By Maxwell Horowitz, DO, MS
In August 2026, the FDA approved a new use for Mounjaro (tirzepatide). In addition to helping control blood sugar in adults with type 2 diabetes, Mounjaro is now approved to lower the risk of major adverse cardiovascular events (MACE) in adults with type 2 diabetes who are at high risk for these problems.
The term MACE covers three serious heart- and blood-vessel problems: death from a heart-related cause, a non-fatal heart attack, and a non-fatal stroke. Lowering the chance of these events is important because people with type 2 diabetes have a higher-than-average risk of heart disease and stroke.
The approval was based on a large, multi-year study (called SURPASS-CVOT) in people with type 2 diabetes and existing heart or blood-vessel disease. Over about four years, Mounjaro was at least as effective as another proven diabetes medicine (dulaglutide or Trulicity) at protecting the heart, and it also lowered the overall risk of death. Earlier research showed Mounjaro can improve weight, blood pressure, cholesterol, and blood sugar, all of which can affect heart health.
This new use is for adults with type 2 diabetes who are at high risk for heart attack, stroke, or heart-related death, often because they already have heart or blood-vessel disease. Mounjaro is given as an injection under the skin once a week, on any day and at any time, with or without food. It is started at the low dose of 2.5mg weekly, and uptitrated by 2.5mg at least every 4 weeks to identify the most effective and tolerable dose for each individual (maximum dose 15mg weekly).