Mounjaro constipation: Why it happens and how to get relief?

Mounjaro can slow down stomach motility and how fast food moves through your digestive tract, which may cause or worsen constipation. Constipation occurs commonly with the use of Mounjaro, in about 6% to 7% of people. An increase in dietary fiber and fluids, regular exercise, and slowly increasing your dose at the start of treatment may help prevent constipation.

Other types of stomach side effects are common when you first start Mounjaro injections and include:

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Heartburn or indigestion
• Stomach pain

Stomach-related side effects tend to clear up in most patients as they adjust to their Mounjaro dose. Your healthcare provider will slowly increase your dose to help minimize these effects, so closely follow all prescribed dosing instructions.

Also tell your healthcare provider if you have any medical problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food. Mounjaro has not been studied in patients with severe gastrointestinal disease, including severe gastroparesis, and is therefore not recommended in these patients.

Because Mounjaro delays gastric emptying, it may also affect the absorption of other oral medications you take. Have your pharmacist and physician review your medications for any potential drug interactions.

• Learn More: Mounjaro (tirzepatide) Drug Interactions

Mounjaro (tirzepatide) is a medicine approved by the FDA to help lower blood sugar (glucose) in adult patients with type 2 diabetes. It is used in addition to an appropriate weight-loss diet and exercise plan.

It is given as a weekly subcutaneous (under the skin) injection. You, or a caregiver, can learn to administer this medicine for home use.

Mounjaro is not approved as a weight loss medication, but it may help you lose some weight if you have type 2 diabetes. In studies, some people using Mounjaro lost up to 25 lbs (11 kg) with higher doses, but increased doses can also worsen constipation, so it’s important to start treatment slowly.

Related: How does Mounjaro work for weight loss?

Why do I get constipated on Mounjaro?

You may get constipated while using Mounjaro injection for several reasons:

• Slowed gastrointestinal movement: The transit of food through your gut (gastric emptying) is slowed down when you take Mounjaro. This can help control your blood sugar and make you feel fuller for a longer period of time, but reduced intestinal movement can also lead to constipation. In addition, water in your stool may be absorbed, leading to harder, more difficult to pass stools.
• Reduced appetite: Since your appetite can be reduced while taking this medicine, you may not eat enough fiber or drink enough fluids, which may cause constipation.
• Other medications: Many medicines are known to cause or worsen constipation. Review your medications, including prescription, over-the-counter (OTC), and herbal or dietary supplements with your healthcare provider before you start taking Mounjaro.

Constipation is a well-known and expected side effect with Mounjaro (tirzepatide). Constipation has also been reported as a side effect of Zepbound in 11% to 17% of patients, which also contains tirzepatide, but is approved to treat weight loss in adults with overweight and a weight-related medical problem or obesity and to treat obstructive sleep apnea in patients with obesity.

Related: If Mounjaro has no diet plan, what should you eat?

If your constipation or other stomach side effects do not go away or worsen, contact your healthcare provider right away for further advice.

Related questions

• Mounjaro vs Ozempic: Which is right for you?
• Ozempic Side Effects to Watch For
• Zepbound Vs Mounjaro: Complete Comparison Guide for Weight Loss and Diabetes Treatment

How do I relieve my constipation with Mounjaro?

Here are some tips that may help prevent or relieve constipation with Mounjaro:

1. Adjust your diet: Add fresh fruits, vegetables and whole grains to help prevent constipation. A diet high in fiber may also help control your blood sugar levels. Slowly increase your consumption of dietary fiber up to 25 grams (women) to 34 grams (men) per day on average, to help prevent bloating, gas and other stomach side effects.
2. Increase your fluids, water: Boost the amount of water you drink each day to help keep your stools soft. The amount of water you need can vary, but it is recommended to get about 9 cups (women) to 12 cups (men) of fluids per day. Drink plenty of fresh water or unsweetened beverages with your meals. Caffeine can cause dehydration, which can lead to constipation, so you may need to avoid added caffeine.
3. Regular exercise: Your doctor will most likely recommend an exercise routine to help with blood sugar control and weight loss with Mounjaro treatment. An added benefit of exercise is that it can help to relieve constipation by increasing the movement of your intestines. Be sure to replenish fluids during and after exercise.
4. Laxatives: Certain products, like the bulk-forming agent psyllium (Metamucil), stool softeners like docusate sodium (Colace), or the osmotic laxative polyethylene glycol (Miralax) may be appropriate for occasional instances of constipation. Natural products, like prunes or prune juice, may also be effective. If you want to use an over-the-counter (OTC) laxative while taking Mounjaro, check with your healthcare provider first, especially if you have severe constipation.
5. Dose adjustments: Higher doses or quickly increasing your dose of Mounjaro may worsen side effects like constipation. Have your healthcare provider review your dose if constipation occurs.

Who is most at risk for constipation with Mounjaro?

People who may be at an increased risk of constipation while using Mounjaro include:

• Patients on a higher dose or who raise their treatment doses too quickly. Studies with Mounjaro have shown higher doses may worsen constipation.
• Those with a history of constipation, problems with digesting food, or gastrointestinal conditions like gastroparesis (slowed emptying of your stomach). It is recommended that patients with gastroparesis do not use Mounjaro.
• People who are dehydrated: Mounjaro may be associated with nausea, vomiting or diarrhea, which can lead to dehydration and electrolyte imbalance and may aggravate constipation. Dehydration can also lead to acute kidney injury.
• Older adults can be more prone to dehydration and constipation due to a decreased ability to sense thirst.

Not everyone will develop constipation as a side effect with Mounjaro, and for most people, stomach side effects lessen or go away after a few weeks of treatment and once the normal maintenance dose is reached.

This is not all the information you need to know about Mounjaro (tirzepatide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.