Zepbound Side Effects

Written by Kristianne Hannemann, PharmD on Dec 30, 2024.

Generic name: tirzepatide

Important warnings This medicine can cause some serious health issues

Warning: Risk of Thyroid C-Cell Tumors - In rodents, tirzepatide causes thyroid C-cell tumors.

It is unknown whether tirzepatide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of tirzepatide-induced rodent thyroid C-cell tumors has not been determined.

Tirzepatide is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Zepbound (tirzepatide) is a medication commonly prescribed for weight loss and maintaining weight loss long-term in adults with obesity or certain adults who are overweight. While effective, it can cause a range of side effects. This guide will help you understand the potential side effects of Zepbound, both common and serious, and provide tips for managing them. Always consult your healthcare provider if you experience any symptoms that are severe or persistent.

Common side effects

Common side effects of Zepbound are generally mild to moderate and include:

• nausea and vomiting,
• diarrhea,
• constipation,
• stomach pain,
• indigestion,
• injection site reactions,
• fatigue,
• burping, and
• hair loss

These side effects are often manageable with simple lifestyle adjustments and over-the-counter remedies.

Serious side effects

Although less common, Zepbound can also cause more serious side effects that may require immediate medical attention. These include:

• hypoglycemia (especially when combined with insulin or sulfonylureas),
• allergic reactions,
• tachycardia,
• vision changes,
• pancreatitis,
• gallstones, and
• kidney damage.

Additionally, animal studies suggest Zepbound has the potential to cause thyroid cancer, which may lead to lumps in the throat and difficulty swallowing. It's important to be aware of these potential risks and consult your healthcare provider if you experience any severe symptoms.

This page provides detailed information on each side effect, including its frequency, severity, and tips for management, to help you use Zepbound safely and effectively.

Common side effects in more detail

Nausea and vomiting

Nausea and vomiting from Zepbound are common side effects. Nausea occurs in up to 29% of patients, while up to 13% of patients experience vomiting. For most people, the nauseous feeling is mild to moderate. Nausea and vomiting are most common when you first start Zepbound and when you are raising your dose up to the maintenance dose. These side effects should get better with time. If you experience nausea that is severe or persistent, contact your healthcare provider.

Tips for managing nausea and vomiting

• Eat smaller meals
• Avoid greasy foods
• Stay hydrated
• Rest after eating
• Keep upright after a meal
• Try peppermint or ginger

Zepbound reviews for nausea and vomiting

Diarrhea

Diarrhea is another common side effect of Zepbound, with it occurring in up to 23% of patients. For most people, diarrhea is mild to moderate. You may experience frequent, loose, or watery stools after starting Zepbound. This is most common during the first weeks of taking it, and should get better over time.

Tips for managing diarrhea

• Stay hydrated by drinking plenty of fluids
• Avoid spicy or high-fat foods
• Eat smaller meals throughout the day
• Choose bland foods
• Do not consume products with sweeteners ending in “ol” (sorbitol, mannitol, xylitol)
• Consider over-the-counter antidiarrheals after consulting a healthcare provider

Zepbound reviews for diarrhea

Constipation

Zepbound can commonly cause constipation. It occurs in up to 17% of patients. You may have infrequent or difficult bowel movements. It is not clear how long constipation from Zepbound lasts. If you continue to have constipation you should tell your healthcare provider.

Tips for managing constipation

• Choose foods that are high in fiber
• Exercise regularly
• Stay hydrated
• Maintain a regular toilet routine
• Consider over-the-counter remedies after consulting a healthcare provider

Zepbound reviews for constipation

Stomach pain

Another common side effect from Zepbound is stomach pain, with it occurring in up to 10% of patients. You may experience discomfort or cramping in the stomach area. It is most common to experience stomach pain during the first few weeks of treatment with Zepbound. This side effect may get better as your body gets used to the medication. Contact your healthcare provider if stomach symptoms are getting worse or not getting better after some time on Zepbound.

Stomach pain can be a sign of pancreatitis (inflammation of the pancreas), which requires immediate medical attention. Seek medical attention if you have severe stomach pain with or without vomiting.

Tips for managing stomach pain

• Eat smaller meals more frequently throughout the day
• Steam meats and vegetables instead of frying in butter or oil
• Avoid spicy or rich foods
• Consider over-the-counter pain medications after consulting a healthcare provider

Zepbound reviews for stomach pain

Indigestion

Zepbound can cause indigestion. Up to 10% of patients reported experiencing indigestion during clinical trials. You may experience a sensation of having eaten too much food, feel bloated, or have acid reflux. This may happen because Zepbound slows down stomach emptying. These symptoms are common in the beginning of treatment with Zepbound, and may improve as you continue to take the medication. Tell your healthcare provider if your symptoms are very bothersome or are not getting better after a few weeks.

