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Zepbound® and hiccups

Hiccups on Zepbound®: not listed in US, Canadian or EU tirzepatide information, what the burping and reflux rows show, and when hiccups need a visit.

Published · Updated · Zepbound®: side effects by symptom · Written by the PepLabo editorial team

When to get help
Context and scope

Bouts of hiccups that seem to follow the weekly Zepbound® injection are a common online complaint, and they can be surprisingly tiring when they keep returning. Unlike the semaglutide label for Wegovy®, no official tirzepatide document names hiccups. This page explains what that absence means, which Zepbound® rows sit closest, what little research exists, and when hiccups deserve a visit.

Key takeaways 5
  • Hiccups are absent from Zepbound®’s US Table 1, which lists reactions in at least 2% of users and above placebo, and from the Canadian table, which goes down to 1%. [1][3]
  • Burping was reported by 4%, 5% and 5% on Zepbound® 5, 10 and 15 mg versus 1% on placebo; reflux by 4–5% versus 2%. [1]
  • Tirzepatide slows stomach emptying most after the first dose, and the effect fades with later doses. [1][3]
  • For semaglutide, a different GLP-1 medicine, an analysis of FDA reports counted 47 hiccup reports; this says nothing direct about tirzepatide. [6]
  • General guidance treats hiccups lasting longer than two days as persistent and a reason to call a provider. [8]

Searching the tirzepatide documents

We read the three main official sources for Zepbound® and tirzepatide on 20 October 2026. None of them mentions hiccups, either in a table or in the text. [1][3][4] For contrast, the US label for Wegovy®, a semaglutide product, does list hiccups in its gastrointestinal paragraph, without a percentage. [5] The two medicines work differently and their labels are written from different trials, so one cannot be read across to the other.

An absent word is not proof that something never happens. The US table only admits reactions reported by at least 2% of people on Zepbound® and more often than on placebo, and the label’s section 6.1 text covers a limited set of other reactions. [1] Hiccups could have occurred at lower rates without being described. What the documents do give is a clear picture of the neighbouring upper stomach symptoms.

Hiccups and the nearest upper-gut rows for Zepbound® / tirzepatide (checked 20-10-2026)
SourceHiccupsBurpingReflux (GERD)Indigestion
US label, Table 1, SURMOUNT-1 and -2: 5 / 10 / 15 mg vs placebo [1]Not mentioned4 / 5 / 5% vs 1%4 / 4 / 5% vs 2%9 / 9 / 10% vs 4%
Canadian monograph, Table 2 (≥1%) [3]Not listed3.8 / 5.5 / 5.1% vs 0.6%4.3 / 3.9 / 4.6% vs 2.1%8.9 / 9.0 / 9.9% vs 3.9%
EU, tirzepatide sold as Mounjaro® [4]Not listedCommonCommonCommon

Research: one study, a different drug

A PubMed search for tirzepatide and hiccups (including the medical term singultus) returned no studies on 20 October 2026. The closest research looked at semaglutide. A 2022 analysis of the FDA Adverse Event Reporting System from early 2018 to early 2022 counted 47 reports of hiccups linked to semaglutide and rated them a signal of moderate priority. [6]

Two cautions apply. First, spontaneous reports cannot show that a medicine caused a symptom or how often it occurs. Second, semaglutide is a different molecule from tirzepatide, which acts on two hormone receptors instead of one. The study tells us that hiccups were reported often enough with one GLP-1 medicine to stand out in a reporting database; it says nothing direct about Zepbound®.

How a weekly injection might connect to hiccups

It helps to separate three levels of confidence.

  • What the label shows. Zepbound® slows stomach emptying, and the delay is largest after the first dose before diminishing. [1] The Canadian monograph adds that the effect was greatest after a single 5 mg dose. [3] Stomach side effects were most frequent while the dose was being raised every 4 weeks, [1] and burping and reflux were clearly more common than on placebo. [1]
  • What is plausible but untested. Hiccups start when something irritates the nerves that make the diaphragm contract, including the vagus and phrenic nerves, and reflux and gastritis are recognised causes of longer bouts. [8] A fuller, slower stomach and more reflux could plausibly set off that reflex, but no one has studied this with Zepbound®.
  • What is generally true. Short bouts often follow very hot, cold or spicy food, and MedlinePlus notes that most hiccups have no specific cause at all. [7][8]

Other reasons hiccups hang on

Hiccups that last days point beyond the injection. Cleveland Clinic lists digestive conditions such as reflux and gastritis; nervous system conditions such as stroke, Parkinson’s disease and multiple sclerosis; lung conditions such as pneumonia or a clot in the lung; metabolic problems; infections such as flu and shingles; some medicines; and recent surgery or anaesthesia. [8] MedlinePlus adds abdominal surgery, harmful fumes and illnesses that irritate the nerves of the diaphragm. [7]

Two of those are worth flagging for Zepbound® users. Many people have elective procedures while on treatment, and the label already asks you to tell the team about Zepbound® before anaesthesia or deep sedation. [1] And if reflux seems to arrive with the hiccups, that is itself a labelled Zepbound® reaction worth mentioning.

