Mounjaro (tirzepatide): Overview, how it works, and more

What is Mounjaro?

Mounjaro is a brand name for the medication tirzepatide, approved by the FDA for type 2 diabetes management in May 2022. The drug is in a class of medications called GLP-1s, which mimic a hormone called glucagon-like peptide-1. Mounjaro also mimics another hormone called glucose-dependent insulinotropic polypeptide (GIP). The combination of a GLP-1 and GIP helps manage blood sugar levels and reduces your appetite, leading to weight loss.

Mounjaro generic

Currently, there is no generic version of tirzepatide, the active ingredient in Mounjaro. The manufacturer, Eli Lilly, has a patent on the drug until January 5, 2036, at which point you may be able to find generic versions.

Mounjaro uses

Mounjaro is approved to help people with type 2 diabetes regulate their blood sugar, but a Mounjaro prescription can have other benefits as well.

What is Mounjaro used for?

Mounjaro has been shown to reduce blood sugar levels, which can help people better manage their type 2 diabetes. It can also result in a significant amount of weight loss, even though Mounjaro is not approved for that purpose (the version of tirzepatide approved for weight loss is called Zepbound).

According to clinical trials, adults with type 2 diabetes taking the highest dose of tirzepatide (15 mg) achieved an A1C reduction of 2.46 percent and a weight loss of about 13 percent over 40 weeks. Even at the lowest dose of 5 mg of tirzepatide, clinical trial participants reduced their A1C levels by 2.09 percent and lost 8.5 percent of their body weight.

Mounjaro’s active ingredient, tirzepatide, is also being studied to treat or lower the risk of other conditions, like cardiovascular disease — and it was recently approved to treat sleep apnea, says Dr. Sue Decotiis, M.D., a triple board-certified physician in internal medicine, antiaging medicine, and obesity medicine, who leads a weight-loss practice in Scarsdale, NY. In fact, the FDA has approved Zepbound, the form of tirzepatide prescribed for weight management, to treat moderate to severe sleep apnea in adults with obesity.

How does Mounjaro work?

Mounjaro works by mimicking two different hormones in the body. The first hormone is GLP-1, short for glucagon-like peptide 1, which your body produces naturally whenever you eat. This hormone signals the pancreas to release insulin and decrease glucagon as a way to control blood sugar, and slows the rate of stomach emptying, so you feel full for longer. Both of these actions help to improve insulin response and manage type 2 diabetes more effectively as a result, says Decotiis.

The second hormone in Mounjaro is called glucose-dependent insulinotropic polypeptide (GIP), which also has an effect on insulin and slows digestion. Additionally, the hormones target the appetite control centers in the brain which, combined with the slower gastric emptying, reduce appetite to help you lose weight. Research suggests GIP may also play a role in causing fat to break down faster in the body, further aiding weight loss. By adding GIP to a GLP-1, the medicine can have a bigger impact on your health than GLP-1 alone.

Mounjaro dosage

Mounjaro comes in six different dosages: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. Your provider will tell you which dose to take and how long to stay on it, but most people begin with the lowest dose and then gradually increase over time until they find a "maintenance dose" — the one you’ll stick with — that works well for them, according to Dr. Alexandra Sowa, M.D., a New York City-based physician double-board certified in internal medicine and obesity medicine, and the author of The Ozempic Revolution.

A typical Mounjaro dosing schedule looks like:

• Week 1-4: 2.5mg
• Week 5-8: 5mg
• Week 9-12: 7.5mg
• Week 13-16: 10mg
• Week 17-20: 12.5mg
• Week 21-onward: 15mg

You won’t necessarily make it all the way to 15 mg, though. "You'll be monitored on each dose as you increase, to find the one that can control your blood sugar effectively," Sowa says. "If you can maintain a stable blood sugar level at 5 mg, for example, there's no need for you to continue increasing the dosage."

Forms and strengths

You will use a single-dose pen to inject yourself with Mounjaro each week. No matter which dose level you’re taking, your pen will contain 0.5 mL of solution (in addition to the drug tirzepatide, the solution contains stabilizers, water, and other inactive ingredients).

Alternatives to Mounjaro

The most obvious medications to use instead of Mounjaro are the other GLP-1s approved for type 2 diabetes. This includes Ozempic (semaglutide), Victoza (liraglutide), and Trulicity (dulaglutide). While they all have similar mechanisms to Mounjaro, they only mimic a GLP-1 while Mounjaro also mimics that second hormone, GIP.

Other medications that help reduce blood sugar are also possible alternatives, including:

• Metformin
• DPP-4 inhibitors like linagliptin (Tradjenta) and sitagliptin (Januvia)
• SGLT2 inhibitors like empagliflozin (Jardiance) and dapagliflozin (Farxiga)
• Sulfonylureas like glimepiride (Amaryl) and glyburide (Diabeta)
• TZDs like rosiglitazone (Avandia) and pioglitazone (Actos)

Mounjaro warnings and precautions

According to the FDA, some rare but serious issues have occurred in clinical trial participants, and those include:

• Pancreatitis
• Hypoglycemia
• Hypersensitivity reactions
• Acute kidney injury
• Severe gastrointestinal disease
• Diabetic retinopathy complications
• Acute gallbladder disease

Talk to your provider to ensure you aren’t at a higher risk for those possible complications. The FDA also notes that there’s insufficient data about use of Mounjaro in pregnant women. Because of that, Mounjaro is not recommended for use during pregnancy.

Mounjaro interactions

Mounjaro can interact with other drugs, so it's important to discuss all other medications you're taking with your provider. The ones most likely to increase health risks or cause issues when taking Mounjaro include:

• Insulin or sulfonylureas, since taking these with Mounjaro can increase risk of hypoglycemia (low blood sugar)

• Blood thinners like warfarin, which may not get absorbed as well on Mounjaro

• Oral contraceptives, since Mounjaro can make those less effective; because of that, experts recommend using other birth control methods when taking the medication

Also, be cautious when drinking alcohol when taking Mounjaro, since that combination may have a dangerous impact on blood glucose levels.

Mounjaro cost and coupons

Mounjaro's retail price is $1,069.08 for a one-month supply, and how much of that (if any) is covered by insurance will depend on your plan. While not all GLP-1s are covered by all plans, it’s more likely that one prescribed for type 2 diabetes is covered compared to one prescribed for weight loss.

If your plan doesn’t include Mounjaro, you may be able to use a savings card from the manufacturer, Eli Lilly. Those who are eligible might pay as little as $25 for a one-month or three-month prescription. To be eligible, you must be prescribed Mounjaro for type 2 diabetes (not for weight management), be enrolled in a commercial drug insurance plan, and not be part of any state, federal, or government funded healthcare program such as Medicare or Medicaid. If you qualify, the card may be used for a maximum of 13 prescription fills per calendar year.

The bottom line

A combination of two hormones (GLP-1 and GIP), Mounjaro can be effective for managing blood sugar levels in people with type 2 diabetes. It may also result in a significant amount of weight loss due to its impact on appetite. Mounjaro can have some gastrointestinal-related side effects, but they tend to improve once your body gets used to the medication. As with any drug, it's essential to talk with your health provider about your goals for diabetes control, to see if Mounjaro might be a fit for your needs.