Can You Drink Alcohol on Mounjaro?

Understanding Mounjaro

What is Mounjaro?

By affecting these hormones, Mounjaro slows down the emptying of the stomach. A result of this is that patients feel fuller for longer and therefore consume fewer calories. This is one of the ways it works as an aid to weight loss in conjunction with a low-carbohydrate diet and exercise.

Mounjaro will also increase your body's sensitivity to insulin which controls how your body deals with blood sugar levels. Its role as a diabetes medication cannot be understated and has been proven in clinical trials.

How Mounjaro Works

Tirzepatide works on two hormone pathways. The first is the glucose-dependent insulinotropic polypeptide pathway (GIP). GIP is a hormone which is released from the small intestine and stimulates insulin secretion to keep blood sugar levels low after eating, thereby improving glycaemic control.

The presence of fatty or high-sugar food triggers the release of this hormone. Once released, however, levels of GIP quickly decline. Tirzepatide takes over, keeping the levels of GIP high so that more insulin is released.

The other pathway tirzepatide works on is the glucagon-like peptide-1 (GLP-1) pathway. GLP-1 also stimulates the release of insulin. Additionally, it also acts in the brain to make you feel fuller for longer by slowing the emptying of the stomach.

Tirzepatide is the first molecule that activates both these pathways. When compared to similar medications, such as semaglutide (Ozempic or Wegovy), which only activate the GLP-1 pathway.

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Alcohol and Medication Interactions

The Basics of Alcohol and Medicine

Alcohol can interact with many, but not all medicines. It's always a good idea to speak to a medical professional for advice, each time you start a new medicine.

The current recommended weekly alcohol intake is no more than 14 units spread over 3 or more days. This is not as simple as limiting your alcohol use to one drink daily as different drinks contain different concentrations of alcohol.

Even if there isn't a documented interaction, alcohol can still affect your treatment. Most medicines can cause side effects such as nausea, vomiting, headaches or drowsiness. Alcohol can also cause the same side effects therefore the combination can worsen these effects. If drowsiness is enhanced, this could impair your ability to drive or perform mechanical skills.

All medicines have multiple ingredients, including alcohol, with some preparations containing up to 10%. Consuming alcohol on top of this, may take you over your daily limit and lead to adverse effects.

Our bodies break down and absorb medicines in different ways. Alcohol can disrupt this process in 2 main ways;

• Increasing the effect of the medication - which may lead to an overdose. This also possesses an increased potential risk of side effects.

• Decreasing the effect of the medication - which leads to inadequate treatment.

Mounjaro and Alcohol: The Specifics

Can You Drink Alcohol on Mounjaro?

The short answer is yes, but in moderation. Mounjaro isn't known to have direct interaction with alcohol, but it is strongly advised to limit your intake.

The main factors to consider if alcohol is safe with Mounjaro are:

1. The aim of Mounjaro treatment - Will alcohol interfere with how the medication works?

2. Its effect on your health - Will alcohol worsen the condition you are trying to treat?

3. Side effects - Do Mounjaro and alcohol have similar side effects? if so, will the combination be detrimental to your health?

Whilst there are no official guidelines on drinking alcohol with Mounjaro, as a general rule you should aim for a reduced intake, lower than even the recommended limit of 14 units per week. Always speak to your healthcare provider for advice specific to your individual circumstances.

For patients on Mounjaro treatment, a healthcare professional is optimally placed to provide specific advice based on their health history, including current weight and blood sugar levels.

Potential Risks of Mixing Mounjaro and Alcohol

Both Mounjaro and alcohol consumption can cause the same side effects, such as nausea, vomiting and diarrhoea. The combination can increase your risk of these side effects. Additionally, alcohol dehydrates the body. Mounjaro treatment recommends an adequate water intake to reduce the risk of headaches and also kidney problems.

Drinking alcohol can affect your Mounjaro treatment indirectly;

• Excessive alcohol intake is associated with an increased risk of type 2 diabetes, which is what Mounjaro is used to treat.

