Drug Interaction Report

Tirzepatide can cause an increase in heart rate and may have additive effects with other medications that can also increase heart rate such as caffeine. There are times when an elevated heart rate is appropriate, like when you are exercising. However, you should contact your doctor if you notice that your heart rate is high at other times for unknown reasons or if it is occurring frequently. Signs and symptoms of an elevated heart rate may include a sensation of a racing or pounding heartbeat, chest pain, shortness of breath, or a heart rate greater than 100 beats per minute in an adult. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Tirzepatide may affect the absorption of oral medications, as it can delay the emptying of stomach content into the intestines. This may impact blood levels and/or the time that it takes for dihydrocodeine to become most effective, if dihydrocodeine is being administered by mouth or directly into the stomach via a feeding tube. These effects are most apparent at the start of treatment with tirzepatide or after a dose increase and tend to diminish the longer that you are on a stable regimen of tirzepatide. Contact your doctor if you have any questions or notice a change in how any of your oral medications are working. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Ask your doctor before using acetaminophen together with ethanol (alcohol). This can cause serious side effects that affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Tirzepatide may affect the absorption of other medications that you take by mouth. In some cases, this may affect how well and/or how fast those medications work, or it may make no difference. Talk to a healthcare provider if you have any questions or concerns, and contact your doctor if your symptoms worsen or your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

Information for this minor interaction is available on the professional version.