Oral tirzepatide: Is there a pill version of Mounjaro?

Key Points

• No FDA-approved oral tirzepatide currently exists; these compounded versions were discontinued after March 19, 2025
• Oral alternatives for type 2 diabetes include Rybelsus (oral semaglutide), metformin, and other types of diabetes drugs
• Injectable tirzepatide combined with diet and exercise showed average weight loss up to 22.5%, but people lost an extra 21% with diet and exercise
• Always consult your doctor before making any changes to your diabetes medications

Tirzepatide drugs like Mounjaro and Zepbound are rapidly becoming household names.

This comes as no surprise, as the meds help many people achieve significant weight loss and lower blood sugar levels. They are also in high demand because they reduce appetite and help you feel full faster.

However, these drugs are available as injectables, and let's face it, needles can be intimidating. Plus, injectable medications must be refrigerated and can be hard to travel with. In general, they’re also more expensive than pills.

It’s natural to wonder if an oral version of tirzepatide is available. Let’s take a closer look at your options.

How does tirzepatide work?

Registered Dietitian, Lyla Joffe, RD, explains, “Tirzepatide is an agonist of GLP-1 and GIP. An agonist is like a key that fits into a lock and opens that lock. It unlocks and stimulates GLP-1 and GIP. GLP-1 is a hormone that tells your body to stop eating and stimulates insulin to process blood sugar. GIP helps to regulate blood sugar after eating. These two work together to facilitate stable blood sugar and weight loss.”

In clinical trials, people lost an average of 16% of their body weight on a 5 mg dose of tirzepatide, 21.4% on 10 mg, and 22.5% on 15 mg.

Is there an oral tirzepatide?

Currently, there is no FDA-approved oral tirzepatide. Some pharmacies previously sold compounded versions of oral tirzepatide that dissolved when placed under the tongue (sub-lingual). This drug delivery system is designed to help the medication enter the bloodstream through the muscles of the tongue.

A compounded drug is a DIY version of an approved medication that the FDA permits during drug shortages. So, in 2022-2024, when there was a nationwide tirzepatide shortage, compounded versions of Mounjaro and Zepbound were allowed.

However, in October 2024, the FDA declared the tirzepatide drug shortage over, so no compounded tirzepatide could be sold after March 19, 2025.

Why did the FDA stop sales of compounded tirzepatide?

The FDA stopped pharmacies from selling compounded tirzepatide after confirming that the manufacturer of Mounjaro and Zepbound could meet the rising demand for the drug.

While this may have disappointed some users, the FDA's decision was driven by safety concerns.

Risks of compounded tirzepaide:

There are risks associated with using compounded tirzepatide, including:

• There are no clinical trials that study how well oral tirzepatide works; all we have is anecdotal evidence from individual users on social media platforms
• Unlike medications authorized by the FDA, compounded versions are not regulated. This means they are not under the same scrutiny as FDA-approved drugs to maintain quality, regulatory, and safety standards
• The FDA received several complaints of adverse events from compounded tirzepatide (over 300 as of February 28, 2025). The agency also notes that this number may be underreported and, in reality, could be much higher

Since oral tirzepatide is not available anymore, options to manage type 2 diabetes include injectable tirzepatide (Mounjaro), Ozempic (injectable semaglutide), or other oral diabetes medications.

Potential oral tirzepatide alternatives

If you prefer oral diabetes medications and no longer have access to oral tirzepatide, there are a few options you could explore with your doctor.

Please note that this content is merely educational about common medications for type 2 diabetes. Always discuss your medication with a healthcare provider.

1. Rybelsus (oral semaglutide)

A close cousin to tirzepatide is another GLP-1 agonist, semaglutide, available in an oral form as Rybelsus. The drug is FDA-approved to treat type 2 diabetes in adults.

While tirzepatide is a dual-action medication (targeting GLP-1 and GIP), semaglutide mimics one hormone, GLP-1, which regulates appetite, slows digestion, and triggers insulin release.

Blood sugar control: In one study, Rybelsus lowered A1C levels by an average of 1% at a dose of 7 mg and 1.3% at 14 mg in 6 months.

For weight loss: Although Rybelsus is not approved as a weight loss drug, some providers may prescribe it off-label. In trials, people with an average weight of 200 pounds lost about 5 pounds on 7 mg of Rybelsus and 7 pounds on 14 mg.