Settling a bout, and what to ask about

The Zepbound® Medication Guide has no advice specific to hiccups. [2] MedlinePlus says there is no sure way to stop them and lists common things people try, such as holding the breath, drinking a glass of cold water or breathing repeatedly into a paper bag. [7] Cleveland Clinic suggests looking for triggers by keeping a short journal, eating and drinking more slowly, and cutting back on fizzy and alcoholic drinks and very hot or cold foods. [8]

For bouts that will not stop, a clinician can look for an underlying cause and may consider medicine, including acid-reducing drugs when reflux is involved. [8] MedlinePlus is clear that neck (carotid) massage is for providers only and should not be tried at home. [7] Ask a pharmacist before using any over-the-counter heartburn remedy, because Zepbound® can change how some oral medicines are absorbed. [1]

Zepbound® and Mounjaro® are registered trademarks of Eli Lilly and Company. Wegovy® is a registered trademark of Novo Nordisk A/S. PepLabo is not affiliated with or endorsed by Eli Lilly and Company or Novo Nordisk.

When to get help

The signs and contact information below come from this article’s sourced guidance.

Emergency

  • Swelling of the face, lips or throat, trouble breathing or swallowing, or fainting

    Contact: Stop Zepbound® and get emergency help (911 or local number)

    Medication Guide [2]

Today

  • Severe stomach pain that does not go away, sometimes spreading to the back, with or without vomiting

    Contact: Stop Zepbound® and call your prescriber right away

    Medication Guide [2]

  • Hiccups with ongoing vomiting, prolonged bloating or severe nausea

    Contact: Your prescriber, promptly

    Medication Guide [2]; Canadian patient information [3]

  • Hiccups lasting longer than two days, or making it hard to eat, sleep or breathe

    Contact: Your prescriber or primary care provider

    Cleveland Clinic [8]

At your next appointment

  • Hiccups that return around each injection or dose step, with burping or reflux

    Contact: Mention at your next appointment

    Label §6.1 [1]

Questions

Is hiccups a known side effect of Zepbound®?

Not in the official documents. Neither the US label, the Canadian monograph nor the EU information for tirzepatide mentions hiccups. [1][3][4]

The Wegovy® label lists hiccups. Does that apply to Zepbound®?

Not directly. Wegovy® contains semaglutide and its label is based on its own trials. [5] Tirzepatide’s documents do not list hiccups, though both medicines raise burping and reflux. [1]

Why might hiccups follow my first Zepbound® dose?

The label says the delay in stomach emptying is largest after the first dose and lessens later. [1] Whether that explains hiccups has not been studied, but it fits the timing many people describe.

How long is too long for hiccups?

Cleveland Clinic calls hiccups lasting longer than 48 hours persistent and longer than a month intractable, and advises calling a provider after two days. [8] MedlinePlus says to contact a provider if they go on for more than a few days. [7]

Could reflux be behind my hiccups on Zepbound®?

It is possible. Reflux was more common on Zepbound® than placebo (4–5% vs 2%), [1] and reflux is a recognised cause of persistent hiccups. [8] A clinician can check.

Will my hiccups stop if I switch from a pen to a vial?

Nothing in the label links hiccups, or any other reaction, to the type of Zepbound® device. Pens and vials share the same active ingredient, tirzepatide; any change of presentation should be planned with your prescriber. [1]

Sources

Sources checked on

  1. ZEPBOUND® (tirzepatide) Prescribing Information, Eli Lilly and Company Revised 08/2026. Sections 2.1, 2.4, 5.9, 6.1 (Table 1 and gastrointestinal reactions), 7.2, 12.2.
  2. ZEPBOUND® (tirzepatide) Medication Guide, Eli Lilly and Company Revised 08/2026.
  3. ZEPBOUND® (tirzepatide injection) Product Monograph, Eli Lilly Canada Inc. Date of authorization 2026-06-11. Sections 8.2 (Table 2) and 9.2; patient medication information.
  4. Mounjaro (tirzepatide): EPAR – Product Information, European Medicines Agency Section 4.8, Table 1. No Zepbound® EPAR exists; tirzepatide is authorised in the EU as Mounjaro®.
  5. WEGOVY® (semaglutide) injection and tablets Prescribing Information, Novo Nordisk Revised 06/2026. Section 6.1, gastrointestinal adverse reactions (comparison only).
  6. Shu Y et al. Gastrointestinal adverse events associated with semaglutide: a pharmacovigilance study based on FDA adverse event reporting system. Front Public Health 2022 Disproportionality analysis, FAERS 2018 Q1–2022 Q1; full text (PMC9631444), Table 3.
  7. Hiccups, MedlinePlus Medical Encyclopedia (U.S. National Library of Medicine)
  8. Hiccups, Cleveland Clinic

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