Zepbound (tirzepatide) can cause side effects that range from mild to serious. More common side effects include nausea, diarrhea, and constipation. If side effects from Zepbound become hard to tolerate, talk with your doctor about tips for symptom relief or other treatment options.

Zepbound is prescribed along with a reduced-calorie diet and increased exercise to:

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 or vials. You’ll inject the drug under your skin.

Keep reading to learn about the common, mild, and serious side effects that Zepbound can cause.

Some people may experience mild to serious side effects during their Zepbound treatment. Examples of the drug’s commonly reported side effects include:

To learn more, see “Gastrointestinal (digestive system) side effects” in the “Side effects explained” section later in this article.

Mild side effects have been reported with Zepbound. These include:

  • nausea and vomiting
  • diarrhea
  • constipation
  • abdominal pain
  • bloating, gas, or burping
  • indigestion or heartburn
  • injection site reactions, such as bruising, itching, or skin rash
  • fatigue (low energy)
  • hair loss
  • dizziness
  • mild allergic reaction

To learn more about some of these side effects, see the “Side effects explained” section later in this article.

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 previously. See the drug’s prescribing information for details.

Serious side effects have been reported with Zepbound. These include:

Suicidal thoughts or behavior wasn’t reported in studies of Zepbound. But this side effect has occurred in studies of other drugs used for long-term weight management.

To learn more about some of these side effects, see the “Side effects explained” section later in this article.

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.

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 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • 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’re 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 of 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 tend to ease over time.

Both Zepbound and Wegovy also have a boxed warning about a possible risk of thyroid cancer. For more on this warning, see the “Side effects explained” section.

To learn more about how Zepbound and Wegovy compare, talk with your doctor or pharmacist.

Does Zepbound cause long-term side effects?

Long-term side effects weren’t reported in studies of Zepbound. However, additional research needs to be done to determine whether the drug causes long-term side effects.

If you’re concerned about possible long-term side effects from Zepbound, talk with your doctor or pharmacist.

Can Zepbound cause muscle pain?

Muscle pain wasn’t a reported side effect in studies of Zepbound.

But it’s possible to experience muscle pain from certain side effects that Zepbound can cause. For example, gallbladder problems could result in pain in your upper right abdomen. Inflammation from an allergic reaction could lead to general muscle pain.

If you have muscle pain during Zepbound treatment, let your doctor know. They can determine the cause and suggest appropriate treatments for pain relief.

Are there Zepbound coupons and savings options?

To save money on your Zepbound prescription, explore these Optum Perks coupons.

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, tirzepatide, the active ingredient in Zepbound, was found to cause thyroid tumors. (An active ingredient is what makes a drug work.) But it’s unknown 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
  • difficulty 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, which 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.

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.

Gastrointestinal (digestive system) side effects

Zepbound can cause mild and serious digestive system side effects.

The following mild side effects were commonly reported in studies of the drug:

Other mild digestive side effects, such as burping, flatulence (gas), and bloating, occurred less often.

Though rare, some of these side effects may become severe. Also, Zepbound may cause certain serious digestive side effects, including pancreatitis (inflammation in the pancreas) and gallbladder problems, such as gallstones.

What might help

Mild digestive system side effects of Zepbound tend to go away after a few days to a couple of weeks. But if any don’t go away or worsen, tell your doctor. They can recommend treatments and home remedies to ease your symptoms. You can also try these tips for easing nausea, diarrhea, and constipation.

Ask your doctor what symptoms of Zepbound’s serious side effects you should watch for while receiving the drug. If you develop such symptoms, contact your doctor right away. They’ll try to determine the cause and recommend appropriate treatment as soon as possible.

If you have any digestive system problems, be sure to tell your doctor before starting Zepbound. They may recommend a different medication for your condition.

Kidney problems

Kidney problems, such as acute (sudden) kidney failure, were a rare side effect reported in studies of Zepbound. Kidney problems may cause symptoms such as:

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.

Allergic reaction

Like most drugs, Zepbound can cause an allergic reaction in some people. This was a rare side effect reported in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • 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 whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty 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.

The following is important information you should consider before using Zepbound.

Boxed warning: Risk of thyroid cancer

Zepbound has a boxed warning for the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

To learn more, see the “Side effects explained” section.

Other warnings

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:

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

It’s unlikely that doctors will prescribe Zepbound for someone who’s pregnant or breastfeeding.

Pregnancy

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.

Breastfeeding

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.

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.