2. Metformin (Glucophage, Glucophage XR, Fortamet)

Metformin (biguanide) is the granddaddy of diabetes medications. It’s been used in Europe since the 1950s and was approved in the United States in the 1990s. It is commonly prescribed, well-studied, and quite cost-effective, with generic versions available.

Metformin is an oral pill available in standard and extended-release versions.

While Rybelsus is only approved for use in adults, metformin can be used to treat diabetes in children 10 and older.

3. Alpha-glucosidase inhibitors (Glyset)

Alpha-glucosidase inhibitors work by preventing the breakdown of starches and some sugars. Starches like potatoes, rice, bread, pasta, and cereals raise blood sugar levels compared to proteins and fat, so inhibiting their breakdown can help stabilize blood sugar levels.

4. DPP-4 inhibitors (Januvia, Nesina, Onglyza, and Tradjenta)

DPP-4 inhibitors prevent the hormone, GLP-1, from breaking down in the body. GLP-1 is key in slowing digestion, reducing appetite, and stimulating insulin release. So, by delaying its breakdown, GLP-1 stays in your body longer, helping lower blood sugar levels.

5. Meglitinides (Starlix, Prandin)

Meglitinides stimulate the pancreas to release insulin, so taking the drug right before a meal can trigger insulin to be released into the bloodstream to process sugar in the blood.

6. SGLT-2 inhibitors (Jardiance, Farxiga, Invokana)

SGLT-2 inhibitors prevent the kidneys from reabsorbing glucose and eliminate this excess glucose in urine. This way, they help lower postprandial glucose (sugar levels after eating). These medications can lead to weight loss and lower blood pressure levels as well.

Important: This list of oral diabetes medications is not exhaustive and is not meant to guide medical decisions. Please consult a healthcare provider to learn about diabetes medications and what may be right for you.

Managing diabetes on tirzepatide

Managing diabetes is more than taking medication; following a diabetes-friendly diet is extremely important to control blood sugar levels and lose weight on tirzepatide or other diabetes drugs.

This is evident even in tirzepatide clinical trials. People lost an average of up to 22.5% of their body weight, but when they also followed a nutritious diet and exercised, they lost an extra 21.1% in just three months.

However, achieving these results is not always easy when you’re on tirzepatide.

When you’re taking Mounjaro or Zepbound (the injectable form of tirzepatide), getting the nutrition you need can be hard when you don’t have much appetite. Plus, you may be battling common side effects of tirzepatide, like GI upset (stomach upset), nausea, vomiting, stomach pain, and diarrhea.

While these side effects may feel daunting, there are strategies to help manage them effectively.

According to Joffe, RD, “GI upset is common on tirzepatide. However, protein is essential to avoid muscle wasting. So, easily-tolerated protein sources like protein smoothies, scrambled eggs, yogurt, and cottage cheese bowls are recommended. Aim for small and frequent meals. Prioritize hydration. Avoid GI upset triggers like alcohol, sugar, and greasy/fried foods.”

But how do you plan your meals to get the proper amounts of protein, carbohydrates, and fats? How do you time your meals to minimize side effects? How do you find the best diabetes diet for your body?

You do not have to navigate it alone.

Get a personalized diabetes diet made by a registered dietitian covered by insurance.

Frequently Asked Questions (FAQs)

1. How effective is oral tirzepatide?

Oral tirzepatide is not FDA-approved, and there are no clinical trials to tell us how effective oral tirzepatide is. There are claims from certain websites on how effective oral tirzepatide is, but they are not based on clinical research. There is also anecdotal evidence from individuals online who share their experience with compounded oral tirzepatide.

2. Is oral tirzepatide FDA-approved?

Oral tirzepatide is not FDA-approved. A few years ago, when there was a tirzepatide shortage, the FDA allowed pharmacies to make their versions of the drug (compounded tirzepatide). And some pharmacies made oral tirzepatide that dissolved under the tongue (sublingual). However, compounded oral tirzepatide has not been available since March 19, 2025.

3. Tirzepatide vs. semaglutide: What’s better for weight loss?

A study of over 18,000 participants found that tirzepatide led to greater weight loss and improved blood sugar levels compared to semaglutide. 

Get your personalized tirzepatide diet plan. Find a registered dietitian covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.