What are the most common side effects of Zepbound?

The label lists nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion and others among reactions reported in at least 5% of patients. The full frequency table is in the label itself, linked below; any percentage quoted on this page is the label's own figure.

What not to do when taking Zepbound?

The Zepbound label names six: do not combine it with another tirzepatide product or any other GLP-1 drug; do not take a missed dose more than 4 days late; do not rely on the contraceptive pill alone after starting or after a dose increase; do not keep taking it once a pregnancy is recognized; do not reuse the same injection site; and never share a KwikPen, even with a new needle, because it can pass on blood-borne infection. A missed dose is taken within 4 days (96 hours); past that it is skipped and the next dose taken on the usual day. For the pill, the label says to switch to a non-oral method, or add a barrier method, for 4 weeks after the first dose and for 4 weeks after each dose increase, because the drug slows stomach emptying and can make the pill less reliable; contraception that is not swallowed is not affected. On pregnancy it says weight loss offers no benefit to a pregnant patient and may cause fetal harm. Its warnings add two more: tell any surgeon or anesthesiologist before a procedure under sedation, because stomach contents have been found despite normal fasting, and do not start it with a personal or family history of medullary thyroid carcinoma or MEN 2.

Do the side effects mean the price is not the issue?

They meet at titration. Most of these reactions are worst in the weeks after a dose increase, and those are also the weeks when some sellers charge a lower starting price. So the months people are most likely to stop are not the months that show what the drug costs. The maintenance price is on the Zepbound price page.

← Zepbound (tirzepatide)

Zepbound (tirzepatide) side effects

Zepbound's FDA label lists 12 common reactions, 8 serious warnings and 2 contraindications, plus a boxed warning. All of them are below in the label's own order; any percentage is the label's own figure, and nothing here is a recommendation.

No clinician has reviewed this page. Label and trial statements are quoted from the FDA label or the trial cited beside them. General guidance is marked as such, and every price carries the date it was verified. That is sourcing, not medical review. What we do and do not check · Who checked the price

Last updated 2026-09-02 — the version of the FDA label this page quotes. Read and dated by Alex Seot.

What are the side effects of Zepbound?

The FDA label for Zepbound lists nausea, diarrhea, vomiting, constipation and abdominal pain among the reactions reported in at least 5% of patients. It carries a boxed warning, the strongest the FDA issues: In rodents this molecule caused thyroid C-cell tumors at human-relevant doses. The label's serious warnings include severe gastrointestinal reactions; acute kidney injury from volume depletion; acute gallbladder disease; and acute pancreatitis. It is contraindicated in 2 cases, among them a personal or family history of medullary thyroid carcinoma, or MEN 2, meaning the label says not to prescribe it at all. Every line above is quoted from FDA prescribing information for ZEPBOUND rather than summarized from a secondary source, because a side-effect list paraphrased twice stops being the label. That label version was published 2026-09-02. Frequencies are not repeated here second-hand: the percentage table lives in the label itself, which is linked on the page.

Boxed warning — the strongest warning the FDA issues

In rodents this molecule caused thyroid C-cell tumors at human-relevant doses. Whether it does so in people is unknown, and the label carries that as a boxed warning. It is contraindicated outright with a personal or family history of medullary thyroid carcinoma or MEN 2.

Common, and usually manageable

Reactions the label reports in at least 5% of patients.

nausea
diarrhea
vomiting
constipation
abdominal pain
indigestion
injection-site reactions
fatigue
hypersensitivity reactions
burping
hair loss
reflux

Most people who stop Zepbound because of side effects do so in the first few months, over gastrointestinal reactions such as nausea, vomiting and diarrhea. In the two weight trials 4.8% to 6.7% stopped because of side effects, rising with the dose, against 3.4% on placebo. Most nausea, vomiting and diarrhea comes during dose escalation and eases over time. If a maintenance dose is not tolerated, the label's answer is a lower maintenance dose, which is a conversation with the prescriber rather than a reason to quit unannounced.

Serious, and worth knowing before you start

Severe gastrointestinal reactions: 1.7% at 5 mg, 2.5% at 10 mg and 3.1% at 15 mg against 1% on placebo in the two weight-reduction trials. Not recommended in severe gastroparesis
Acute kidney injury from volume depletion, in some cases needing dialysis, reported mostly in people who became dehydrated through nausea, vomiting or diarrhea
Acute gallbladder disease: cholelithiasis in 1.1% against 1% on placebo, cholecystitis in 0.7% against 0.2%, cholecystectomy in 0.2% against none
Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis: persistent or severe abdominal pain, sometimes radiating to the back. The label says to stop the drug if it is suspected
Hypersensitivity reactions including anaphylaxis and angioedema: severe reactions in 0.1% of Zepbound-treated patients and in no placebo-treated patients
Hypoglycemia: plasma glucose under 54 mg/dL in 4.2% against 1.3% on placebo in the type 2 diabetes trial, and 10.3% among those also taking a sulfonylurea
Diabetic retinopathy complications in people with type 2 diabetes, because rapid improvement in glucose control can temporarily worsen it
Pulmonary aspiration during general anesthesia or deep sedation: the drug delays gastric emptying, and stomach contents have been found despite normal preoperative fasting. Tell any surgeon or anesthesiologist you are taking it
Never share a KwikPen between patients, even with a new needle (5.10) — sharing risks passing on blood-borne infection

Who cannot take it

A personal or family history of medullary thyroid carcinoma, or MEN 2
Known serious hypersensitivity to tirzepatide or any excipient

Each of these, on its own

What the label says, why it happens, how it tracks the dose schedule and the point at which it stops being ordinary.

What it costs Dosage schedule

Everything on Zepbound

Questions

What are the most common side effects of Zepbound?: The label lists nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion and others among reactions reported in at least 5% of patients. The full frequency table is in the label itself, linked below; any percentage quoted on this page is the label's own figure.
Who should not take it?: The label contraindicates it in these cases: A personal or family history of medullary thyroid carcinoma, or MEN 2; Known serious hypersensitivity to tirzepatide or any excipient.
What not to do when taking Zepbound?: The Zepbound label names six: do not combine it with another tirzepatide product or any other GLP-1 drug; do not take a missed dose more than 4 days late; do not rely on the contraceptive pill alone after starting or after a dose increase; do not keep taking it once a pregnancy is recognized; do not reuse the same injection site; and never share a KwikPen, even with a new needle, because it can pass on blood-borne infection. A missed dose is taken within 4 days (96 hours); past that it is skipped and the next dose taken on the usual day. For the pill, the label says to switch to a non-oral method, or add a barrier method, for 4 weeks after the first dose and for 4 weeks after each dose increase, because the drug slows stomach emptying and can make the pill less reliable; contraception that is not swallowed is not affected. On pregnancy it says weight loss offers no benefit to a pregnant patient and may cause fetal harm. Its warnings add two more: tell any surgeon or anesthesiologist before a procedure under sedation, because stomach contents have been found despite normal fasting, and do not start it with a personal or family history of medullary thyroid carcinoma or MEN 2.
Do the side effects mean the price is not the issue?: They meet at titration. Most of these reactions are worst in the weeks after a dose increase, and those are also the weeks when some sellers charge a lower starting price. So the months people are most likely to stop are not the months that show what the drug costs. The maintenance price is on the Zepbound price page.

Source: FDA prescribing information for ZEPBOUND, the version published 2026-09-02. Information only, not medical advice: a side effect you are having is a conversation with your prescriber, not with a comparison site.