Does Mounjaro Cause Diarrhea? Insights into Side Effects

Mounjaro, formulated with tirzepatide, was initially approved by the FDA in 2022 to address type 2 diabetes. Mounjaro is frequently prescribed to facilitate significant weight reduction and was later approved under the brand name Zepbound for the treatment of obesity. In a study featured in the New England Journal of Medicine, more than 2,500 individuals with obesity or who were overweight with weight-related health conditions (i.e., high blood pressure, high cholesterol) were divided into groups receiving once-weekly, subcutaneous doses of tirzepatide (5 mg, 10 mg, or 15 mg) or a placebo over 72 weeks. It was observed that all weekly doses of tirzepatide resulted in significant and consistent reductions in body weight (1).

However, like any pharmaceutical, Mounjaro has potential side effects, diarrhea being among them. This article explores whether diarrhea is a common side effect, investigates the causes, and offers practical tips for managing it.

Is Diarrhea a Common Side Effect of Mounjaro?

Yes, diarrhea can occur as a side effect of Mounjaro. While not everyone taking Mounjaro will experience diarrhea, it is reported frequently enough to be considered a notable side effect (1). Clinical trials have shown that a segment of patients undergoing treatment with Mounjaro report gastrointestinal issues, including nausea, vomiting, constipation, and diarrhea (1). A meta-analysis examined over 4,500 patients involved in trials examining the efficacy of tirzepatide and found that around 16% of participants on tirzepatide reported diarrhea as a side effect (2). It's important to understand that while it might be uncomfortable, it's a relatively common response as the body adjusts to the medication.

Why Does Mounjaro Cause Diarrhea? 

Mounjaro works by mimicking the naturally occurring gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors in the body to enhance the actions of certain hormones involved in glucose control, emptying of the stomach contents, and appetite control (2). These modifications in hormone levels can lead to changes in digestive processes, potentially leading to diarrhea. Key factors include:

• Alterations in Gut Bacteria: Certain dietary changes or medications can lead to shifts in the gut microbiome.  GLP-1 medications are known to affect the intestinal environment, and these changes in gut microbiota may trigger digestive issues, including diarrhea (3).

• Gut Motility Changes: This medication directly affects the gastrointestinal tract, resulting in changes in gut motility and mucus secretion. These changes in the gut may be partially responsible for causing diarrhea (4).  

These factors do not guarantee that a patient will experience diarrhea, but they contribute to its potential development.

Tips for Managing Diarrhea While on Mounjaro

If you are experiencing diarrhea while on Mounjaro, consider the following tips to help manage and potentially alleviate this side effect:

• Stay Hydrated: Diarrhea can lead to dehydration as you lose lots of watery stool. Prevent this by drinking plenty of fluids, especially electrolyte-rich fluids (5). Fruit juices or soda along with saltine crackers are often sufficient to replace fluid losses in mild to moderate cases of medication-induced diarrhea in adults (6). Bone broth with full salt content is also a great way to rehydrate.

•  Modify Your Diet: To help solidify stools, opt for bland, easy-to-digest foods found in the BRAT diet (Bananas, Rice, Applesauce, Toast). Starchy foods, including rice, wheat, potatoes, and lentils, are good options (5). Avoid fatty foods, spicy foods, and foods high in fiber, which may worsen symptoms.
• Over-the-counter Medications: In some cases, over-the-counter anti-diarrheal medications such as loperamide may be helpful, but it's essential to consult with a healthcare provider before starting any new medication.
• Probiotics: There is insufficient evidence to support the use of probiotics in restoring a healthy gut flora balance (6). 
• Monitor Your Symptoms: Keep track of your diarrhea episodes and report persistent cases to your healthcare provider. They might adjust your medication dosage or explore alternative treatments.

Communication with Your Healthcare Provider is crucial. If diarrhea becomes severe or is accompanied by other concerning symptoms (like fevers or chills, blood in the stool, severe abdominal pain, or signs of severe dehydration), it’s essential to seek medical advice promptly. Your healthcare provider can offer more personalized strategies to manage or mitigate this side effect, ensuring that Mounjaro remains a beneficial component of your weight loss plan without the discomfort of persistent diarrhea.

Diarrhea Risk on Mounjaro vs other GLP-1 Therapies

The GLP-1 medications are all known to cause diarrhea as a side effect (7). Comparing diarrhea as a side effect between semaglutide (marketed under brand names like Ozempic and Rybelsus) and tirzepatide (Mounjaro), it is noted that both medications, being part of the GLP-1 receptor agonist family, exhibit gastrointestinal side effects, including diarrhea. However, due to tirzepatide's novel action of engaging GIP receptors, users might experience different gastrointestinal responses. Clinical evidence suggests that while both medications present a risk of diarrhea, the incidence rate and severity may vary from one individual to another, underscoring the importance of personalized medical advice when managing side effects in diabetes treatment.

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Managing Side Effects On Your Weight Loss Journey

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At Mochi Health, we understand the challenge of weight loss. Having guidance from health professionals can make all the difference in your journey, from managing side effects to maximizing your results. That's why we offer customized support, including GLP-1 prescriptions, from our team of experts. Membership includes virtual visits with a Mochi provider, unlimited appointments with a registered dietitian, access to health screenings, and 24/7 customer support. Curious about brand-name medication prices? They may vary based on your insurance coverage, but Mochi Health offers compounded medications as a reliable and cost-effective solution. Experience the convenience of getting compounded semaglutide at the same low prices for any dose, delivered straight to your doorstep! See if you're eligible for our program and take the first step towards a healthier you today. 

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Sources:

1. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. https://www.nejm.org/doi/10.1056/NEJMoa2206038?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

2. Karrar, H. R., Nouh, M. I., Nouh, Y. I., Nouh, M. I., Khan Alhindi, A. S., Hemeq, Y. H., Aljameeli, A. M., Aljuaid, J. A., Alzahrani, S. J., Alsatami, A. A., Alkredees, M. A., Almuqati, A. O., Abanmi, S. N., & Alshehri, A. M. (2023). Tirzepatide-Induced Gastrointestinal Manifestations: A Systematic Review and Meta-Analysis. Cureus, 15(9), e46091. https://www.cureus.com/articles/170540#!/

3. Kato, S., Sato, T., Fujita, H. et al. Effects of GLP-1 receptor agonist on changes in the gut bacterium and the underlying mechanisms. Sci Rep 11, 9167 (2021). https://www.nature.com/articles/s41598-021-88612-x

4. Holst, J. J., Andersen, D. B., & Grunddal, K. V. (2022). Actions of glucagon-like peptide-1 receptor ligands in the gut. British journal of pharmacology, 179(4), 727–742. https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bph.15611

5. Avery, M. E., & Snyder, J. D. (1990). Oral therapy for acute diarrhea. The underused simple solution. The New England journal of medicine, 323(13), 891–894. https://www.nejm.org/doi/10.1056/NEJM199009273231307?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

6. Riddle, M. S., DuPont, H. L., & Connor, B. A. (2016). ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. The American journal of gastroenterology, 111(5), 602–622. https://journals.lww.com/ajg/fulltext/2016/05000/acg_clinical_guideline__diagnosis,_treatment,_and.14.aspx

7. Gorgojo-Martínez, J. J., Mezquita-Raya, P., Carretero-Gómez, J., Castro, A., Cebrián-Cuenca, A., de Torres-Sánchez, A., García-de-Lucas, M. D., Núñez, J., Obaya, J. C., Soler, M. J., Górriz, J. L., & Rubio-Herrera, M. Á. (2022). Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. Journal of clinical medicine, 12(1), 145. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821052/