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Mounjaro (tirzepatide) is a once-weekly injection licensed in the UK for treating type 2 diabetes mellitus. As a dual GIP and GLP-1 receptor agonist, it improves blood glucose control and promotes weight loss. Whilst Mounjaro has demonstrated significant clinical benefits, patients may experience side effects, prompting questions about specific symptoms such as vertigo. Understanding whether vertigo is associated with Mounjaro is important for patient safety and informed decision-making. This article examines the evidence regarding vertigo as a potential side effect of Mounjaro, explores common adverse reactions, and provides guidance on managing dizziness or balance disturbances whilst taking this medication.
Quick Answer: Vertigo is not a recognised or common side effect of Mounjaro according to UK regulatory data and clinical trials.
Mounjaro (tirzepatide) is a prescription medicine licensed in the UK for the treatment of type 2 diabetes mellitus. It is administered as a once-weekly subcutaneous injection and represents a novel class of medication known as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.
The mechanism of action of tirzepatide involves activating both GIP and GLP-1 receptors, which are naturally occurring incretin hormones. By stimulating these receptors, Mounjaro enhances insulin secretion in a glucose-dependent manner, meaning insulin is released primarily when blood glucose levels are elevated. This reduces the risk of hypoglycaemia compared to some other diabetes medications. Additionally, tirzepatide suppresses glucagon secretion (a hormone that raises blood glucose), slows gastric emptying, and promotes satiety through central appetite regulation.
These combined effects lead to improved glycaemic control in people with type 2 diabetes and significant weight reduction. Clinical trials have demonstrated that Mounjaro can reduce HbA1c levels substantially and produce weight loss in patients with type 2 diabetes. The Medicines and Healthcare products Regulatory Agency (MHRA) approved Mounjaro for type 2 diabetes in September 2022, and the National Institute for Health and Care Excellence (NICE) has issued guidance on its use within the NHS (Technology Appraisal 857).
It is important to note that in the UK, tirzepatide for weight management is available under a separate brand name (Zepbound).
Key points about Mounjaro:
Dual GIP/GLP-1 receptor agonist
Once-weekly subcutaneous injection
Improves blood glucose control and promotes weight loss
Available on NHS prescription under specific criteria
May affect the absorption of oral medications, including oral contraceptives, due to delayed gastric emptying
Vertigo — the sensation that you or your surroundings are spinning — is not listed as a recognised or common side effect of Mounjaro in the official Summary of Product Characteristics (SmPC) approved by the MHRA or in data from pivotal clinical trials. There is no established pharmacological mechanism by which tirzepatide would directly cause true vertigo, which typically arises from disturbances in the vestibular system of the inner ear or central nervous system pathways.
However, patients taking Mounjaro may experience dizziness, which is distinct from vertigo but can sometimes be confused with it. Dizziness associated with Mounjaro may be attributed to secondary effects such as dehydration, reduced caloric intake, rapid weight loss, or changes in blood pressure. The medication's effect on gastric emptying and appetite can lead to decreased fluid and food consumption, potentially resulting in orthostatic hypotension (a drop in blood pressure upon standing) or volume depletion, both of which may manifest as light-headedness or dizziness. Additionally, hypoglycaemia, which can occur particularly when Mounjaro is used with insulin or sulfonylureas, is an important differential diagnosis for dizziness in people with diabetes.
It is important to differentiate between true vertigo and general dizziness when reporting symptoms to healthcare professionals. True vertigo involves a rotational sensation and is often accompanied by nausea, vomiting, and balance difficulties. Dizziness may present as light-headedness, unsteadiness, or a feeling of faintness without the spinning sensation.
If you experience symptoms you describe as vertigo while taking Mounjaro, it is essential to discuss this with your GP or diabetes specialist. They can assess whether the symptoms are related to the medication, an underlying condition, or another cause entirely.
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The most frequently reported side effects of Mounjaro are gastrointestinal in nature, reflecting the medication's mechanism of slowing gastric emptying and affecting gut motility. According to the UK SmPC, these effects are generally mild to moderate in severity and tend to diminish over time as the body adjusts to treatment.
