whether your heart rate needs monitoring, particularly if you have a heart condition or take cardiovascular medicines. |
Seek urgent medical help if you develop severe or persistent abdominal pain, especially if it spreads to your back, or if you have difficulty breathing, swelling of the face or throat, difficulty swallowing or other signs of a serious allergic reaction.
If you have a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, tell your prescriber before using Mounjaro. You should also tell them if you have diabetic retinopathy or significant cardiovascular problems so they can consider your individual treatment needs.
