Tirzepatide Side Effects and Drug Interactions
Tirzepatide Side Effects and Drug Interactions
Table of Contents
Tirzepatide is a promising new medication for treating type 2 diabetes and promoting weight loss. However, some people may experience temporary side effects when first starting the drug or increasing the dosage. The good news is these side effects are usually short-lived and will subside over time as your body adjusts to the medication.
In this article, we will explore common and serious side effects of tirzepatide and how to manage them. We will also discuss important drug interactions to be aware of if taking tirzepatide.
Nausea
Nausea is one of the most frequently reported side effects of tirzepatide. During clinical trials, around 29% of people taking the 10 mg dose experienced nausea. For most people, nausea occurred when they first started taking tirzepatide or after a dose increase. The good news is that nausea tends to go away within a few weeks as the body adjusts to the medication. 1
If you feel nauseated while taking tirzepatide, there are several things you can do to help manage the symptoms:
- Eat smaller, more frequent meals throughout the day rather than three large meals.
- Sip on cold drinks like water, iced tea, or ginger ale.
- Avoid foods that are greasy, fried, or very sweet.
- Try eating or drinking ginger, which is known to help with nausea. Ginger ale, ginger tea, or ginger biscuits are easy options.
- Get some fresh air. A short walk outside can help if you feel nauseated. 2
The nausea side effect of tirzepatide often improves with time. 1 But if you follow these tips, you can minimize discomfort until your body adjusts to the medication.
Diarrhea
Diarrhea is the second most common side effect of tirzepatide reported in clinical trials. 1 The incidence of diarrhea increased in a dose-dependent manner, occurring in:
- 19% of participants taking tirzepatide 5 mg
- 21% of participants taking tirzepatide 10 mg
- 23% of participants taking tirzepatide 15 mg 1
This side effect typically arises when starting tirzepatide or increasing the dose. Fortunately, diarrhea tends to diminish over time as the body adjusts to the medication. 1
If diarrhea persists for more than a couple of days, contact your doctor. Prolonged diarrhea can lead to dehydration and electrolyte imbalance if left untreated. 3 To manage diarrhea and prevent dehydration, be sure to:
- Drink plenty of water and other clear fluids throughout the day.
- Eat water-rich foods such as soups and broths.
- Follow the BRAT diet by consuming bland, easy-to-digest foods like bananas, rice, applesauce, and toast. 3
Constipation
During clinical trials, constipation was the third most common side effect reported. 1
Tirzepatide can cause constipation by slowing the movement of food through the digestive tract. This can lead to harder, more difficult-to-pass stools. Fortunately, constipation resulting from tirzepatide tends to be temporary, going away over time as your body adjusts to the medication. 1
If you have less than three bowel movements in a week, you may be constipated. 4 If tirzepatide is causing constipation, try these recommendations:
- Stay hydrated by drinking water and consuming water-rich foods.