Very common side effects (affecting more than 1 in 10 people) include:
Nausea — often most pronounced when initiating treatment or increasing the dose
Diarrhoea — may be transient and typically improves with continued use
Decreased appetite — a therapeutic effect but may lead to inadequate nutrition if extreme
Common side effects (affecting up to 1 in 10 people) include:
Vomiting — can contribute to dehydration if severe or persistent
Constipation — may occur as part of gastrointestinal effects
Abdominal pain or discomfort — usually mild and self-limiting
Dyspepsia (indigestion)
Fatigue — may relate to reduced caloric intake or metabolic changes
Injection site reactions — redness, itching, or swelling at the injection site
Hypoglycaemia — particularly when Mounjaro is used in combination with insulin or sulfonylureas
To minimise gastrointestinal side effects, the SmPC recommends starting at the lowest dose (2.5 mg weekly) and gradually titrating upwards every four weeks. Patients should be advised to eat smaller, more frequent meals, stay well hydrated, and avoid high-fat foods that may exacerbate nausea.
Serious but less common side effects requiring immediate medical attention include:
Pancreatitis — severe, persistent abdominal pain, sometimes radiating to the back
Gallbladder disease — including cholelithiasis (gallstones) and cholecystitis (gallbladder inflammation)
Dehydration — which may lead to acute kidney injury in severe cases
Diabetic retinopathy complications — particularly in patients with pre-existing retinopathy experiencing rapid improvement in blood glucose control
Severe allergic reactions — though rare, these require immediate medical attention
The SmPC also notes that tirzepatide may reduce the absorption of oral medications due to delayed gastric emptying. This is particularly relevant for women taking oral contraceptives, who may need to consider additional contraceptive methods during initiation and dose escalation periods.
If you develop dizziness or symptoms you interpret as vertigo whilst taking Mounjaro, it is important to take appropriate steps to ensure your safety and determine the underlying cause.
Immediate self-care measures:
Sit or lie down if you feel dizzy to prevent falls or injury
Ensure adequate hydration — drink water regularly throughout the day, particularly if you have experienced nausea, vomiting, or diarrhoea
Monitor your blood pressure if you have access to a home monitor, especially when moving from sitting to standing
Check your blood glucose if you have diabetes, as hypoglycaemia can cause dizziness
Avoid sudden position changes — rise slowly from sitting or lying positions to minimise orthostatic symptoms
Do not drive or operate machinery while experiencing dizziness or vertigo
When to contact your GP or diabetes specialist:
Dizziness is severe, persistent, or worsening
You experience true vertigo with a spinning sensation, especially if accompanied by hearing changes or tinnitus
You have signs of dehydration (dark urine, dry mouth, reduced urination)
You experience fainting episodes or near-syncope
Symptoms interfere with daily activities or safety
Seek emergency care (call 999 or go to A&E) if you experience:
Sudden, severe headache
Facial drooping, arm weakness, or speech difficulties (possible stroke symptoms)
New focal neurological symptoms (such as numbness, weakness, or visual disturbances)
Chest pain or palpitations
Severe, continuous vomiting or signs of severe dehydration
Severe abdominal pain (which could indicate pancreatitis—in this case, stop taking Mounjaro and seek urgent medical attention)
Your healthcare professional may review your medication regimen, assess for drug interactions, check your blood pressure and glucose levels, and evaluate for other causes of dizziness unrelated to Mounjaro. They may adjust your dose, provide additional supportive measures, or refer you for specialist assessment if vertigo symptoms suggest an inner ear or neurological condition.
Report suspected side effects through the MHRA Yellow Card scheme (available online or via the Yellow Card app), which helps regulatory authorities monitor medication safety across the UK population.
Yes, patients taking Mounjaro may experience dizziness due to dehydration, reduced caloric intake, or orthostatic hypotension (blood pressure drops upon standing). This differs from true vertigo, which involves a spinning sensation and typically arises from inner ear or neurological disturbances.
The most common side effects are gastrointestinal, including nausea, diarrhoea, and decreased appetite, affecting more than 1 in 10 people. These effects are generally mild to moderate and tend to diminish as the body adjusts to treatment.
Contact your GP if dizziness is severe, persistent, or worsening, or if you experience fainting, signs of dehydration, or symptoms interfering with daily activities. Seek emergency care immediately if you develop sudden severe headache, stroke symptoms, chest pain, or severe abdominal pain.
All medical content on this blog is created based on reputable, evidence-based sources and reviewed regularly for accuracy and relevance. While we strive to keep content up to date with the latest research and clinical guidelines, it is intended for general informational purposes only.
DisclaimerThis content is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any medical questions or concerns. Use of the information is at your own risk, and we are not responsible for any consequences resulting from its use.
