If you have gallstones, or have had them in the past, you may be wondering whether Mounjaro is suitable for you. You may also find conflicting information online, with some sources suggesting that gallstones prevent treatment and others suggesting that they do not matter.
The situation is more nuanced. Gallstones do not automatically mean that you cannot use Mounjaro, but they are relevant to the prescribing decision because tirzepatide has been associated with gallbladder related problems. Your prescriber will consider your medical history, whether you currently have symptoms and whether Mounjaro is appropriate for you.
For adults in the UK who have current or previous gallstones or other gallbladder problems, this page explains the main points to consider before starting or while taking Mounjaro. This includes the possible link between Mounjaro, weight loss and gallbladder problems, when a history of gallstones may still allow treatment, which symptoms need prompt medical attention and why discussing your history with your prescriber matters.
The Short Answer
Gallstones are not listed as an absolute contraindication to Mounjaro. However, the prescribing information includes warnings and precautions relating to gallbladder problems, so a history of gallstones is something your prescriber should know about.
Gallbladder problems are a recognised potential side effect of tirzepatide. Gallstones and other gallbladder related events have been reported during treatment, although they do not happen to everyone.
Your symptoms are important. If you currently have abdominal pain or other symptoms that could be related to your gallbladder, your prescriber may want to assess these before deciding whether Mounjaro is appropriate. This is not something you should decide based on your history alone.
Why Gallstones and Mounjaro Matter Together
There are two factors to consider here, which is why gallstones can be an important part of your Mounjaro assessment.
Mounjaro and gallbladder problems
Gallbladder related events, including gallstones and inflammation of the gallbladder, have been reported in people taking Mounjaro. The UK prescribing information advises that patients should be investigated if gallstones or other gallbladder problems are suspected.
In placebo controlled clinical trials, acute gallbladder events were reported in 0.6% of people taking tirzepatide compared with 0% of people taking placebo. These events were also associated with weight reduction in the trials.
This does not mean that everyone with existing gallstones will develop a problem while taking Mounjaro. It does mean that your prescriber should consider your history and any current symptoms when assessing treatment.
Weight loss and gallstones
Weight loss itself can also affect your risk of developing gallstones. This is particularly relevant when weight is lost quickly.
During rapid weight loss, changes in bile composition and reduced gallbladder emptying may contribute to gallstone formation. Rapid weight loss is also recognised as a risk factor for gallstones independently of whether medication is being used.
This means that when someone takes Mounjaro and loses weight, there can be more than one factor to consider. The medicine may be associated with gallbladder related events, while the weight loss itself may also contribute to gallstone risk.
This is one reason why your rate of weight change, symptoms and overall health are worth discussing with your prescriber rather than focusing only on the medication.
Many weight management approaches aim for gradual and sustainable weight loss rather than very rapid changes. If you are concerned about your rate of weight loss, your diet or your existing gallstones, speak with your prescriber or another healthcare professional.
If you develop new or severe abdominal pain while taking Mounjaro, particularly if the pain is persistent or accompanied by vomiting, fever or yellowing of the skin or eyes, seek medical advice promptly. These symptoms can have several possible causes, including gallbladder problems, and need appropriate assessment.
Where You Might Stand
These are general descriptions of how this is usually approached. They are not an assessment of your case.
| Your situation | How this is generally approached |
|---|---|
| Symptomatic gallstones now (pain, colic, recent attacks) | Treatment is often deferred until the condition has been appropriately assessed and managed . This is a temporary bar, not a permanent one |
| asymptomatic gallstones found incidentally on a scan | Treatment may be possible with caution and monitoring, decided case by case |
| Gallbladder already removed | People who have had their gallbladder removed should still disclose this during assessment, although prescribing may be more straightforward in some cases . Still disclose it |
| Past attack, no stones now | Relevant history. Disclose it, including when and what happened |
| Current acute cholecystitis | Treatment is not appropriate while this is active |
If you are unsure which of these describes you, it is worth clarifying before starting treatment. Your GP or specialist may be able to explain the results of previous imaging, including whether you have asymptomatic gallstones, symptomatic gallstones, or no current stones.
What "Your Prescriber Decides" Means Here
You may see the phrase "your prescriber decides" on many pharmacy websites, but it is useful to understand what that actually means.
If you have a history of gallstones, your prescriber may ask whether your stones have caused symptoms, when you last had symptoms, whether you have had any imaging, whether surgery has been discussed, and whether you have any other relevant medical conditions.
Based on this information, the prescriber may decide that treatment is appropriate, ask for more information, or decide that Mounjaro is not suitable for you at that time.
A decision not to prescribe can be appropriate when treatment does not meet prescribing criteria or is not considered clinically suitable. A private prescribing service should assess each person individually rather than approving treatment automatically.
If treatment is not appropriate and medicine is not supplied, you are not charged for the medicine.
If you have been declined elsewhere
Some people reach this page after another prescribing service has decided that Mounjaro is not suitable for them and may be looking for another service that will approve treatment.
