Tirzepatide interactions

Food & lifestyle

• alcohol

  Moderate

  Others

  Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia.

  What to do: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

  9 sources

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72

  Show all 9 sourcesShow fewer sources

  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60

Conditions

Conditions in which Tirzepatide needs care, as documented in this source.

• Thyroid Neoplasms

  Major

  Tirzepatide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) and in patients with multiple endocrine neoplasia syndrome type 2. Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. Patients should be counseled regarding the potential risk for MTC with the use of tirzepatide and should be informed of symptoms of thyroid tumors.

  1 source

  1. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2022):

• Acute Kidney Injury

  Moderate

  Tirzepatide has been associated with gastrointestinal adverse reactions (including nausea, vomiting, diarrhea); such events may lead to dehydration, which could cause acute kidney injury if severe. There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure (which may sometimes require hemodialysis) in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; some of these events were reported in patients without known underlying renal disease, and most of the reported cases occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration. Renal function should be monitored when starting or escalating doses of tirzepatide in patients with renal dysfunction reporting severe gastrointestinal adverse reactions. No dose adjustment is recommended for patients with renal dysfunction.

  1 source

  1. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2022):

• Diabetic Retinopathy

  Moderate

  Tirzepatide has not been studied in patients with nonproliferative diabetic retinopathy requiring acute therapy, proliferative diabetic retinopathy, or diabetic macular edema; caution is recommended in these patients. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.

  1 source

  1. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2022):

• Gastrointestinal Diseases

  Moderate

  Use of tirzepatide has been associated with gastrointestinal adverse reactions (sometimes severe). Because tirzepatide has not been studied in patients with severe gastrointestinal disease (including severe gastroparesis), it is not recommended in these patients.

  1 source

  1. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2022):

• Pancreatitis

  Moderate

  Acute pancreatitis (including fatal and nonfatal hemorrhagic or necrotizing pancreatitis) has been observed in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; acute pancreatitis has been reported in patients treated with tirzepatide in clinical trials. Tirzepatide has not been studied in patients with history of pancreatitis; it is unknown if such patients are at higher risk of developing pancreatitis on tirzepatide. After initiation of tirzepatide, patients should be observed carefully for signs/symptoms of pancreatitis (including persistent severe abdominal pain [sometimes radiating to the back], with or without vomiting); if pancreatitis is suspected, tirzepatide should be discontinued and appropriate management should be started.

  1 source

  1. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2022):

Therapeutic duplication

Drug classes that overlap with Tirzepatide, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Insulin degludec/liraglutide

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Soliqua