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Can I take Mounjaro and Metformin together?

Drug interaction guide

When taken together, these medicines can increase the risk of your blood sugar levels dropping too low (hypoglycaemia). While both drugs work to lower blood sugar, they do so in different ways, which can sometimes lead to an additive effect. Additionally, Mounjaro slows down how quickly your stomach empties, which might slightly change how your body absorbs Metformin, though this is usually not a major concern.

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Why this happens

Both Mounjaro (tirzepatide) and Metformin are used to lower blood glucose. Mounjaro mimics hormones that tell your body to release insulin, while Metformin makes your body more sensitive to the insulin you already have. Because they both push blood sugar down, the combined effect can occasionally go too far. Mounjaro also slows 'gastric emptying' (the speed at which food and pills leave the stomach), which can alter the timing of Metformin absorption.

What you should do

You should monitor your blood sugar levels regularly, especially when you first start taking Mounjaro or when your dose is increased. Learn to recognise the signs of low blood sugar (hypoglycaemia), such as feeling shaky, sweaty, dizzy, or hungry. Always keep a fast-acting glucose source (like glucose tablets or a sugary drink) with you. If you experience frequent low blood sugar episodes, speak to your doctor, as they may need to adjust your Metformin dose.

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Important precautions

Severe stomach or bowel problems

This medicine can cause severe gastrointestinal issues and may worsen pre-existing conditions like gastroparesis or inflammatory bowel disease. Seek immediate medical help if you experience severe, persistent stomach pain, as this can be a sign of acute pancreatitis.

Severe kidney impairment or dehydration

If you develop severe vomiting, diarrhoea, or a high fever, you must stop taking Metformin temporarily. These conditions increase the risk of lactic acidosis, a rare but life-threatening build-up of acid in the blood.

Type 1 Diabetes or Diabetic Ketoacidosis

Neither medicine is a substitute for insulin. They must not be used to treat Type 1 diabetes or diabetic ketoacidosis, as they will not prevent these life-threatening conditions from developing.

Food and drink warnings

Alcohol

Drinking alcohol while taking metformin can increase the risk of a rare but serious condition called lactic acidosis. It can also increase the risk of low blood sugar (hypoglycaemia). Avoid excessive alcohol consumption and binge drinking.

High-fat meals

While not a direct drug interaction, eating large or very high-fat meals can significantly worsen the common side effects of Mounjaro, such as nausea, bloating, and indigestion, because the medicine slows down how quickly your stomach empties.

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Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 24 Jan 2026 | Originally published
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