• Most alcoholic drinks contain a lot of empty calories which can lead to weight gain. If you are using Mounjaro for weight loss, this would impact your ability to lose weight.

• Patients who are taking Mounjaro are urged to reduce their carbohydrate intake. Common alcoholic drinks contain a lot of carbs, which can again, impact your weight loss journey.

• Alcohol dehydrates the body. Patients on Mounjaro are urged to remain adequately hydrated to reduce the risk of headaches.

• Other health risks include a rise in blood pressure, nerve damage and in severe cases, can also lead to cancers and heart disease.

• Drinking alcohol can cause a 'hypo' (low sugar levels). When blood sugar levels are low, the liver, which stores extra glucose, releases some back into the blood when needed. Alcohol impacts the liver's ability to do this, potentially leading to dangerously low levels. This is more likely when you consume alcohol on an empty stomach.

The liver is one of the most important organs in the body. It helps filter the blood of toxins and alcohol, helps with digestion and also helps to regulate blood sugar levels. It will also help break down medicines so they don't stay in your body for longer than they need to.

Each time your liver filters alcohol, some of the liver cells die. Over time these regenerate but prolonged alcohol consumption will eventually affect the liver's ability to regenerate these damaged cells.

This means the liver cannot then carry out its basic tasks, affecting digestion and blood sugar levels. It may mean other medications you take, including Mounjaro, will stay in your body for longer, leading to an overdose and an overexpression of side effects.

Key Considerations for Mounjaro Users

Monitoring Alcohol Intake

How much alcohol you drink depends on various factors. Your biological makeup, gender and age can all dictate the minimum safe level for you. If you are taking other medications, this will also affect this limit.

Current UK guidelines state to drink no more than 14 units per week, spread over 3 or more days.

With Mounjaro, it is advisable to limit your intake beyond this or abstain altogether. Heavy drinking will affect your weight loss treatment by increasing your calorie intake whilst simultaneously increasing the risk of low sugar levels - This is the most serious warning associated with Mounjaro and is classed as a medical emergency. Certain drug interactions of Mounjaro and alcohol are also potentially exacerbated further leading to reduced efficacy of treatment.

Understanding Your Risk

Some patients may be at an even higher risk of adverse effects when mixing medicines such as Mounjaro and alcohol:

1. Age - older adults are more likely to be taking other medications which may interact with alcohol. Additionally, alcohol is not broken down as efficiently in the older population.

   As we get older, our body water percentage decreases, which can lead to more complications.

2. Gender - women are more likely to develop complications. Compared to men, they have a lower body water percentage and higher body fat percentage. The more water there is in your blood, the more diluted alcohol will be.

3. Genetics - alcohol is broken down through enzymes. Research indicates different populations express differences in these enzymes and therefore metabolise alcohol to different levels.

   Patients of East Asian origin, due to their unique expression of these genes make drinking alcohol unpleasant even in small to moderate amounts.

4. Diet - the amount of food in your stomach can influence how your body metabolises alcohol. The presence of high-fat foods inhibits alcohol absorption, therefore leading to a lower blood alcohol level.

   With Mounjaro, you would be eating less due to feeling fuller for longer. Patients therefore drinking alcohol would need to exercise caution as the same amount of alcohol consumption pre-treatment may now lead to an excessive blood alcohol level.

5. Alcohol Use Disorder (AUD) - also known as alcohol dependence. A medical condition where patients frequently drink alcohol even when it causes harm.

   Even if you do not have alcohol dependence, a family history can put you at a higher risk of developing it. Research has indicated children of alcoholics are four times more likely to develop alcohol problems.

   For those patients looking at starting Mounjaro treatment, the whole history is therefore crucial at determining possible interactions and treatment outcomes.

Mounjaro's Interactions with Other Substances

Drug Interactions

As it slows down the rate at which your stomach empties, there is a potential risk Mounjaro interacts with all oral medications, as the other drug would now remain in your system for longer than was originally intended. These would potentially require a dosage adjustment.

