Mounjaro - advice on vomiting/upset stomach

[WhamBhamThankYouMham]

Completed 4 weeks of Mounjaro on 2.5mg with no side effects. Moved up to 5mg last Thursday and from Monday this week have had on and off diarrhoea and vomiting.

I have IBS so the diarrhoea doesn't really worry me as I am so used to it but I have never really been a vomiter!

I have altered my diet since the beginning so am not eating anything fatty or processed. For example yesterday was:

Scrambled egg/smoked salmon
Protein shake made with oat milk
Plain chicken stir fry with a v small portion of noodles (no sauce)
Apple

I was really violently sick again this morning. Peppermint tea which usually takes away any nausea I have ever felt (pre-Mounjaro) hasn't really done anything.

What tips have worked for others? And at what point does vomiting/diarrhoea become problematic enough that I should just assume the jabs are not for me?

I just stopped taking it. You could titrate down to 2.5 again I suppose? But for me I figured it wasn't suiting my biology, and I couldn't live like that (in my case the side effects were panic attacks and pounding heart).

@VoyOySaveloy Fair enough - the thing is it has already been pretty transformational for me so I don't want to give up too soon. As a peri-menopausal 49 year old, I feel like this is my best shot at shedding a significant amount of weight. My starting BMI was 45...

My thoughts were, that there are ways of losing weight that don't involve literal waves of fear coursing through me (or in your case, vomiting and feeling like shit). I had hoped for the transformation you talk of after 40+ years of owning an unacceptable body.

I guess it has to be your decision. Only you can decide if you are prepared to put up with the side effects? The issue that made me make my decision was viewing how it doesn't just boost you back to where you were; it boosts you higher each injection so I couldn't really see side effects diminishing enough.

That sucked I feel for you. Good news it will pass. The jump to 5 is the hardest because you are doubling your dose. Can be a bit of a shock, but it does settle down.

For now drink water preferably with electrolytes if you have them. Wait until you are properly hungry to eat, and then eat lightly and slowly. Stop well before you are full.

Diarrhea isn't an unusual side effect but vomiting repeatedly is. I would strongly urge you speak to your prescriber in the first instance as they have responsibility to oversee your treatment and can advise much better than annonymous randoms on social media, who don't have medical training or a full picture of your medical history. Failing this, speak to your doctor. Please!

Thanks @KrankyKumquat - I am doing that as well - I agree that I don't want to just rely on online advice but was just interested in others experience. Probably took me by surprise more as I had zero side effects in the first for weeks.

I understand, didn't mean to assume but what you described sounds way beyond the norm and I worried for you (I feel a bit bilious most of the time but nowhere near actually up chucking!). Good luck and I hope your prescriber/GP gives you some good advice and you start to feel better soon.

I had side effects going up to 7.5. It took a week to settle.

Vomiting isn't an unusual side effect, I just wanted to say. If you are vomiting a lot, that may be different.
I've vomited once a week since titrating to 5mg 3 weeks ago, and this week (well, last night, actually) I had a second session. In my case, the need to vomit has come on quickly, and while spectacular (aka projectile) at the time, I've felt hugely better immediately afterwards.
When I was on the lowest dose, I was getting a lot of acid reflux, but this has now largely gone. At night I usually take some Gaviscon (or similar) as a precaution. I'm still trying to work out how to overcome the vomiting, but on the positive side I no longer feel nauseous all the time, which was how it was at the outset.
The way this drug works is quite remarkable and it's not unreasonable to expect that our bodies take a while to adjust to it.

I was vomiting going from 2.5 to 5 but I had the runs. It only lasted a day and the next dose was fine. A friend said this is the only time your are doubling your dose which is true. I'd do 4mg next week and see how that goes. If it's OK do 5 the week after.

Also smoked salmon might have been to oily at the time you went up. So personally I'd avoid that near injection day for a while. I find the day after I inject and the day after that I can't eat much at all. I don't feel sick anymore.

What was in the protein shake? Is it something you’d normally have? The ones you can buy give me a dodgy stomach, I know you said nothing processed, just wondered if it could be the culprit?

Yes, that thought had also occurred to me. For the body, it's a big change. It isn't putting me off as the advantages to me could be immense (I'm Type 2 diabetic and have never found weight loss easy, no matter what I've tried). A huge benefit that deserves more credit is how, unlike dieting or other weight loss methods, with Mounjaro you are not obsessing about food - rather the reverse. I was never a big eater, but having now a total disinterest in food thanks to all 'food noise' being switched off, I'm having to MAKE myself eat.😂

Smoked salmon or stir fry too oily

What was the reason for moving up if 2.5mg was working well? You don't have to rush through the doses. I am presuming you were loosing weight on 2.5 as you said after it was transformational and if that is the case, I would drop back down to 2.5mg for your next dose if you have satiety and are loosing weight (30 clicks from a 5mg pen). Then try again in a few weeks, maybe going to 3.75mg first (45 clicks from a 5mg pen).

In the meantime, ginger lozenges, pepto bismol and alka seltza all help me when I am nauseous.

I felt nauseas, very nauseous, for the first two weeks on 5mg, for about 4 days each time, less the second week, third I was fine. I suspect one of two potential culprits, the salmon or the oat milk.

see how it goes op. A lot of folks struggle thr first couple of weeks on 5, it’s the first and lowest therapeutic dose. Unless it doesn’t resolve I’d keep on to be honest, but cut out thr milk and fatty food.

I didn’t have nausea, but did struggle to eat properly with the step up to 5mg. If it was working well for you on 2.5mg then I’d go back down to 2.5mg or 3.75mg (30 to 45 clicks if you have a 5mg pen). 3.75 is working well for me. You can go up slowly later if you need to.

Have you thought about doing 3.75 dose? I had a different set of side effects and my prescriber recommended an off shelf dose that really helped me.