Zepbound (tirzepatide) is a prescription drug that’s used for weight loss in certain people. Zepbound can cause side effects that range from mild to serious. Examples include nausea, diarrhea, and constipation.
Zepbound is prescribed to help with weight loss and long-term weight management. It’s used along with a reduced-calorie diet and increased exercise in adults who have either:
- a body mass index (BMI) of 30 or higher (obesity)
- a BMI of 27 or higher and a weight-related health condition, such as type 2 diabetes, high cholesterol, heart disease, high blood pressure, or obstructive sleep apnea
The active ingredient in Zepbound is tirzepatide. (An active ingredient is what makes a drug work.) The drug comes as a solution inside prefilled, disposable pens. You’ll inject the drug under your skin.
Keep reading to learn about the common, mild, and serious side effects that Zepbound can cause. For a general overview of the drug, including details about its uses, see this article.
Some people may experience mild to serious side effects during their Zepbound treatment. Examples of the drug’s commonly reported side effects include:
Mild side effects have been reported with Zepbound. These include:
- nausea and vomiting
- abdominal pain
- bloating, gas, or burping
- indigestion or heartburn
- injection site reactions, such as bruising, itching, or skin rash
- fatigue (low energy)
- hair loss
- mild allergic reaction*
In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop using Zepbound unless your doctor recommends it.
Zepbound may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
* To learn more about this side effect, see the “Side effects explained” section below.
Serious side effects have been reported with Zepbound. These include:
- severe digestive side effects
- pancreatitis (inflammation in the pancreas)
- gallbladder problems, such as gallstones
- low blood sugar
- kidney problems*
- boxed warning: risk of thyroid cancer*
- severe allergic reaction*
- suicidal thoughts or behavior†
If you develop serious side effects during your Zepbound treatment, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zepbound, visit MedWatch.
* To learn more about this side effect, see the “Side effects explained” section below.
† This side effect wasn’t reported in studies of Zepbound, but has occurred in studies of other drugs used for long-term weight management.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Get answers to some frequently asked questions about Zepbound’s side effects.
How do side effects of Zepbound compare with those seen with Wegovy?
Zepbound and semaglutide (Wegovy) are both used to help with weight loss and long-term weight management. These drugs are very similar and can cause many of the same side effects.
For example, both drugs commonly cause digestive side effects, such as nausea, vomiting, and diarrhea. With both drugs, these side effects are more likely to occur when starting treatment and are eased over time.
To learn more about how Zepbound and Wegovy compare, talk with your doctor or pharmacist.
Does Zepbound cause long-term side effects?
It’s unlikely. Long-term side effects weren’t reported in studies of Zepbound.
If you’re concerned about possible long-term side effects from Zepbound, talk with your doctor or pharmacist.
Learn more about some of the side effects Zepbound may cause.
Risk of thyroid cancer
Zepbound has a boxed warning about a possible risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
In animal studies, the active ingredient* in Zepbound (tirzepatide) was found to cause thyroid tumors. But it’s not known whether Zepbound can cause thyroid cancer in humans. Studies in animals don’t always predict what will occur in humans.
Thyroid cancer may cause symptoms such as:
- swelling or a lump in your neck
- trouble swallowing or breathing
- hoarseness that doesn’t go away
Your risk of thyroid cancer may be higher if:
- you or someone in your family has ever had a type of thyroid cancer called medullary thyroid cancer
- you have a condition called multiple endocrine neoplasia type 2 (this condition raises your risk of thyroid cancer)
Due to the possible risk of thyroid cancer with Zepbound, your doctor likely will not prescribe this drug if these risk factors apply to you.
* An active ingredient is what makes a drug work.
What might help
If you take Zepbound, talk with your doctor about the symptoms of thyroid cancer to watch for.
If you develop symptoms of thyroid cancer during Zepbound treatment, talk with your doctor right away. They may order tests to check for thyroid cancer.
