Managing GI Side Effects of Mounjaro: Nausea and Constipation Relief

Mounjaro is a medication that works similarly to other drugs like Ozempic, Trulicity, and Victoza. It affects the stomach and intestines, making them move slower. As a result, people may feel fullness, nausea, constipation, and abdominal pain.

The manufacturer of Mounjaro says that the most common side effect is feeling nauseous. Other side effects include diarrhea, loss of appetite, vomiting, constipation, indigestion, and abdominal pain.

The percentages of these side effects are summarized in the table below:

In addition, these less common GI side effects were also reported:

It can be seen from the above tables that Nausea is the most common side effect of Mounjaro. It can occur in 12 to 18% of the patients who are using Mounjaro.

Constipation affects 6 to 7% of the patients. Diarrhea was also very commonly reported. It affected 12 to 17% of the patients.

How to Treat Nausea and Motion Sickness Caused by Mounjaro?

Here are some general tips to get relief from Nausea caused by Mounjaro:

• Follow the recommended dosing schedule and titrate the dose gradually:

It’s important not to start using Mounjaro at the 5 mg or 10 mg dose right away. You should not make a big jump from a 2.5 mg dose to 7.5 mg or 10 mg either. The manufacturer suggests a specific dosing schedule to follow.

First, you should start with a 2.5 mg dose once a week for 4 weeks. After that, you can increase the dose to 5 mg once a week for another 4 weeks. Then, you can gradually increase the dose to 7.5 mg, 10 mg, 12.5 mg, and 15 mg, with each increase happening every four weeks.

It’s important to increase the dose slowly and follow the recommended schedule. If you have recently increased your dose and the nausea is bothering you, you can switch back to the previous dose that you tolerated well.

Some people find relief by changing the injection site from the belly to the thighs, but there isn’t a strong scientific explanation for why this might work.

• Eat small meals:

Eating smaller meals is generally beneficial for most people. Since Mounjaro slows down stomach movements, consuming large meals can lead to stomach distension, which can cause nausea.

To avoid this discomfort, it is recommended to divide your meals into five or six smaller portions instead of having two or three big meals. This can help prevent stomach distension and reduce the likelihood of experiencing nausea.

• Limit the intake of foods rich in fats:

Similar to Mounjaro, foods that are high in fat can slow down the movement of your stomach. This is also a key aspect of the keto diet, which is a diet that includes a lot of fat and protein. Eating these kinds of foods can make you feel full for longer periods.

While this can help with weight loss, it’s important to note that it may also increase the chances of experiencing gastrointestinal (GI) side effects such as nausea and a bloated or distended abdomen.

• Keep yourself hydrated:

Remember to drink enough fluids to stay hydrated. Take small sips of simple, clear water or herbal/ginger tea. Hydration not only helps relieve nausea but also prevents dehydration, which can be harmful to your kidneys.

• Take Ginger tea:

Ginger tea has a soothing effect. It has some anti-inflammatory properties as well. One to two cups of ginger tea per day after meals may help relieve nausea and bloating caused by Mounjaro.

Ginger extracts are available as ready-made drinks, candies, and gummies  but you can also make ginger tea at home by following these simple steps:

• Peel and thinly slice a piece of fresh ginger root (about 1 to 2 inches).
• Bring a cup of water to a boil in a saucepan.
• Add the sliced ginger to the boiling water and let it simmer for about 5 to 10 minutes.
• Remove the saucepan from the heat and let the tea steep for an additional 5 minutes.
• Strain the tea to remove the ginger slices.
• Optionally, you can add honey or lemon juice to enhance the flavor.
• Enjoy the warm ginger tea slowly.

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• Use over-the-counter antacids:

Over-the-counter antacids can be used to relieve nausea when simple measures don’t help you. Antacids help reduce the symptoms of nausea by either reducing acid production or they bind to the acid in the stomach and neutralizing them.

Some of the OTC antacids include:

• Use over-the-counter motility-enhancing drugs:

Over-the-counter drugs that may help nausea caused by Mounjaro by helping your stomach move include peppermint extract, ginger extract, and Vitamin B6.

Other drugs like Domperidone and Maxolon may or may not be available OTC.