Over-the-counter medication such as paracetamol and similar drugs do not require dose adjustments. The dosages as mentioned on the patient package insert are relatively safe.

In women taking birth control pills, the advice is to include an additional barrier method for the first 4 weeks of Mounjaro treatment and for 4 weeks after each dose increase. This is because Mounjaro may reduce the effectiveness of the hormonal contraceptive.

Using Mounjaro alongside certain diabetes medications, such as insulin or sulphonylureas, can increase the risk of low blood sugar. Theoretically, any medicine that increases the risk of low sugar levels must not be used alongside Mounjaro.

Other Considerations

Your Mounjaro treatment may affect or be affected by other medical conditions to varying degrees. Even if you do not have a past medical history, it is important to know what signs to look out for and seek medical attention if necessary.

Mounjaro may cause thyroid cancer. If you have a personal or family history of thyroid tumours, you must not use Mounjaro. Lumps or swelling in the neck, trouble swallowing, hoarseness and shortness of breath are all signs that must be reported to your healthcare provider.

In patients who are at risk of kidney disease, Mounjaro use can cause side effects such as diarrhoea, sickness and vomiting. This leads to dehydration which causes these problems to get worse. It is therefore crucial to ensure you are drinking adequate water alongside treatment.

Mounjaro can rapidly improve blood sugar levels, which can temporarily worsen diabetic retinopathy, leading to symptoms such as blurry vision.

You must not use Mounjaro if:

1. You have multiple endocrine neoplasia syndrome type 2 (MEN2)

2. If you are allergic to it or any of its ingredients.

Guidance for Mounjaro Users

Before Starting Mounjaro

Eli Lilly, the manufacturer has recommended that you review certain information before starting treatment:

1. The healthcare providers who prescribe Mounjaro should show you how to use the device, including how to inject a dose.

2. Your healthcare professional should ask about low blood sugar (hypoglycemia) and how you should manage this.

3. If you take birth control pills - Mounjaro may reduce their effectiveness and you would therefore require an additional form of contraception.

4. If you have any problems with your pancreas or kidneys - Mounjaro may make these conditions worse.

5. If you take other drugs for diabetes, such as insulin or sulphonylureas - the combination dangerously decreases blood sugar levels.

6. If you have a history of diabetic retinopathy.

7. Pregnant/breastfeeding - Mounjaro will harm an unborn baby, therefore, you cannot fall pregnant whilst on treatment. It is not known if Mounjaro passes into breast milk.

8. If you take other medication, including supplements or herbal treatments.

While Taking Mounjaro

Due to the risk of low blood sugar, especially when you take Mounjaro alongside diabetes medications or alcohol, it may be necessary to monitor your levels and know the signs of low or high blood sugar.

Signs and symptoms of low blood sugar include:

• Shaking

• Sweating

• Dizziness

• Hunger

• Nervousness

Signs and symptoms of high blood sugar include:

• Feeling thirsty

• Feeling tired

• Blurred vision

• Needing to urinate more often.

There are signs you need to watch out for whilst on Mounjaro treatment. In all these cases, you should stop treatment and speak to your healthcare provider immediately:

1. Severe stomach pain which spreads to the back or chest and is accompanied by nausea or vomiting - may indicate pancreatitis which can be life-threatening.

2. Pain in your upper stomach, accompanied by fever, yellowing of the eyes or skin and clay-coloured stools - are all characteristic of gallbladder problems.

3. Swelling of the face, lips, tongue or throat, including problems breathing and a severe rash - all indicate a severe allergic reaction.

Summary

The bottom line is that you should try to avoid drinking alcohol whilst taking Mounjaro. If you do continue to drink, how much you drink depends on your medical history and any other medication you are taking. This should be limited beyond the normal recommended limits of 14 units per week.

The combination of Mounjaro and alcohol can heighten side effects as well as have a negative impact on how the medicine works. To ensure successful treatment, reduce alcohol intake as part of a low-carb diet, incorporate regular exercise and be sure to inform your healthcare professional if you start to take any other medication to prevent interactions.