- Use a stool softener to make stools easier to pass
- Consume foods rich in insoluble fiber, such as wheat bran, whole grains, and vegetables 4
Burping
Tirzepatide works by slowing the movement of food through the digestive tract. While this effect helps promote the feeling of fullness and reduces appetite, it can also lead to increased burping in some cases. Clinical trials found that about 9% of people taking tirzepatide experienced frequent or unpleasant burping. 1
This burping is usually caused by excess gas in the stomach, such as hydrogen sulfide, that builds up as food is digested more slowly. The gas can lead to foul-smelling burps or excessive burping. 1 If you experience this side effect while taking tirzepatide, try the following tips to reduce burping:
- Stay hydrated
- Avoid alcohol and fizzy drinks
- Take activated charcoal tabs, which may decrease the odor from burps
- Take medications containing simethicone, such as Gas-X 5
Hair Loss
When you lose a substantial amount of weight in a short period of time, it is common to lose more hair than normal. This is why some people taking tirzepatide report hair shedding as they undergo weight loss treatment. 1
Fortunately, hair loss associated with quick weight loss is usually temporary. You will go back to the normal amount of hair shedding once your body adjust to your new weight. 1
Kidney Disease
The gastrointestinal side effects of tirzepatide, including nausea, vomiting, and diarrhea, can lead to dehydration if severe enough. Dehydration stresses the kidneys and may result in acute kidney injury, even in those without pre-existing kidney disease. Though rare, some cases of acute kidney injury have been reported in people taking tirzepatide and other GLP-1 receptor agonists. 1
Before starting tirzepatide, inform your doctor if you have any history of kidney problems. Also, let your doctor know if you experience any of the following symptoms while taking tirzepatide:
- Urinating less frequently
- Swelling in legs, ankles, or feet
- Shortness of breath
- High blood pressure
- Nausea
- Chest pain 6
Gallbladder Disease
A small percentage of participants in the clinical trials experienced gallbladder-related side effects:
- 1% of participants experienced gallstones
- 7% of participants experienced inflammation of their gallbladder 1
If you experience any of the following symptoms, contact your doctor immediately to get evaluated for gallbladder disease:
- Sharp stomach pain that does not go away
- Vomiting
- Sweating
- Nausea
- Dark urine
- Light stools
- Rapid heartbeat 7
Pancreatitis
In rare cases, tirzepatide can cause inflammation of the pancreas (known as pancreatitis). In clinical trials, only 0.2% of participants experienced this side effect. 1
If you experience any of the following symptoms of pancreatitis, contact your healthcare provider immediately:
- Severe abdominal pain that can radiate to the back
- Vomiting 1
If your doctor suspects that you have pancreatitis, they will discontinue tirzepatide immediately and start treatment. 1
Thyroid Tumors
Animal studies have raised concerns about tirzepatide and thyroid tumors. Rats that were treated with tirzepatide developed thyroid C-cell tumors. However, it is unclear if this finding also applies to humans. As a precaution, the FDA has placed a serious boxed warning about this risk on the tirzepatide label. 1
Due to this warning, your doctor will not prescribe tirzepatide if you have a personal or family history of:
- Medullary thyroid carcinoma (MTC)
- Multiple endocrine neoplasia syndrome type 2 (MEN 2) 1
If you are taking tirzepatide, it is important to stay aware of potential symptoms of thyroid cancer. These symptoms include:
- Trouble breathing
- Hoarse voice
- Lump or swelling in your neck
- Shortness of breath 1
Drug Interactions
When starting a new medication, it is important to let your doctor know of all other medications you are taking. Certain drugs can interact with each other, potentially reducing effectiveness or causing side effects.
Tirzepatide has a few drug interactions to be aware of:
- Insulin: Both tirzepatide and insulin lower blood sugar levels. Using them together amplifies this effect, which could lead to dangerously low blood pressure or hypoglycemia. Your doctor may reduce your insulin dosage when starting tirzepatide to prevent this.
- Oral medications: Tirzepatide slows stomach emptying, which can impact the absorption of oral drugs. Your doctor will monitor the effectiveness of any oral medications you take with tirzepatide.
- Oral birth control: The delayed stomach emptying caused by tirzepatide may prevent oral birth control pills from being properly absorbed. This could lead to an unintended pregnancy. To prevent this, your doctor may recommend switching to a non-oral contraceptive method for the first four weeks after starting tirzepatide or increasing your dosage. 1
Conclusion
Like any medication, tirzepatide may cause some unpleasant side effects in certain individuals. However, the good news is that most of these side effects are temporary and can often be managed through simple lifestyle adjustments.
That said, you should consult your doctor right away if any side effects become severe or you experience symptoms that concern you. While rare, tirzepatide may potentially lead to serious adverse events that require medical management.
References
- FDA Zepbound
- NHS Feeling sick (nausea)
- Rosewell Park Comprehensive Cancer Center Managing diarrhea and preventing dehydration
- NHS Constipation symptoms and treatments
- HealthLink BC Gas, Bloating, and Burping
- National Kidney Foundation Acute kidney injury (AKI)
- Johns Hopkins Medicine Gallbladder disease