Zepbound® Side Effects: Common Symptoms and How to Manage Them

The Basics

If you’re searching for Zepbound® side effects, you’re probably curious about two things:

• How will I feel on this medication?
• If I have side effects, what can help, and how do I know if it’s something serious?

Zepbound® is the brand name for tirzepatide, a prescription injection you take once a week. It’s used with lifestyle changes for chronic weight management (it’s also approved for moderate to severe obstructive sleep apnea in adults with obesity).

In this guide, we’ll go over the most common side effects, what can help, and the warning signs that mean you should contact your healthcare provider right away. This is for general education purposes, not medical advice, so always follow your prescriber’s instructions.

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The Most Common Zepbound® Side Effects 

In clinical trials of Zepbound® lasting up to 72 weeks, researchers tracked a wide range of side effects. Below are the most commonly reported reactions, listed by dose compared to placebo.

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Gastrointestinal (GI) Side Effects in Zepbound® Clinical Trials

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Other Common Side Effects

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It’s important to remember that not everyone gets side effects, and most people who do say they’re mild to moderate. Still, knowing what’s common can help you prepare. 

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When Do Side Effects Start–And Do They Go Away?

Many people notice side effects early, especially as their dose increases. That’s also when GI symptoms tend to be most noticeable, like feeling full sooner, nausea, or constipation.

One reason this can happen is that tirzepatide slows stomach emptying, especially earlier in treatment. For many people, the body adapts over time, but everyone’s timeline is different.

If you’re struggling, it’s worth asking your prescriber whether you can stay on your current dose longer before increasing. Many clinicians already do this when symptoms flare.

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How to Manage Zepbound® Side Effects

Most people can reduce the side effects they experience with a few small changes and a little patience. One reason for GI side effects is that tirzepatide slows gastric (stomach) emptying, especially earlier in treatment or after a dose increase. For many people, symptoms ease as the body adjusts, but everyone’s timeline is different.

Here are a few strategies to help:

If you feel nauseated

• Try eating smaller meals, eat slowly, and stop the moment you feel “comfortably full.”
• Choose bland, lower-fat foods as these are often easier on your stomach. Greasy foods can be harder to tolerate.
• Take small sips of water instead of drinking large amounts at once.
• If your nausea gets worse after a dose increase, ask your provider if you can stay on the current dose longer before increasing it again.

If you have diarrhea

• Hydrate
• Temporarily choose simple foods (like rice, toast, bananas) and gradually add back fiber.

If you get constipated

• Fluids + walking go a long way.
• Add fiber slowly—a sudden jump can worsen bloating.
• If it’s persistent, ask your clinician what OTC options may be appropriate for you.

If you have reflux or heartburn

• Avoid lying down right after eating.
• Try smaller dinners and identify trigger foods (fried, spicy, acidic).

If the injection site is irritated

• Rotate sites as instructed (abdomen, thigh, upper arm).
• Avoid injecting into bruised, tender, or scarred areas.

Serious Side Effects: Warning Signs You Shouldn’t Ignore

Most side effects are annoying, but not dangerous. However, if you notice the following symptoms, it’s important to contact your healthcare provider right away.

Pancreatitis (rare, but important)

Get urgent care for severe, persistent belly pain, sometimes moving to the back, with or without vomiting.

Gallbladder problems (gallstones or gallbladder inflammation)

Call a clinician if you notice right upper abdominal pain, fever, jaundice (yellowing of the skin/eyes), or pale/clay-colored stools.

Kidney injury (often related to dehydration)

If vomiting/diarrhea is intense and you can’t keep fluids down, or you’re peeing much less than normal, contact a clinician promptly.

Severe allergic reaction

Trouble breathing, swelling of the face/throat, or widespread hives/rash = emergency.

Low blood sugar (hypoglycemia)

This is especially a risk if tirzepatide is used with insulin or sulfonylureas. Symptoms include sweating, shakiness, confusion, and a rapid heartbeat. If you have diabetes meds in the mix, your clinician may adjust doses.

Mood changes / suicidal thoughts

Mood or behavior changes should be taken seriously. If you experience suicidal thoughts, seek help quickly.

Thyroid tumor warning (boxed warning)

Contact your clinician if you notice a neck lump/swelling, hoarseness, trouble swallowing, or shortness of breath. Zepbound® is contraindicated in patients with a personal/family history of MTC or MEN2.

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Who Should Not Use Zepbound®?

This isn’t a complete list, but common examples include:

• Personal/family history of MTC or MEN2
• Prior serious allergic reaction to tirzepatide or ingredients
• Severe GI disease (Zepbound® is not recommended in severe gastroparesis)

Your clinician should also review your full health history, especially pancreas, gallbladder, kidney, and eye history, as well as your current meds.

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Zepbound® vs Mounjaro® Side Effects: What’s The Difference?

Zepbound® and Mounjaro® both contain tirzepatide, so there’s significant overlap between the two. Especially the GI effects and the boxed warning. Your experience may still differ depending on dose, other meds, and your underlying health.

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What Happens If You Stop Tirzepatide?

A common concern is, “If I stop, will I regain the weight?” In studies where people stopped tirzepatide after losing weight, many regained a meaningful amount of weight over the next year. If you’re thinking about stopping because of side effects, cost, or anything else, talk with a clinician about the safest way to stop and what support you can use to maintain progress.

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