If you have questions or concerns about this warning, talk with your doctor.
Having chronic kidney disease can raise the risk of kidney problems from Zepbound. Other factors that can raise your risk include having severe nausea, vomiting, or diarrhea. These digestive problems are common side effects of Zepbound and are usually mild. But if severe, they can make you lose more fluids than usual, which can lead to dehydration. Prolonged or severe dehydration can cause kidney problems.
What might help
To help avoid digestive side effects that could cause dehydration, your doctor will prescribe a lower Zepbound dosage when you first start treatment. Then, they’ll increase your dosage slowly over time. Be sure to follow your doctor’s dosage instructions.
If you have nausea, vomiting, or diarrhea during your Zepbound treatment, drink plenty of fluids to avoid becoming dehydrated. If your symptoms are severe or don’t get better, talk with your doctor. They may recommend medication to treat these symptoms. Or in some cases, your doctor may lower your Zepbound dosage.
If you have symptoms of kidney problems during your Zepbound treatment, call your doctor right away. They’ll likely order tests to check your kidney function.
If you have questions or concerns about the risk of kidney problems with Zepbound, talk with your doctor.
Symptoms can be mild to serious and can include:
- skin rash
- flushing (temporary warmth, redness, or deepening of skin color)
- swelling under your skin (usually in your eyelids, lips, hands, or feet)
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:
- an oral antihistamine, such as Benadryl (diphenhydramine)
- a product you apply to your skin, such as hydrocortisone cream
If your doctor confirms you’ve had a mild allergic reaction to Zepbound, they’ll decide if you should continue using it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Zepbound, they may have you switch to a different treatment.
Keeping track of side effects
During your Zepbound treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were taking when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how your symptoms affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how Zepbound affects you. They can then use this information to adjust your treatment plan if needed.
Below is important information you should consider before using Zepbound.
Boxed warning: Risk of thyroid cancer
To learn more, see the “Side effects explained” section above.
Zepbound can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Zepbound is a good treatment option for you.
Talk with your doctor about your health history before you take Zepbound. Be sure to tell them if any of the following factors apply to you:
- kidney problems
- severe digestive problems, such as gastroparesis (slow stomach emptying)
- have had pancreatitis (inflammation in your pancreas)
- diabetic retinopathy (eye problems caused by diabetes)
- previous allergic reaction to Zepbound
- history of depression or suicidal thoughts
Alcohol and Zepbound
There are no known interactions between alcohol and Zepbound. It should be safe to drink alcohol during your Zepbound treatment.
If you have questions about consuming alcohol during Zepbound treatment, talk with your doctor or pharmacist.
Pregnancy and breastfeeding with Zepbound
Zepbound is unlikely to be prescribed for someone who’s pregnant or breastfeeding.
Zepbound is not safe to take during pregnancy. Losing weight during pregnancy may harm a fetus. If you’re pregnant or planning to become pregnant, talk with your doctor before starting Zepbound treatment.
If you’re able to become pregnant, your doctor may recommend using a form of birth control during your Zepbound treatment. However, Zepbound can make birth control pills less effective. Your doctor will likely recommend using different or extra birth control for the first 4 weeks after starting Zepbound and for 4 weeks after any dose increases.
If you become pregnant during your Zepbound treatment, you should stop using it and talk with your doctor. Also consider signing up for the drug’s pregnancy registry by calling 800-545-5979. A pregnancy registry collects information about the safety of certain drugs when used during pregnancy. Your doctor can give you more information.
It isn’t known whether Zepbound is safe to use while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before starting Zepbound treatment.
Like most drugs, Zepbound can cause a number of side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Zepbound can cause, talk with your doctor.
Examples of questions to help get you started include:
- How likely am I to have digestive side effects with Zepbound?
- Do I have a higher risk of side effects from Zepbound than others using the drug?
- How do Zepbound’s side effects compare with those of other weight loss drugs?
To learn more about Zepbound, see these articles:
To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.