Zepbound (tirzepatide) is a brand-name injectable solution that’s prescribed for weight loss in certain adults. As with other drugs, Zepbound can cause side effects, such as nausea, vomiting, or diarrhea.

Zepbound can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who used Zepbound in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Zepbound use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Zepbound’s prescribing information.

Mild side effects that have been reported with Zepbound include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while using Zepbound and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Zepbound. For more information, see the “Side effect specifics” section below.

Zepbound may cause serious side effects. However, serious side effects from this medication weren’t common. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Zepbound’s prescribing information.

If you develop serious side effects while using Zepbound, 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.

Serious side effects that have been reported and their symptoms include:

* This side effect was not reported in clinical trials of Zepbound. However, it’s been reported in clinical trials of other medications for long-term weight management.
† Zepbound has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
‡ An allergic reaction is possible after using Zepbound. For more information, see the “Side effect specifics” section below.

Learn more about some of the side effects that Zepbound may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Zepbound.

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). The purpose of a boxed warning is to alert patients and doctors about the risks of taking a medication.

In animal studies, Zepbound caused certain types of thyroid tumors. However, animal studies don’t always predict what may happen in humans. For this reason, it’s not known for certain whether Zepbound may cause thyroid cancer in humans.

Symptoms of thyroid cancer may include:

  • hoarseness
  • difficulty swallowing
  • a lump or swelling in your neck
  • difficulty breathing

What you can do

Before you start treatment with Zepbound, tell your doctor if you have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2). Due to the possible risk of thyroid cancer, Zepbound is not considered safe for you to use if you have such a history. However, your doctor can recommend a different weight management option for you.

They will perform a physical examination and may order other diagnostic tests to check for MTC or MEN2. If necessary, they may stop prescribing Zepbound. In that case, they can recommend a different weight management option for you.

Injection site reaction

It’s possible for Zepbound to cause an injection site reaction. This medication is given as a subcutaneous injection (an injection underneath your skin). For this reason, Zepbound may cause a skin reaction wherever you give yourself the injection.

Injection site reactions were a commonly reported side effect in Zepbound’s clinical trials. Examples of injection site reactions include:

  • bruising
  • redness or discoloration
  • itchiness
  • localized pain
  • skin rash

What you can do

Any injection site reactions you may experience should go away on their own within a few days of injecting your Zepbound dose.

However, if you experience a reaction that’s severe or bothersome to you, talk with your doctor. Depending on the reaction, they can advise different ways to treat it. For example, they may recommend taking an over-the-counter pain medication, such as Tylenol (acetaminophen), for injection site pain. They may also recommend taking Benadryl (diphenhydramine) to treat itchiness or rash.

Allergic reaction

As with most drugs, Zepbound can cause an allergic reaction in some people. In clinical trials, this side effect was rare.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep using Zepbound. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Before starting treatment with Zepbound, be sure to tell your doctor about any other medical conditions that you have or medications that you take. They can help determine whether Zepbound might be safe for you.

Boxed warning: Risk of thyroid cancer

This drug has a boxed warning for the risk of thyroid cancer. This is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you start using Zepbound. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Pancreatic conditions: Before you start using Zepbound, tell your doctor whether you have a condition that affects your pancreas. This includes conditions such as chronic pancreatitis. Zepbound may cause acute pancreatitis, which is sudden swelling and inflammation of your pancreas. If you already have a pancreas condition, using Zepbound may worsen your symptoms. Your doctor will determine whether Zepbound is safe for you to use.

Kidney problems: If you have a kidney problem, tell your doctor before you start using Zepbound. This medication may increase your risk of kidney problems. If you currently have a condition that affects your kidney function, treatment with Zepbound may make it worse. Ask your doctor whether Zepbound is right for your condition.

Digestive problems: If you have a digestive problem, such as gastroparesis (extremely slow digestion), tell your doctor before starting Zepbound. This medication may cause gastrointestinal side effects, such as nausea, vomiting, diarrhea, or constipation. If you already have a condition that affects your digestion, using Zepbound may make your symptoms more severe. Your doctor will advise whether Zepbound is safe for you to use.

Diabetes: If you have diabetes or a condition related to it, such as diabetic retinopathy, tell your doctor before you start using Zepbound. It’s important to know that Zepbound lowers your blood sugar. If you already take a medication to manage your diabetes, it’s possible for Zepbound to worsen your condition.

If your doctor prescribes Zepbound, they may adjust your dose of your other diabetes medications to help prevent extremely low blood sugar. In addition, they’ll likely monitor your symptoms more closely throughout treatment. In some cases, they may stop prescribing Zepbound and recommend another weight management option for you.

Allergic reaction: If you’ve had an allergic reaction to Zepbound or any of its ingredients, your doctor will likely not prescribe Zepbound. Ask your doctor what other medications may be better options for you.

Pregnancy or breastfeeding: If you’re pregnant or breastfeeding your child, talk with your doctor. There are no clinical trials regarding the safety of Zepbound during pregnancy. For this reason, it’s not known whether Zepbound is safe for you to use. However, losing weight during pregnancy may cause harm to a developing fetus. (Zepbound is prescribed for weight loss.)

In addition, Zepbound can make certain birth control pills less effective. If you can become pregnant, talk with your doctor about effective birth control options during treatment with Zepbound.

If you become pregnant during treatment with Zepbound, tell your doctor right away. They will likely recommend that you stop using this drug. If you and your doctor decide the benefits outweigh the potential risks, you may wish to consider joining Zepbound’s pregnancy registry. The purpose of a pregnancy registry is to collect information about the side effects of a drug used during pregnancy. You can sign up for the registry by calling 800-545-5979.

If you’re pregnant, breastfeeding, or planning for either, let your doctor know before starting treatment with Zepbound. Your doctor will advise the safest treatment option for you.

Alcohol consumption: If you drink alcohol, Zepbound is likely safe for you to use. There are no known interactions between this drug and alcohol. Your doctor can advise how much alcohol, if any, is safe to drink during treatment with Zepbound. For more information about Zepbound’s interactions, see this article.

If you’d like to learn more about Zepbound, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Zepbound: For details about other aspects of Zepbound, refer to this article.
  • Cost: If you’d like to learn about Zepbound and cost, see this article.
  • Drug comparison: To learn how Zepbound compares with Ozempic, Wegovy, and Mounjaro, read this article.
  • Dosage: For information about the dosage of Zepbound, view this article.
  • A look at weight loss: For details about weight loss, see our weight management hub.

Disclaimer: Medical News Today 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.