All About Mounjaro: A New Medication for Type 2 Diabetes
Today, there are at least a couple dozen medication options for type 2 diabetes and people who are living with obesity or are overweight. The latest diabetes medication to receive FDA approval on May 13, 2022, is already standing out from the crowd.
What is Mounjaro?
Mounjaro (tirzepatide) is a once-weekly injectable medication from Lilly Diabetes. It is the first and only dual GIP/GLP-1 receptor agonist
- glucose-dependent insulinotropic polypeptide (GIP)
- glucagon-like peptide-1 (GLP-1)
While medications like Mounjaro are usually thought of as a treatment for type 2 diabetes, other related drug classes are sometimes prescribed “off-label” to people with type 1 diabetes who are living with obesity or being overweight.
Through a series of studies over the past few years, Mounjaro has shown to have a big impact on weight loss, A1c and cholesterol.
Let’s take a closer look at the newest diabetes medication on the block.
How does Mounjaro work?
Mounjaro is a dual-action GIP and GLP-1 that works as single molecule to activates the body’s receptors for GIP and GLP-1 and helps to improve your diabetes health in a few ways:
- It increases insulin production, but only when your blood sugar is rising—which makes the risk of low blood sugar minimal.
- It decreases your liver’s production of sugar.
- It slows down the speed at which your stomach empties food into your intestine. This helps manage your blood sugars after eating while also leaving you feeling full longer.
Mounjaro is taken once a week via injection at any time of day.
Research results on Mounjaro
Compared to taking long-acting insulin or sulfonylureas, Mounjaro has performed well in research.
The most recent SURMOUNT-1 study consisted of 2,539 participants with an average starting body weight of 231 pounds.
- At the lowest dose—5 mg—participants lost 15 percent of their body weight over 72 weeks.
- At higher doses—10 and 15 mg—participants lost about 20 percent of their body weight over 72 weeks.
- More than half of the participants taking the higher dose lost 20 percent of their body weight compared to only 1.3 percent taking a placebo.
- Many participants lost 22.5 percent of their body weight—about 52 pounds from a starting weight of 231 pounds.
In prior years, there were several notable studies on Mounjaro, including SURPASS-3, SURPASS-5 and SURPASS-2. The most recent phase 3 of SURPASS-4 included more than 13,000 participants.
- A1c reduction: Trial participants with A1c levels starting at/above 8.0% experienced about a 2.5-point reduction. For example: 9.5% down to 7.0%. According to reports from SURPASS-4 91 percent of participants achieved an A1c of 7% or lower, while 43 percent reached an A1c of 5.7% or lower.
- Weight-loss: The most significant weight loss compared to any other diabetes medication. The average weight loss after 52 weeks was about 25 pounds, with trial participants taking the highest dose (15 mg) losing about 27 pounds, and on the lowest dose (5 mg) about 17 pounds.
- Lessened risk of hypoglycemia compared to other medications: Yes, Mounjaro can potentially cause low blood sugars but the risk appears to be very minimal compared to taking insulin or a sulfonylurea drug.
- Reduction in triglycerides and cholesterol: After 52 weeks, the highest dose, Mounjaro reduced total cholesterol by about 5.6%, triglycerides by 22.5%, LDL cholesterol by 7.9%, VLDL by 21.8%, and increased HDL by 10.8%.
Mounjaro has compared heavily to Ozempic (semaglutide) from Novo Nordisk, which is currently the most effective FDA-approved diabetes medication that also supports weight loss.
Most research results continue to tout Mounjaro as more effective than Ozempic across the board. Novo Nordisk notes that their studies on Ozempic weren’t as long as Lilly’s study on Mounjaro, making the comparison of weight loss a mismatch.
Novo Nordisk also reports fewer digestive side effects and a higher overall tolerance for Ozempic compared to Mounjaro.
What are the side effects of Mounjaro?
Like many diabetes medications, Mounjaro does come with some “gastrointestinal side-effects” including:
- Gas
- Bloating
- Nausea
- Diarrhea
- Vomiting
To lessen the side effects, the dosage of Mounjaro will begin at 5 mg and increase gradually with your doctor’s guidance. Side-effects can worsen temporarily during this “escalation period” and should eventually lessen over time.
Learn more about the less common and more serious side effects.
Who shouldn’t take Mounjaro?
Like any medication, there are certain contraindications (reasons you shouldn’t take it) and potential risks.
You shouldn’t take Mounjaro if:
- You or your family has a history of thyroid cancer—specifically medullary thyroid carcinoma (MTC)
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2)
- You are allergic to any of the ingredients—discuss ingredients with your doctor
So, what will it cost?
Like any medication, it’s only effective in treating a condition if those who need it can afford it. At this time, Lilly has not publicly announced the list price of Mounjaro.
One resource predicts Mounjaro will be $5,500 to $7,500 annually before health insurance coverage—which is slightly higher than the cost of Ozempic. For comparison purposes: with insurance, Ozempic can cost around $150 per month—or less for those who qualify for patient assistance.
Could Mounjaro help you reach your diabetes goals?
Mounjaro might be right for you if you have not been able to manage your blood sugar and achieve your A1c goals with “first-line” diabetes medication options that also do not come with the risk of hypoglycemia (metformin, D-PP4 inhibitors, SGLT2 inhibitors, etc.).
Mounjaro may also be a candidate for those who are overweight or living with obesity but do not have type 2 diabetes.
Curious about Mounjaro? Talk to your healthcare team or get started here.
