8 Zepbound Side Effects: Common and Severe and How to Manage Them

Jun 18, 2024 | Weight Loss

Zepbound is a promising weight loss medication that can help people with obesity and overweight lose weight and keep it off. However, it can cause side effects, especially during the initial stages of treatment or when doses are increased.

The side effects can range from mild to severe. Those who take Zepbound most frequently report experiencing nausea and other gastrointestinal issues.

Luckily, these side effects often disappear as your body adjusts to the medicine.

Discover the common and severe yet rare side effects of Zepbound and how to manage them.


What Is Zepbound?

Zepbound is a weight loss medication prescribed to some individuals. It is a liquid solution in injectable pre-filled pens. You inject the medication under your skin once a week.

Zepbound is prescribed for weight loss and weight management to adults with a body mass index (BMI) of 30 or higher (obesity) or a BMI of 27 or higher (overweight) who have a weight-related medical condition—such as type 2 diabetes, high blood pressure, heart disease, high cholesterol, or obstructive sleep apnea.

It’s prescribed along with a lower-calorie diet and increased physical activity.

It’s important to know that your doctor may not prescribe Zepbound if you take other drugs that contain tirzepatide, the active ingredient in Zepbound, or drugs similar to glucagon-like peptide-1, like liraglutide (Saxenda, Victoza) or semaglutide (Ozempic, Wegovy).

You may also not get Zepbound treatment if you use any other weight-loss products, including over-the-counter, prescription, or herbal treatments.


Common Side Effects of Zepbound

Although Zepbound is a safe and effective drug, like any medication, it can cause side effects. Most gastrointestinal symptoms start after starting the treatment or increasing the dosage and disappear a few days or weeks as the body tolerates each dosage.

However, if your side effects worsen, persist longer than expected, or become worrisome, call your healthcare provider. And don’t stop using Zepbound unless your provider advises you to do so.

Those who used Zepbound in clinical studies experienced the following common side effects:

  • Nausea and vomiting
  • Constipation
  • Bloating, gas, or burping
  • Fatigue
  • Diarrhea
  • Abdominal pain
  • Hair loss
  • Allergic reaction
  • Indigestion or heartburn
  • Injection site reaction
  • Dizziness


Severe Side Effects of Zepbound

While most of Zepbound’s side effects are mild and temporary, it can also cause rare but severe side effects, which should be taken into account.

Zepbound has a boxed warning for medullary thyroid cancer.

Serious side effects associated with Zepbound include:

  • Severe gastrointestinal side effects
  • Pancreatitis
  • Gallbladder issues
  • Hypoglycemia
  • Kidney issues
  • Thyroid cancer
  • Severe allergic reaction


How to Manage Zepbound Side Effects

The negative effects of Zepbound can be extremely uncomfortable for some people. Here’s how you can manage them.


1. Nausea and Vomiting

Nausea and vomiting are the most common side effects of Zepbound, especially when you’re starting with the medication or after your doctor increases your dosage. Other common stomach issues with Zepbound include heartburn, bloating, acid reflux, stomach pain, burping, and gas. These effects may disappear within a few days or weeks.

To minimize nausea and vomiting, your healthcare provider will initially prescribe a low dose of Zepbound. They’ll start you at 2.5 mg. While this dosage is well lower than the recommended target dose to promote weight loss, lowering the dosage at first helps the body adjust to the drug.

Your doctor will gradually increase your dosage approximately every four weeks until you achieve the goal or the highest dose you can tolerate.

Since Zepbound slows digestion and prolongs the time food stays in your stomach, you may feel full for longer. However, if you eat past fullness, you risk experiencing nausea and vomiting. It’s, therefore, important to eat smaller, more frequent meals instead of larger ones and stop eating once satisfied.

It’s also important to avoid foods that may worsen the nausea and vomiting effects of Zepbound. Spicy foods and foods high in fat are known to exacerbate nausea and vomiting. While this may vary with people, it’s essential to be alert to foods that trigger these effects individually and develop meal ideas that prevent these triggers.


2. Diarrhea

Like nausea and vomiting, diarrhea is common when starting with the medication or after a dose increase. However, as your body adjusts to the treatment, it may decrease.

Your healthcare practitioner will slowly increase your dosage for some months until you reach the target or maximum dose. Ensure you follow your provider’s directions and avoid increasing the dosage too quickly.

It’s also important to watch your dietary fat intake.  High-fat foods can be more complex to digest and may exacerbate diarrhea. Choose lean proteins, fruits, and vegetables instead of fried or greasy foods. Eating bland foods like bananas, rice, applesauce, and toast can help soothe the digestive system. These foods are easy to digest and can help firm up stool.

Since diarrhea can lead to dehydration, drinking plenty of fluids is important. Water, clear broths, and oral rehydration solutions are excellent choices. Avoid caffeinated and sugary drinks, which can worsen dehydration.


3. Constipation

Constipation is another common side effect of using Zepbound. This condition arises because Zepbound slows down the digestive process, leading to longer transit times in the intestines. This may cause firm stools or constipation.

The good news is that if you have constipation because of Zepbound, simple lifestyle changes can help manage the condition. Increase your fiber intake. Fiber promotes easy passage by increasing the volume and consistency of bowel movements. It also helps bowel movements move through the digestive system faster.

High-fiber foods include fruits and vegetables, whole grains, and legumes.

Ensure you also hydrate throughout the day. People who don’t drink enough water are likely to be constipated, and it can be even worse with Zepbound since it slows digestion. Proper hydration helps soften stool and promote regular bowel movements.

