Tirzepatide is a new and exciting drug that was first developed to treat type 2 diabetes. It’s not surprising that there is a lot of interest in it as a way to lose weight. This GLP-1 and GIP receptor agonist is sold under the brand name Mounjaro, and it has helped a lot of people lose weight. When taking any medicine, safety is the most important thing, but it’s especially important when it comes to drug interactions.
A common question for people who are thinking about taking Tirzepatide to lose weight or who are already taking it is:
What should you NOT take with Tirzepatide?
We will cover what you need to know about drug interactions and specifically drug interactions regarding antidepressants, insulin, oral diabetes medications, blood pressure medications, and even natural supplements. We will also review safety measures and suggestions to make the most of your weight loss journey.
What Is Tirzepatide?
Before getting into drug interactions, let’s take a quick look at what Tirzepatide is.
Tirzepatide is approved as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. It resembles the effects of two hormones responsible for regulating blood sugar and appetite. They promote insulin release, reduce glucagon, and delay gastric emptying, leading to lower appetite and decreased weight.
Despite this, the FDA has approved its use for type 2 diabetes. Tirzepatide has also become increasingly prescribed off-label for weight loss, especially for individuals who are overweight/obese.
Why Drug Interactions Are Important
Tirzepatide can affect your digestive and hormonal systems, meaning that it could interact with several medications or substances that could potentially lead to reduced effectiveness or increased side effects. Understanding the associated risk will help you ensure that your weight loss supports safe and sustainable changes.
What You Should NOT Take Along With Tirzepatide
Here’s a breakdown of medications and substances that we recommend avoiding—or using extreme caution with—while you are on Tirzepatide:
1. Antidepressants
Tirzepatide does not directly interact with antidepressants; however, it’s sensible to be cautious, especially if you are taking SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Norepinephrine Reuptake Inhibitors).
So why should you care?
- Tirzepatide slows gastric emptying, which possibly alters how antidepressants are absorbed.
- This might change blood levels of your medication, either reducing effectiveness or increasing side effects.
- In rare cases, side effects from nausea or GI distress might be compounded by both medications.
Commonly prescribed antidepressants to consider:
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
If you are taking antidepressants, make sure to talk to your psychiatrist or primary care doctor before starting tirzepatide. They may need to adjust dosages of your medication or may choose to monitor you extremely closely for any side effects (like shifts in mood or increased anxiety).
2. Insulin and Sulfonylureas
If you are already taking insulin or sulfonylureas (i.e., glipizide or glyburide) when you introduce Tirzepatide, you may experience hypoglycemia (low blood sugar levels).
Symptoms of Hypoglycemia:
- Dizziness
- Confusion
- Sweating
- Shakiness
- Fainting
Since Tirzepatide’s function is also to lower blood sugar, the combination can exacerbate the hypoglycemic state.
Solution: Your Prescriber may reduce your dose of insulin or transition you to a safer regimen.
3. Other GLP-1 Receptor Agonists
Using other GLP-1 medications like
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Saxenda, Victoza)
Can increase your gastrointestinal side effects (nausea, vomiting, diarrhea), increase the risk for pancreatitis, and offer no additional benefit. All of these medications work similarly.
4. Oral medications with a narrow therapeutic index
Your Oral medications with a narrow therapeutic index:
- Levothyroxine (for thyroid disorders)
- Warfarin (a blood thinner)
- Digoxin (for heart conditions)
Will be affected due to the delayed gastric emptying caused by Tirzepatide, and therefore may change how your other medications are absorbed.
Monitoring required: Blood levels may need to be monitored more frequently.
5. Blood Pressure Medications
Tirzepatide could lower blood pressure by itself based on weight loss and fluid changes. The blood pressure meds, like an ACE inhibitor or a beta-blocker, could add too much lowering to your blood pressure and lead to hypotension (decreased blood pressure) when you stand after one of the doses of Tirzepatide.
Signs of Low Blood Pressure Include:
- Dizziness
- Blurry vision
- Weakness
- Fainting
If you are already taking hypertension meds, you should consult your doctor and possibly adjust your dosages after starting the Tirzepatide therapy.
6. Alcohol
It is not a med, but alcohol increases some of the side effects from taking Tirzepatide therapy:
- Nausea
- Increased drowsiness
- Increased low blood sugar potential (particularly in combination with any diabetes med)
Alcohol also inhibits the metabolism of fat and appetite regulation, which is not beneficial for weight loss.
Best practice: limit or avoid alcohol during any Tirzepatide therapy for maximum benefit.
7. Natural Supplements and Herbal Products
Natural supplements do not always mean they are safe for everyone. Some popular supplements:
- Berberine (often used for blood sugar control)
- Ginseng
- Bitter melon
- Cinnamon capsules
Has shown an effect on reducing blood glucose levels, and using the natural supplement on top of the tirzepatide will increase the effect on blood glucose levels, leading to a risk for hypoglycemia. Some supplements can also delay the absorption and/or lead to gastrointestinal distress, which could cause your Tirzepatide treatment not to be effective as needed.
Be sure to tell your health care provider about any supplements you are taking.
General Safety Precautions During a Tirzepatide Cycle
To maximize your benefits while minimizing side effects, you can do a few things:
1. Consistency is key
Make sure you are injecting tirzepatide on the same day and time each week to maintain levels in your body.
2. Stay Hydrated
GI side effects, such as vomiting or diarrhea, may lead to dehydration. Make sure you are drinking plenty of fluids every day.
3. Start low and go slow
Most providers start you with a weekly dose of 2.5 mg and increase it slowly, hopefully decreasing side effects.
4. Do not eat fatty meals
Fatty meals can make nausea or bloating worse, so eat lean proteins, vegetables, and whole grains.
5. Test your blood sugar if you are diabetic.
Check your glucose levels often if you are taking other medications that lower blood sugar.
When to Call Your Provider
Call 911 or go to the local ER for immediate medical attention for the following:
- Severe nausea and vomiting
- Signs of pancreatitis (pain in the upper abdomen, fever, vomiting)
- Allergic reactions or side effects (rash, trouble breathing)
- Low blood sugar that won’t go away
- Suicidal mood changes or thoughts if you are taking an antidepressant (especially if suicidal thoughts suddenly change after using Tirzepatide)
Final Thought: Is Tirzepatide right for you?
Tirzepatide has advantages for weight loss, but nothing is for everyone. Knowing what you shouldn’t take with Tirzepatide is key to unlocking the full set of benefits and minimizing your risks.
If you are on antidepressants, insulin, herbal supplements, or blood pressure meds, it is best to work very closely with your medical providers. A thoughtful plan based on your concerns, put side by side with healthy lifestyle changes, will position you for sustainable success.
Frequently Asked Questions (FAQs)
Can I take Tirzepatide while on antidepressants?
Yes, provided you’re under close medical supervision. You may have some absorption problems with the tirzepatide in that case.
Is it safe to drink alcohol while taking Tirzepatide?
Alcohol should be limited and avoided for the most part, as this may increase side effects.
Can I take supplements like berberine or cinnamon?
Exercise caution with these types of supplements. Always see your doctor first when combining supplements with Tirzepatide.
What do I do if I miss a dose?
If you miss a dose and it has been less than 4 days, take it as soon as you remember. If it has been longer than 4 days, skip the dose and return to your normal schedule.
Eager to Begin Your Tirzepatide Weight Loss Journey?
Licensed professionals at Healify Weight Loss will work with you using Tirzepatide for effective and safe weight loss. Book a consultation and start on your way to a healthier you today.
