Safety information

What to know about tirzepatide.

Most patients tolerate tirzepatide well. The most common side effects are mild-to-moderate digestive changes during dose escalation that improve over a few weeks. Below is the full prescribing information your provider will review with you before you start. Take a moment to read it, save the page, and bring up anything that feels unclear during your consultation.

Nausea

Most common side effect. Usually mild, improves within days to weeks as your body adjusts.

Slow start

Your dose begins low and increases only when you’re tolerating the current one well.

Ask anytime

Message your provider any time in the portal. They respond within business hours.

Full prescribing information below

Boxed warning

Risk of Thyroid C-Cell Tumors

In animal studies, tirzepatide caused dose-dependent and treatment-duration-dependent thyroid C-cell tumors. It is unknown whether tirzepatide causes such tumors in humans. Do not use tirzepatide if you or a family member has a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients on the potential risk and symptoms of thyroid tumors (e.g., a mass in the neck, hoarseness, difficulty swallowing, or persistent shortness of breath).

Indications

Tirzepatide is a GLP-1 + GIP receptor agonist prescribed to support weight management in adults with a BMI of 30 or greater (obesity), or 27 or greater (overweight) with at least one weight-related comorbidity such as type 2 diabetes, high blood pressure, dyslipidemia, or obstructive sleep apnea. Your U.S.-licensed provider makes the final determination whether tirzepatide is appropriate based on your complete medical history.

Contraindications

Do not use tirzepatide if you:

Have a personal or family history of medullary thyroid carcinoma (MTC)
Have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Are allergic to tirzepatide or any of its ingredients
Are pregnant, planning to become pregnant, or breastfeeding
Have severe gastrointestinal disease, including gastroparesis

Warnings & Precautions

The following risks should be discussed with your provider before starting and monitored throughout treatment:

Acute pancreatitis
Has been reported with GLP-1 receptor agonists. Stop use and seek medical attention for persistent severe abdominal pain, with or without vomiting.
Acute kidney injury
Dehydration from gastrointestinal side effects can worsen kidney function. Stay hydrated; report decreased urination or swelling.
Hypoglycemia
When used with insulin or sulfonylureas, tirzepatide increases the risk of low blood sugar. Dose adjustments may be needed.
Gallbladder disease
Rapid weight loss can increase the risk of gallstones and gallbladder inflammation. Report right-upper-abdominal pain.
Serious hypersensitivity reactions
Discontinue and seek care for anaphylaxis, angioedema, or severe rash.
Diabetic retinopathy complications
Rapid improvement in blood glucose can temporarily worsen existing diabetic retinopathy. Baseline and ongoing eye exams recommended for diabetic patients.
Suicidal behavior and ideation
Monitor patients for depression, suicidal thoughts, or unusual mood changes. Discontinue if these occur.

Common Side Effects

Commonly reported side effects of tirzepatide are gastrointestinal and are usually mild-to-moderate, especially during dose escalation:

Nausea

Diarrhea

Vomiting

Constipation

Abdominal pain

Decreased appetite

Fatigue

Injection-site reactions

Indigestion

Symptoms typically improve within days to weeks. Your provider will titrate your dose slowly to minimize side effects.

Drug Interactions

Tirzepatide delays gastric emptying, which may affect the absorption of other oral medications. Tell your provider about every medication you take, especially insulin, sulfonylureas, warfarin, thyroid medications, and oral contraceptives. Patients using oral contraceptives should use an alternative method of contraception or add a barrier method for four weeks after starting tirzepatide and four weeks after each dose increase.

Pregnancy, Lactation, Fertility

Tirzepatide is not recommended during pregnancy or while breastfeeding. Discontinue at least two months before a planned pregnancy. If you become pregnant while taking tirzepatide, stop use immediately and notify your provider.

Storage & Handling

Store unopened vials refrigerated at 36 to 46°F (2 to 8°C). Once opened, follow the instructions provided with your shipment. Do not freeze. Protect from light. Dispose of used needles and syringes in an approved sharps container.

Compounded Medication Disclosure

This product is a compounded preparation dispensed by a U.S.-licensed 503A compounding pharmacy. Compounded drugs are not FDA-approved, are not evaluated by FDA for safety or effectiveness, and are prepared for an identified individual patient based on a valid prescription. Compounded tirzepatide contains the same active pharmaceutical ingredient as the brand-name version but may differ in formulation. Your provider will discuss the benefits and risks of compounded medication during your consultation.

Report Side Effects

Call your provider or seek emergency care for any serious side effect. You may report suspected adverse reactions to the FDA at 1-800-FDA-1088 (MedWatch). You may also notify PepHaūs at safety@thepephaus.com.

Next steps

Questions before you start?

Every patient talks to a U.S.-licensed provider before receiving tirzepatide. Your provider will review your complete medical history, discuss the information above, and confirm whether treatment is appropriate for you.

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This page is informational and does not replace the advice of a licensed healthcare provider. Last reviewed April 2026.