• Prescription medications to treat Nausea:

When simple lifestyle changes and OTC medications fail to improve your symptoms, you may need to visit your doctor and get a prescription for any of these medications.

Your doctor is the best judge to decide which nausea medicine will help you the most. However, the most commonly used are domperidone, Maxolon, Zofran, and promethazine.

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How to get relief from constipation caused by Mounjaro?

Constipation is commonly reported with GLP-1 analogs and Mounjaro. Constipation is usually associated with abdominal pain, bloating, and nausea as well.

It is more common in older people and those who have preexisting constipation. If you have developed constipation during Mounjaro treatment, here are some hacks that can help you:

• Make a toilet routine:

Make a habit to visit the toilet early in the morning after breakfast daily. In the first few days, when you are not used to it, you may need to sit for a while but when your gut knows your routine, it will start moving at that time of the day.

Do not strain as you may develop a fissure or piles which can be very painful and disturbing.

• Eat foods rich in fiber:

Eat fiber-rich fruits and vegetables. Sometimes you may need to take fiber supplements if your dietary habits are not very good.

The fiber in your diet increases the volume of your stools exert pressure on your intestines and your intestines start moving. In addition, fiber also draws water into the intestines and softens the stools.

• Drink plenty of water:

Water intake is essential for regular bowel movements. When you are dehydrated, your body tries to absorb as much water from your intestines as possible, and hence your stools become harder.

This leads to constipation. In addition, dehydration can lead to electrolyte disturbances which can also result in constipation.

Water is the best choice for hydration. You can also take green tea, coffee, green tea, or an electrolyte solution to keep yourself hydrated.

• Go for a workout:

Regular workout is not only helpful for your muscles, bones, and fat but also for your bowels. With a regular 30-minute workout your intestines move more and constipation is relieved.

Some of the best exercises are swimming, running, jogging, and yoga. Yoga can be done at home without any requirements (You just need a comfortable dress and a Yoga Mat)

• Take over-the-counter laxatives:

Laxatives are needed when all the above natural methods do not work and you are not comfortable with your bowels. Some people have to stop Mounjaro because of constipation, rather prematurely, without trying other simple methods to relieve their constipation.

Here is a list of OTC laxatives that can be used safely to move your bowels with ease:

• Prescription medications to relieve constipation:

Some of the commonly used prescription medicines that may be used to treat Mounjaro-associated constipation include Duphalac (Lactulose), Sodium Picosulphate (Skilax), and other novel drugs.

Medications to relieve constipation available only via prescription are tabulated below:

How to Treat Diarrhea and Abdominal Pain Caused by Mounjaro?

Diarrhea, commonly described as loose motions, is one of the common side effects of Mounjaro. It is not known which patients may develop and which patients may develop constipation.

Diarrhea is usually associated with abdominal pain, cramps, and dehydration. If you have developed diarrhea with Mounjaro use, here are some tips and guidelines that can help you:

• Keep hydrated:

Taking adequate amounts of fluids may not help in relieving diarrhea but it is important to keep yourself hydrated while having diarrhea.

Dehydration can cause your kidneys to stop functioning which can be very serious. You can take clear water, herbal teas, and diluted fruit juices to keep yourself hydrated. In addition, you can use ORS and electrolyte solutions too.

However, it is best to avoid alcohol and coffee as these drinks may worsen dehydration.

• Take simple meals:

Take simple meals which can be easily digested by your stomach. A simple diet includes the BRAT diet (banana, rice, applesauce, and toast).

You may also try boiled potatoes, cooked carrots, plain yogurt, and lean proteins such as chicken or fish. However, avoid greasy, spicy, and even high-fiber foods which may worsen diarrhea.

• Use over-the-counter anti-diarrheal medications:

If diarrhea is severe and not controlled by changing meals, you may need OTC antidiarrheals to slow your gut movements and prevent dehydration.

Commonly used OTC antidiarrheals are listed in the table below:

• Prescription medications:

When diarrhea is severe and you don’t get relief by changing your diet and trying OTC medicines, it is best to consult your doctor.

Some of the prescription medications that may help you are listed here: