Zepbound Side Effects: What to Expect
Every reaction the tirzepatide trial program recorded, alongside the boxed warning and the Section 5 risks its FDA label carries.
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Most Common Zepbound Side Effects
Every reaction the Zepbound FDA label records, showing how often it appeared among tirzepatide-treated patients and how often it appeared on placebo. The figures are taken from the label's Section 6, DailyMed SetID487cd7e7-434c-4925-99fa-aa80b1cc776b.
| Adverse reaction | Incidence (Zepbound vs placebo) |
|---|---|
| Nausea | 25–29% (placebo 8%) |
| Diarrhea | 19–23% (placebo 8%) |
| Vomiting | 8–13% (placebo 2%) |
| Constipation | 11–17% (placebo 5%) |
| Abdominal pain | 9–10% (placebo 5%) |
| Dyspepsia | 9–10% (placebo 4%) |
| Injection site reactions | 6–8% (placebo 2%) |
| Fatigue | 5–7% (placebo 3%) |
| Hypersensitivity reactions | 5% (placebo 3%) |
| Eructation (burping) | 4–5% (placebo 1%) |
| Hair loss (alopecia) | 4–5% (placebo 1%) |
| Gastroesophageal reflux disease (GERD) | 4–5% (placebo 2%) |
Source: Zepbound FDA prescribing information via DailyMed (SetID 487cd7e7-434c-4925-99fa-aa80b1cc776b), Section 6 Adverse Reactions, read on 2026-05-31. Treat this as a summary — the full label is the document, and a prescriber is the person to discuss it with.
Boxed Warning — Thyroid C-Cell Tumors
“In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether ZEPBOUND causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of tirzepatide-induced rodent thyroid C-cell tumors has not been determined. ZEPBOUND is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).”
Quoted word for word from the Zepbound FDA label (DailyMed SetID 487cd7e7-434c-4925-99fa-aa80b1cc776b). Nothing the FDA issues carries more weight than a boxed warning. Your own history and your family's both need to be on the table before you start Zepbound, and that means talking to a licensed prescriber.
Serious Warnings & Precautions
Past the everyday reactions above, Section 5 of the Zepbound label sets out these serious risks. They arrive far less often, and some of them need care the same day — which is why the symptoms are worth knowing and when to seek care.
- Risk of thyroid C-cell tumors
- Severe gastrointestinal adverse reactions
- Acute kidney injury due to volume depletion
- Acute gallbladder disease
- Acute pancreatitis
- Hypersensitivity reactions
- Hypoglycemia
- Diabetic retinopathy complications in patients with type 2 diabetes mellitus
- Pulmonary aspiration during general anesthesia or deep sedation
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Related deep-dives
What to do about each symptom, and the evidence underneath it, is covered here:
- How long GLP-1 side effects last →
- Hair loss and muscle loss on a GLP-1 →
- Pancreatitis and gallbladder risk →
- What the thyroid cancer warning rests on →
- Eye risk: NAION and retinopathy →
- Drinking on a GLP-1 →
- What happens when you stop →
- Where to inject, and why the site matters →
- Tirzepatide side effects over the long run →
- Side effects reported on compounded tirzepatide →