Side effects on 2.5mg Mounjaro - what to do now?

[Junmaro]

I took my first injection of 2.5mg of Mounjaro last Monday. For the first few days things were brilliant, the suppression was spot on and food noise gone et cetera. Around four days in, I had an awful night with terrible stomach cramps and nausea which I found really upsetting. Since that first difficult night, the symptoms have abated but are not fully gone.

I’m now trying to work out what to do next. I really felt that the medication worked for me, but at the expense of being miserable. I’m fearful of putting myself through that all again.

If you had similar side-effects on 2.5 mg, what did you do? And how did it pan out?

Unfortunately you're just going to have to push through it or start at a much lower dose such as 1.5mg until your body gets used to it.

I've been on MJ since last May and now micro dose for maintenance but never managed to get past 3.75mg as the side effects were dreadful.

Keep a food diary, it may be that certain things trigger symptoms but others don’t. Lots of people find they struggle with fatty/spicy/surgary foods but not with other foods. I know I have to be mindful about carbs, too many and I get bad constipation!

Firstly make sure your diet aligns with the drug. Everyone is different but certain foods can generally set people off - high sugar, high fat, high salt, alcohol, artificial ingredients. Additionally, for some foods like legumes or pulses that ferment in the gut can cause pain.

So make sure you’re eating whole foods - fruit and vegetables, carcass meat (rather than processed meat), fish, dairy and whole grains.

@Sallycinnamum can I ask how you micro dose for 3.25? I would like to try something similar like 2.5mg on a Sunday and a 1.25 on a Friday maybe but can’t figure out how many ‘clicks’ to get a 1.25mg dose on a 5mg pen 🖊️

They are very common side effects when initiating treatment. This early on I would speak to your pharmacist about how to best manage them until your body adapts to the medication before starting to mess about with partial dosing.

Watch what/how you are eating for triggers, ask them about anti sickness meds.

What did you eat and drink first few days.Fatty foods and alcohol can cause upset stomach.

You also have to get the right balance of fibre and water. Not enough fibre (as well as too much fibre and not enough water) can lead to things getting backed up, which then ferments in digestive system and later releases dramatically.

So you need to do things to make sure you don’t get backed up.

drinking lots of water
eating slowly and smaller meals
getting enough fibre
not eating fatty foods or lots of alcohol.

I take supplements that are designed to be used with GLP. They have an ingredient that tackles sulphur burps, and have soluble fibre.
I also take magnesium citrate which helps keep things moving.

I would definitely persist for a couple more weeks and see how you get on.
If you had a good first few days, I’d say it was probably something you ate. Something high in fat, spicy? I can’t eat things like that now without it going straight through me ( sorry ) so no more takeaway pizza and Nando’s did not agree with me either!

Be careful of the social media armchair pharmacists, partial dosing to the usual schedule is fair enough and is reasonably low risk when you understand the pen/clicks/take care etc, but changing the frequency of dosing is different.

@katcha16 I microdose 2.5mg from a 5mg pen every 8/9 days using a clicks chart I found on the web.

A 5mg pen roughly lasts me 8 weeks. Hope that makes sense.

@katcha16 monj.co.uk/monj-mounjaro-click-chart/

At the OP I would drop down to 1.25 for a few weeks (just do 30 clicks instead of 60). I did 5 or 6 weeks on 1.25, still lost weight, and was then fine when I went up to 2.5.

I suffered with similar side effects @Junmaro, although mine kicked in on day 1. I felt absolutely awful for the whole of the first week, to the point where I was dreading my second jab, but thankfully week 2 was much better, I felt almost normal again. I'm now on day 2 of week 3 and all good. I lost weight throughout and it spurred me on. Don't give up yet, hang on in there and keep drinking the water!

I had horrible diarrhoea 3 days after taking my first dose. I didn’t get it again until I moved up to 5mg but again just on the first week. Fingers crossed your body will be more used to it going forwards.

@WeAllHaveWings@Sallycinnamum@PearlsTeapotthank you all!

Honestly, I wouldn’t start messing about with dosing and timing this early on, after just one jab. I’m not unsympathetic, it’s horrible to feel like that but what you describe is so common in the first few weeks it’s probably more uncommon to feel ok. I’d speak to your provider about symptom management, make sure you stay well hydrated, focus on plain protein rich food and rest when you can. And don’t be tempted to rush up the doses, let your body fully adjust.

It’s more likely related to what you’ve eaten if you had no side effects within the first 4 days when the drug is at it’s strongest in your system.

You do need to eat carefully on MJ and focus on high protein, low carb foods so include lots of salad and veg and you should really avoid carb heavy, fatty and highly processed foods as these can cause digestive issues.