It is worth taking a step back here. If a prescriber reviewed your medical history and decided that treatment was not appropriate, the most useful next step is to understand the reason for that decision rather than simply looking for a different service.
If you think the original assessment did not include important information, explain this to the prescriber and provide the missing details. A further assessment may be appropriate if relevant information was unavailable the first time.
What to Tell Your Prescriber
Be as specific as you can during your assessment. If you have gallstones or have had them in the past, make sure your prescriber knows.
You may be asked about:
- Whether you currently have gallstones, have had them in the past, or have had your gallbladder removed
- When you were diagnosed and how, such as through an ultrasound
- Whether you have ever had symptoms or an attack, and when the most recent episode occurred
- Whether surgery has been recommended, scheduled or completed
- Any current pain in the upper right side of your abdomen, even if it seems mild
- Any other medicines you take and medical conditions you have
Even if you were previously told that your gallstones did not require treatment, mention them during your assessment. A previous episode from several years ago is also relevant medical history.
Gallstone Symptoms to Act On
If you are taking Mounjaro and develop symptoms that could indicate a gallbladder problem, contact your prescriber, GP or NHS 111 for medical advice promptly. Some symptoms may require urgent assessment.
Look out for:
- Severe or persistent pain in the upper abdomen, particularly on the right side or in the centre, which may sometimes spread to the back or right shoulder
- Abdominal pain that lasts for several hours
- Fever together with abdominal pain
- Yellowing of the skin or whites of the eyes
- Persistent vomiting
- Pale stools or unusually dark urine
In an emergency, call 999.
These symptoms can have several possible causes, including gallbladder or biliary problems, so they should not be ignored. If you develop symptoms that concern you, seek appropriate medical advice rather than waiting for your next routine appointment.
Suspected side effects of Mounjaro can also be reported through the MHRA Yellow Card scheme.
Nausea, indigestion and reduced appetite are among the gastrointestinal side effects reported with tirzepatide and do not necessarily indicate a gallbladder problem. However, severe or persistent abdominal pain, particularly when it occurs with fever, vomiting or jaundice, needs medical assessment.
What Happens If Gallstone Complications Develop During Treatment
If you develop symptoms that could point to gallstones or another gallbladder problem while taking Mounjaro, the prescribing information recommends appropriate gallbladder investigations and clinical follow up. If acute gallbladder disease is confirmed, your clinician will decide whether treatment should be paused or stopped.
This does not necessarily mean that treatment has to stop permanently. Once the problem has been assessed and managed, your clinician can discuss whether restarting Mounjaro is appropriate for you.
If you develop symptoms, contact your prescriber for advice rather than stopping treatment without discussing it. Seeking medical advice allows your symptoms and treatment to be assessed properly and helps your healthcare professional decide what to do next.
Does the Same Apply to Wegovy and Other GLP 1 Medicines?
Broadly, yes. Gallstones and other gallbladder problems are recognised with GLP 1 receptor agonists, including semaglutide. The risk can also be linked to weight loss itself, particularly when weight is lost quickly.
For example, gallstones have been reported in clinical studies of semaglutide. The exact risk can vary depending on the medicine, dose, study population and other factors.
Switching to another GLP 1 medicine may not remove gallbladder related considerations. If you have a history of gallstones or gallbladder problems, tell your prescriber before starting or switching treatment. They can consider your medical history and discuss whether another treatment is appropriate for you.
General Eligibility for Mounjaro
For weight management, the licensed criteria include a BMI of 30 or above, or a BMI of 27 or above where there is at least one weight related health condition, such as hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, prediabetes or type 2 diabetes. Tirzepatide is also licensed for the treatment of type 2 diabetes.
Treatment may not be appropriate for everyone. Tell your prescriber if you are pregnant, breastfeeding or trying to conceive, or if you have a personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, pancreatitis or certain gastrointestinal conditions. Mounjaro is not licensed for use in people under 18.
These criteria are only a starting point. Your prescriber will consider your individual medical history, current medicines and other relevant factors before deciding whether Mounjaro is suitable for you.
Treatment suitability depends on an individual clinical assessment. Our guide to prescription weight loss treatments covers the options more broadly, and current pricing is on the Mounjaro treatment page.
Key Takeaways
- Gallstones are not an absolute contraindication to Mounjaro, but they are a recognised consideration when assessing treatment suitability
- If you have symptoms from gallstones, your prescriber may recommend addressing the gallbladder problem before starting or continuing treatment
- Asymptomatic gallstones do not necessarily rule out treatment, but your prescriber may consider your history and monitor you appropriately
- Clinical studies have found an increased risk of gallbladder and biliary problems with tirzepatide, although the overall number of events remains relatively low
- Rapid weight loss can also increase the risk of developing gallstones, so both factors may be relevant during treatment
- Switching to another GLP 1 medicine may not remove gallbladder related considerations
- Severe upper right abdominal pain, fever, yellowing of the skin or eyes, or persistent vomiting should be assessed promptly
- Tell your prescriber about any current or previous gallstones, even if you were previously told they were not a concern