If lifestyle changes are not working for you, you may speak with your provider or pharmacist about choosing the right laxative, which may help soften or add water content to stool.


4. Injection Site Reactions

Zepbound is injected under the skin once a week, either on the upper arm, thigh, or abdomen. This may cause injection site reactions, including discomfort, pain, swelling, bleeding, redness, itching, or rash. These reactions may disappear within a few days of injecting your Zepbound dose.

Your provider will also demonstrate how and where to inject Zepbound to prevent this. However, your healthcare provider will advise you on different treatment methods if the reactions still occur.


5. Risk of Thyroid Cancer

Zepbound has a boxed warning about a potential risk of thyroid cancer. Tirzepatide, the active ingredient in Zepbound, has been shown to trigger thyroid cancers in animal tests. However, it’s unknown if Zepbound can lead to thyroid cancer in people. Research conducted on animals does not necessarily apply to humans.

Thyroid cancer symptoms include swelling or a lump in your neck, difficulty breathing or swallowing, and persistent hoarseness.

You are at a higher risk of thyroid cancer if you have multiple endocrine neoplasia type 2, have ever had medullary thyroid cancer, or someone in your family has. Your doctor may not prescribe Zepbound if you have any risk factors.


6. Pancreatitis

Zepbound can cause acute pancreatitis or abrupt swelling and inflammation of the pancreas. Signs of pancreas inflammation include severe mid-upper abdomen pain, which frequently radiates to the back, as well as persistent strong feelings of nausea and vomiting.

Tell your doctor if you have a pancreas-related illness before beginning Zepbound treatment. Zepbound may worsen your pancreatic disease if you already have it. Your healthcare provider will determine if Zepbound is safe for you.


7. Hypoglycemia

Zepbound may lower your blood sugar. Low blood sugar may result when Zepbound is taken with insulin, sulfonylureas, or other drugs that might lower blood sugar. Hypoglycemia can cause lightheadedness, sweating, confusion, blurred vision, shaking, rapid heartbeat, agitation, hunger, weakness, and jitteriness.

If your doctor prescribes Zepbound, they may change the dosage of your other diabetic medications to prevent dangerously low blood sugar. They’ll also keep a closer eye on your symptoms during treatment. They may also advise on stopping Zepbound and recommend another weight-management medication.


8. Kidney Injury

Severe vomiting and diarrhea may cause fluid loss, which can impact kidney function. Chronic kidney disease can increase the chance of Zepbound kidney issues.

Symptoms of kidney problems include dark-colored urine, reduced urine, fatigue, and swelling of ankles or legs.

Stay hydrated while using Zepbound by drinking plenty of fluids to avoid dehydration.


Can You Drink Alcohol With Zepbound?

There are no documented interactions between alcohol and Zepbound. Zepbound is likely safe to use if you consume alcohol. However, Your healthcare provider may advise on how much alcohol is safe to drink while receiving Zepbound treatment.

This is because some of the negative effects of Zepbound may worsen if you drink alcohol while taking the medication. For instance, you might feel more nauseous or vomit up.


Pregnancy and Breastfeeding With Zepbound

If you’re pregnant or breasting, consult your provider before taking Zepbound. Zepbound is prescribed for weight loss, and losing weight while pregnant may harm the development of the baby.

Zepbound can also reduce the effectiveness of some birth control pills. If you can conceive, discuss effective birth control methods with your doctor while taking Zepbound treatment.

Tell your doctor immediately if you become pregnant while receiving Zepbound treatment. They may likely advise you to stop taking this medication.

If you and your healthcare provider determine the advantages outweigh the possible risks, you might consider signing up for Zepbound’s pregnancy registry. Pregnancy registries are designed to gather data about the adverse effects of medications taken during pregnancy.

Before beginning Zepbound medication, tell your doctor if you’re pregnant, breastfeeding, or planning any. Your doctor will recommend a safe option for you.




What should I do if I experience severe side effects from Zepbound?

Call your doctor right away if you experience any severe effects from Zepbound. Call 911 if you have a medical emergency or potentially fatal Zepbound adverse effect, as you may require emergency medical assistance.


Can I prevent the side effects of Zepbound before they start?

To prevent Zepbound side effects, your healthcare provider will start you at a low dose and slowly increase the dosage. Ensure you follow your provider’s instructions carefully.


How long do Zepbound side effects typically last?

Zepbound side effects may last a few days to a few weeks. However, if they worsen, last longer than expected, or are worrisome, contact your doctor or pharmacist.


Manage Zepbound Side Effects With Confidence

Like any other medication, Zepbound side effects can range in severity from mild to possibly risky. These side effects are most common when starting the medication or when the dosage is increased and usually go away on their own. It’s recommended that you take Zepbound under medical supervision to be sure it is safe and suitable for your needs.

At NP2GO, we understand that managing weight loss medications like Zepbound can sometimes be challenging due to side effects. We aim to support you every step of the way, ensuring you feel confident and comfortable throughout your weight loss journey.

Our experienced healthcare providers will work closely with you to tailor a treatment plan that meets your unique needs. We’ll start with a thorough assessment to understand your medical history, lifestyle, and weight loss goals. Based on this information, we’ll provide personalized recommendations on how to minimize and manage Zepbound side effects effectively.

With flexible appointments and telehealth consultations, getting the care you need is simple and hassle-free. Contact us today to schedule a consultation and take the first step towards a healthier, happier you.