This article discusses the potential side effects of terzepatide, also known as Mounjaro, a medication often used for weight management. It also covers contraindications and important considerations before starting the medication.
Common Side Effects
The most common side effects associated with terzepatide are typically mild gastrointestinal (GI) issues.
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Nausea: Some individuals may experience feelings of nausea.
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Diarrhea: Changes in bowel habits can include diarrhea.
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Constipation: Conversely, constipation can also occur.
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Reflux: Terzepatide slows stomach emptying, potentially worsening existing reflux or causing it in individuals who didn't have it before. The slower emptying means the stomach contents stay longer, increasing the chance of reflux.
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Decreased Appetite: The medication is designed to suppress appetite, but the degree of suppression varies.
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Fatigue: Some people may experience fatigue.
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Headache: Mild headaches are another potential side effect.
The timing of these side effects can vary. Some people experience them mainly in the 24 hours after their weekly injection, while others have them more evenly distributed throughout the week. Some individuals simply experience mild stomach upset without vomiting or other severe symptoms.
Rare Side Effects
While less common, some more serious side effects can occur.
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Acute Kidney Injury: Dehydration while taking terzepatide can increase the risk of kidney irritation and potentially acute kidney injury. It's important to stay well-hydrated.
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Gallbladder Dysfunction: Rapid weight loss, regardless of the method, can increase the risk of gallbladder issues. This isn't specific to terzepatide but is a potential concern.
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Pancreatitis: There is a rare, but serious, risk of pancreatitis. This is a significant concern, and terzepatide is generally not recommended for individuals with a history of pancreatitis or other pancreatic issues.
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Hypoglycemia: While more common in individuals with diabetes, there is a risk of hypoglycemia (low blood sugar) even in those without diabetes, although the risk is much lower.
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Injection Site Reactions: As with any subcutaneous injection, local injection site reactions are possible.
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Allergic Reactions: Allergic reactions are a risk with any medication.
Contraindications
Certain conditions make terzepatide unsafe to use.
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Multiple Endocrine Neoplasia Type 2 (MEN2) or Medullary Thyroid Carcinoma: A personal or family history of these specific genetic cancers is a strict contraindication.
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Diabetic Retinopathy: The use of terzepatide in patients with diabetic retinopathy requires a careful risk-benefit assessment, including consultation with an ophthalmologist. The severity of the retinopathy needs to be considered, and close monitoring may be necessary.
Important Considerations
The decision to use terzepatide should always be made in consultation with a healthcare professional. For patients with diabetic retinopathy, a collaborative approach involving the prescribing physician, ophthalmologist, and patient is crucial. Ultimately, the patient has the final say after being fully informed of the risks and benefits.
Anecdotal Observations
Anecdotally, some physicians have observed that Mounjaro may lead to greater weight loss with fewer side effects compared to semaglutide. However, access to Mounjaro can be more challenging, especially for individuals without diabetes, as it may not be covered by insurance. Despite this, many patients who are on Mounjaro, regardless of their diabetic status, tolerate it well, with a side effect profile that is often milder than semaglutide.