Tips for managing indigestion

• Eat smaller, more frequent meals
• Do not lie down right after eating
• Chew your food slowly and thoroughly
• Wear loose-fitted clothing
• Limit caffeine and alcohol

Zepbound reviews for indigestion

Injection site reactions

Injection site reactions are common from Zepbound. They occur in up to 8% of patients. You may experience redness, itching, bruising, pain, or a rash near the area you inject Zepbound. Tell your healthcare provider if your symptoms seem severe or aren’t improving within a few days.

Tips for managing injection site reactions

• Rotate your injection site each week
• Apply an ice pack to reduce swelling
• Consider over-the-counter pain medications after consulting a healthcare provider

Fatigue

Zepbound can make some people feel more tired or weak. In studies, up to 7% of patients reported fatigue as a side effect. You may have less energy, which might be due to your appetite being lower compared to normal. When you eat less food, you tend to have less energy and feel tired during the day. Consult a healthcare provider if fatigue persists.

Tips for managing fatigue

• Take rest breaks throughout the day
• Maintain a balanced diet
• Drink plenty of fluids to stay hydrated
• Manage stress with relaxation techniques

Zepbound reviews for fatigue

Burping

Burping is another common and mild side effect of Zepbound, with it occurring in up to 5% of patients. Burping is how the body releases excess air from the stomach. While not harmful, it can be bothersome.

Tips for managing burping

• Avoid carbonated beverages
• Eat slowly and chew your food well
• Keep a food diary and avoid trigger foods
• Limit fatty foods, which can slow down digestion
• Do not chew gum

Zepbound reviews for burping

Hair loss

Zepbound can cause hair loss, with it occurring in up to 5% of patients. You may notice more hair in your comb or thinner hair on your head. This may be related to weight loss. Tell your healthcare provider if you think you are experiencing hair loss from Zepbound.

Tips for managing hair loss

• Do not use tight hair bands
• Avoid using harsh chemicals on your hair
• Use gentle hair products
• Minimize heat styling
• Brush your hair gently with a wide-tooth comb
• Maintain a balanced diet

Zepbound reviews for hair loss

Serious side effects in more detail

Hypoglycemia

Hypoglycemia (low blood sugar) from Zepbound is a side effect that is more likely in people with type 2 diabetes when used with insulin or sulfonylureas. Zepbound causes hypoglycemia in 4% of patients with type 2 diabetes. Most cases of hypoglycemia are mild or moderate, but severe cases do happen. 

If you experience symptoms of hypoglycemia (e.g., shakiness, sweating, blurry vision, dizziness), check your blood sugar level. If your blood sugar is low (70 mg/dL or less), take 15 grams of fast-acting carbohydrates. Wait 15 minutes and check your blood sugar level again. Get emergency medical help if you are not responding to fast-acting sugar sources or if your blood sugar level is below 55 mg/dL. Consult your healthcare provider for dose adjustments if needed.

Zepbound reviews for hypoglycemia

Allergic reactions

Severe allergic reactions to Zepbound are rare, occurring in less than 1% of patients. If you experience allergy symptoms such as hives, swelling in your face or throat, or trouble breathing, stop using Zepbound and seek immediate medical attention.

Zepbound reviews for allergic reactions

Tachycardia

Some people who take Zepbound may experience an increase in their heart rate of about 1 to 3 beats per minute. Tachycardia from Zepbound is rare. Monitor your heart rate, avoid stimulants, and consult your healthcare provider if you experience persistent or severe symptoms.

Vision changes

When blood sugar levels improve too quickly, some people with type 2 diabetes experience a temporary worsening of diabetic retinopathy. If this happens, you may notice blurry vision or other changes to your vision. Contact your healthcare provider if you notice any unusual changes in your vision.

Pancreatitis

Pancreatitis from Zepbound is a rare side effect, occurring in less than 1% of patients. Signs of pancreatitis include severe stomach pain and vomiting. Seek immediate medical attention if you experience these symptoms. If you do develop pancreatitis while taking Zepbound, it is not recommended to start the medication again.

Gallstones

Rarely, patients taking Zepbound experience gallstones. Gallstones occur in about 1% of patients taking Zepbound. Contact your healthcare provider for further evaluation if you experience severe abdominal pain, fever, clay-colored stools, or yellowing of your skin or whites of your eyes.

Kidney damage

Some patients taking Zepbound have reported kidney injury and worsening kidney function. Because Zepbound can cause nausea, vomiting, and diarrhea as side effects, you are more likely to become dehydrated. Dehydration can contribute to kidney injury. Make sure to stay hydrated and consult your healthcare provider if you experience symptoms such as swelling or changes in urination.

Frequently asked questions

• Ozempic Side Effects to Watch For
• Zepbound Vs Mounjaro: Complete Comparison Guide for Weight Loss and Diabetes Treatment
• Why am I not losing weight on Mounjaro?
• How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?
• How much is Zepbound with or without insurance?
• Can you get tirzepatide from a compounding pharmacy?
• How long does it take for Zepbound to work?
• How do Zepbound and Wegovy compare?
• Is Zepbound covered by insurance?

Further information

Zepbound side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer