Drug Interactions between acetaminophen / caffeine / dihydrocodeine and tirzepatide

Consumer information for this interaction is not currently available.

MONITOR: Additive increases in heart rate may occur when tirzepatide is coadministered with other drugs that can also increase heart rate. The mechanism by which tirzepatide may affect heart rate is unknown. In placebo-controlled trials, treatment with tirzepatide resulted in an average increase in heart rate of 2 to 4 beats per minute (bpm) compared to an average increase of 1 bpm in patients receiving placebo. The incidence of patients who had a change in heart rate of greater than 20 bpm from baseline for 2 or more consecutive visits was 2.1%, 3.8% and 2.9% for tirzepatide 5 mg, 10 mg and 15 mg, respectively, compared with 2.1% for placebo. Episodes of sinus tachycardia, associated with a concomitant increase in heart rate of greater than or equal to 15 bpm from baseline, were reported in 4.3%, 4.6%, 5.9% and 10% of subjects treated with placebo or tirzepatide 5 mg, 10 mg and 15 mg, respectively. For patients enrolled in Japan, the reported frequencies of these episodes were 7% (3/43), 7.1% (3/42), 9.3% (4/43) and 23% (10/43), respectively.

MANAGEMENT: Although the clinical relevance of the effects on heart rate is not currently known, some authorities suggest observing caution when tirzepatide is coadministered with other drugs that can increase heart rate such as those with sympathomimetic or anticholinergic activity. Advise patients of the potential risk of tachycardia and to contact their healthcare provider if it occurs in the absence of a known cause (i.e., at rest).

Tirzepatide may affect the absorption of oral medications, as it can delay the emptying of stomach content into the intestines. This may impact blood levels and/or the time that it takes for dihydrocodeine to become most effective, if dihydrocodeine is being administered by mouth or directly into the stomach via a feeding tube. These effects are most apparent at the start of treatment with tirzepatide or after a dose increase and tend to diminish the longer that you are on a stable regimen of tirzepatide. Contact your doctor if you have any questions or notice a change in how any of your oral medications are working. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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