Hiccups are not listed as a recognised side effect in the UK prescribing information for Mounjaro (tirzepatide), though some patients report experiencing them. The most common adverse reactions to this type 2 diabetes medication involve the gastrointestinal system, including nausea, diarrhoea, vomiting, and constipation. Hiccups may occur secondary to these digestive changes, gastric distension, or altered eating patterns rather than as a direct pharmacological effect. If you experience persistent or troublesome hiccups whilst taking Mounjaro, discuss this with your GP or prescribing clinician to determine the underlying cause and appropriate management.

Are Hiccups a Side Effect of Mounjaro?

Hiccups are not listed as a recognised adverse reaction in the official UK prescribing information (Summary of Product Characteristics) for Mounjaro (tirzepatide) approved by the Medicines and Healthcare products Regulatory Agency (MHRA). The most commonly reported adverse effects of Mounjaro relate to the gastrointestinal system, including nausea, diarrhoea, vomiting, constipation, and abdominal discomfort. While hiccups are not specifically listed in clinical trial data, anecdotal reports from patients exist, though causality remains unproven.

Hiccups can occur for numerous reasons, including rapid eating, consuming carbonated beverages, gastro-oesophageal reflux disease (GORD), or gastric distension—all of which may be more common in individuals adjusting to appetite changes or experiencing gastrointestinal side effects from the medication. It is important to distinguish between a direct pharmacological effect and secondary symptoms arising from altered eating patterns or digestive function.

If you experience persistent or troublesome hiccups while taking Mounjaro, it is advisable to discuss this with your GP or prescribing clinician. They can assess whether the hiccups are related to the medication, an underlying condition, or lifestyle factors. Keeping a symptom diary noting when hiccups occur, their duration, and any associated activities (such as meals) can help your healthcare provider determine the cause and recommend appropriate management strategies. While hiccups are generally benign and self-limiting, persistent episodes lasting more than 48 hours warrant medical evaluation to rule out other causes.

How Mounjaro Works and Common Side Effects

Mounjaro (tirzepatide) is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for the treatment of type 2 diabetes mellitus. The medication works by mimicking the action of incretin hormones, which are naturally released by the gut in response to food intake. By activating both GIP and GLP-1 receptors, tirzepatide enhances insulin secretion in a glucose-dependent manner, suppresses glucagon release, slows gastric emptying, and reduces appetite—collectively improving glycaemic control and promoting weight loss.

The most frequently reported side effects of Mounjaro are gastrointestinal in nature and typically occur during the initial weeks of treatment or following dose escalation. According to the UK SmPC, these include:

• Nausea (very common, affecting more than 1 in 10 patients)

• Diarrhoea and constipation (very common)

• Vomiting and abdominal pain (common)

• Decreased appetite and dyspepsia (common)

These symptoms are generally mild to moderate in severity and tend to diminish over time as the body adjusts to the medication. The delayed gastric emptying caused by tirzepatide is a key mechanism contributing to satiety and weight loss but also underlies many of these gastrointestinal effects.

Other notable adverse effects include injection site reactions (redness, itching, or swelling), fatigue, and dizziness. Hypoglycaemia is uncommon when Mounjaro is used alone but may occur when combined with insulin or sulphonylureas. In animal studies, tirzepatide was associated with thyroid C-cell tumours, though the relevance to humans is unknown and this is not listed as an adverse reaction in the UK SmPC. Rare but serious risks include pancreatitis and gallbladder disease.

This is not a complete list of side effects. Patients should read the Patient Information Leaflet provided with their medication and discuss any concerns with their healthcare provider.

When to Seek Medical Advice About Mounjaro Side Effects

While many side effects of Mounjaro are mild and self-limiting, certain symptoms require prompt medical attention. Patients should be educated about red flag signs that warrant urgent evaluation to ensure timely diagnosis and management of potentially serious complications.

