6 Ways to Manage Tirzepatide Side Effects

Tirzepatide is a weekly injectable medication that helps lower blood sugar and promote weight loss. There are two different medications that contain tirzepatide — Mounjaro and Zepbound. Mounjaro is FDA-approved to treat Type 2 diabetes. Zepbound is FDA-approved to treat obesity and obstructive sleep apnea (OSA).

Tirzepatide can be a great medication for many people. But like any medication, tirzepatide can cause side effects. Let’s look at how to manage the most common tirzepatide side effects. 

What are the most common side effects of tirzepatide?

One way that tirzepatide works is by slowing the movement of food through your digestive tract. So it’s not surprising that many side effects of tirzepatide affect your gut. 

Common tirzepatide side effects include:

• Nausea and vomiting

• Constipation

• Heartburn

• Diarrhea 

• Decreased appetite

• Weight loss

How common are tirzepatide side effects?

Nausea and diarrhea are the most common side effects of tirzepatide. One review found that up to 20% of people taking tirzepatide had nausea, 16% had diarrhea, and about 7% had dyspepsia (upset stomach). Another study showed similar results — nausea and diarrhea were the most common side effects. 

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Severe side effects like acute pancreatitis or problems in the gallbladder are rare. 

There have been reports of people developing pancreatitis while taking tirzepatide. But research suggests that taking tirzepatide doesn’t significantly increase the risk of developing pancreatitis. Tirzepatide may increase the risk of developing gallstones, but it doesn’t seem to significantly increase the risk of inflammation in the gallbladder (cholecystitis). 

Cholecystitis is a more serious condition that needs urgent medical attention. Gallstones don’t always need treatment because they don’t always cause symptoms. 

What are the best ways to manage tirzepatide side effects?

Not everyone will have side effects while taking tirzepatide. But if you do notice an upset stomach or changes in your bowel movements, here are six things you can do to help ease your symptoms. 

1. Eat smaller meals

You may find yourself eating less once you start tirzepatide. Many people have less of an appetite while taking it. Eating smaller meals not only helps with weight loss, but it can also help you avoid some side effects like upset stomach and nausea. 

2. Take a stool softener

If you notice changes in your bowel habits while taking tirzepatide, you aren’t alone. Tirzepatide can cause constipation and hard-to-pass stools. Taking an over-the-counter (OTC) stool softener can help you manage this problem. You can also try psyllium husk (Metamucil) or polyethylene glycol (Miralax).

EXPERT PICKS: WHAT TO READ NEXT

• How does tirzepatide work? Pharmacists explain the science behind how tirzepatide — the active ingredient in Mounjaro and Zepbound — works in the body.

• What taking Mounjaro feels like: Real people share their experiences with Mounjaro, a medication that’s proven effective at treating Type 2 diabetes.

• Possible side effects: Read about tirzepatide’s potential side effects — from diarrhea to hair loss — and how to manage them.

3. Avoid greasy or spicy foods

Acid reflux or heartburn is another possible side effect of tirzepatide. Spicy dishes, greasy foods, or acidic foods or drinks (like orange juice, coffee or alcohol) can trigger heartburn. Instead, choose foods that are high in fiber and low in acidity to minimize acid reflux symptoms. 

4. Stay hydrated

Drinking enough water is important for everyone. But it’s particularly important if you’re losing extra fluids due to diarrhea. If you’re having loose, frequent stools while taking tirzepatide, be sure to replace the water you’re losing. Water, electrolyte drinks, clear broth, and tea are all great drink choices when you have diarrhea. 

5. Work with a dietician

For many people, losing weight is one benefit of taking tirzepatide. But it’s important to do so safely. Working with a dietician can help you make food choices that will support your nutritional needs while still being “gut friendly.” 

6. Adjust your dose of tirzepatide

Talk to a healthcare professional if you’re having trouble managing side effects of tirzepatide. They may recommend lowering your dose or adjusting the time between doses. 

How long do tirzepatide side effects usually last?

Tirzepatide side effects are usually temporary. Most people notice side effects within 24 to 48 hours after taking their weekly dose of medication. Side effects are more likely when you’re first starting the medication. There are higher reports of side effects in the first 2 weeks of taking tirzepatide. After that, side effects tend to go away as your body gets used to the medication. 

You may experience a return of side effects if you need to increase your tirzepatide dose. But they should start to go away as your body adjusts to the new dose. 

Some people do have side effects that last longer. It’s rare, but some people need to stop taking tirzepatide because of side effects.

When should you seek care for tirzepatide side effects?

Let your healthcare team know about any side effects you notice when starting tirzepatide. Side effects like nausea or an upset stomach often get better with time. Your healthcare team may have tips to ease your symptoms. They may also adjust your dosing schedule so you experience fewer side effects. Don’t stop taking tirzepatide without talking with your healthcare team first. 

You should seek immediate medical care if you develop severe symptoms while taking tirzepatide, like:

• Vomiting or diarrhea that stops you from eating or drinking

• A urine output that is less than normal

• Low blood sugar that doesn’t get better after eating 15 g of carbohydrates

• Blood sugar lower than 55 mg/dL

• Chest pain

• Changes in heart rate or palpitations

• Fainting

• Severe stomach pain that doesn’t go away or gets worse

• Stomach pain that gets worse after eating

• Yellowing of the eyes or skin

Allergic reactions to tirzepatide are possible. Call 911 if you or a loved one develops signs of anaphylaxis (a severe allergic reaction) after taking tirzepatide. This includes:

• Hives

• Trouble breathing 

• Wheezing

• Chest tightness

• Trouble swallowing

• Throat tightness or swelling

• Swelling of the eyelids, lips, or tongue

• Vomiting, diarrhea, or abdominal pain

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Written by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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