Seek immediate medical help (call 999 or go to A&E) if you experience:

• Severe allergic reactions, such as difficulty breathing, swelling of the face or throat, or widespread rash

• Severe, persistent abdominal pain, particularly if radiating to the back, which may indicate pancreatitis

• Severe dehydration with confusion, dizziness when standing, or inability to keep fluids down

Contact your GP urgently or call NHS 111 if you experience:

• Persistent vomiting that prevents you from keeping down fluids for more than 24 hours

• Signs of dehydration, including reduced urination, dark urine, dry mouth, or dizziness

• Symptoms of gallbladder problems, including upper right abdominal pain, fever, or jaundice (yellowing of skin or eyes)

• Visual changes or eye pain, which may suggest diabetic retinopathy complications (particularly if you have pre-existing retinopathy and your blood glucose levels improve rapidly)

Contact your GP or diabetes specialist nurse if:

• Gastrointestinal symptoms (nausea, vomiting, diarrhoea) persist beyond the first few weeks or worsen over time

• You experience recurrent hypoglycaemia (blood glucose below 4 mmol/L), especially if taking other diabetes medications

• You notice unexplained weight loss exceeding expected therapeutic effects

• Side effects significantly impact your quality of life or ability to continue treatment

Regular monitoring is essential for patients on Mounjaro. NICE guidance recommends periodic assessment of glycaemic control (HbA1c), renal function, and weight. Your healthcare team will also review your medication regimen to optimise diabetes management and minimise adverse effects. Never discontinue Mounjaro abruptly without consulting your prescriber, as this may affect glycaemic control.

If you suspect you've experienced a side effect from Mounjaro, you can report it directly to the MHRA through the Yellow Card scheme at yellowcard.mhra.gov.uk or via the Yellow Card app.

Managing Digestive Symptoms While Taking Mounjaro

Gastrointestinal side effects are the most common reason patients struggle with Mounjaro, but several practical strategies can help minimise discomfort and improve tolerability. These approaches focus on dietary modifications, eating behaviours, and lifestyle adjustments that work synergistically with the medication's mechanism of action.

Dietary and eating habit modifications:

• Eat smaller, more frequent meals rather than large portions, as Mounjaro slows gastric emptying and smaller meals are better tolerated

• Chew food thoroughly and eat slowly to reduce the risk of bloating, indigestion, and gastric discomfort

• Avoid high-fat, greasy, or spicy foods, which can exacerbate nausea and delayed gastric emptying

• Limit carbonated beverages, as these may increase bloating and potentially contribute to hiccups or belching

• Stay well hydrated by sipping water throughout the day, particularly important if experiencing vomiting or diarrhoea

• Identify and avoid personal trigger foods that worsen symptoms; keeping a food diary can be helpful

Practical management tips:

• Take Mounjaro at a consistent time each week, ideally when you can rest if nausea occurs

• Consider ginger tea, which some patients find helpful for nausea (discuss with your pharmacist first)

• Remain upright for at least 30 minutes after eating to reduce reflux symptoms

• If constipation occurs, increase dietary fibre gradually and maintain adequate fluid intake

• For persistent nausea, your GP may prescribe anti-emetic medication, though these have important restrictions:

• Metoclopramide should only be used for short-term treatment (maximum 5 days)
• Domperidone has cardiac safety restrictions and is only appropriate for certain patients after careful assessment

Dose titration considerations:

Mounjaro is initiated at a low dose (2.5 mg weekly) and gradually increased every four weeks to minimise side effects. If gastrointestinal symptoms are particularly troublesome, discuss with your prescriber whether delaying dose escalation might be appropriate. Some patients benefit from a slower titration schedule, though this should be individualised based on glycaemic control and symptom severity.

If you experience persistent vomiting or inability to keep fluids down for more than 24 hours, seek medical advice promptly as this may lead to dehydration and acute kidney injury. Your healthcare team can provide personalised advice to optimise both efficacy and tolerability of Mounjaro treatment.

Frequently Asked Questions