Nausea and diarrhea in the label tables
Nausea and diarrhea are among the most common side effects in every one of these labels. The table below copies those two rows from each label’s main placebo-controlled table, using the highest dose column in that table.
| Label (population) | Placebo nausea % | Nausea, highest dose in table % | Placebo diarrhea % | Diarrhea, highest dose in table % |
|---|---|---|---|---|
| Mounjaro® 15 mg (type 2 diabetes) | 4 | 18 | 9 | 17 |
| Zepbound® 15 mg (weight management) | 8 | 28 | 8 | 23 |
Each row comes from a different trial programme with different people, durations and doses. The labels themselves say rates from one medicine’s trials cannot be compared directly with another’s, so this table is not a ranking. [1][2] The European Union product information (SmPC and package leaflet) is published by EMA [3]; local leaflets can differ in detail.
Shared serious warnings
Both labels carry the boxed warning: in rodent studies tirzepatide led to thyroid C-cell tumors, and whether it does in humans is unknown. Shared serious adverse reactions [1][2]:
- Risk of thyroid C-cell tumors (the boxed warning)
- Acute pancreatitis
- Acute gallbladder disease
- Low blood sugar (hypoglycemia), with a higher risk alongside insulin or sulfonylurea-type medicines
- Acute kidney injury due to fluid loss (volume depletion)
- Severe gastrointestinal adverse reactions
- Hypersensitivity (allergic) reactions
- Diabetic retinopathy complications (eye problems related to diabetes)
- Food or liquid entering the lungs (pulmonary aspiration) under general anesthesia or deep sedation
What happens if I stop tirzepatide?
The labels do not describe how side effects change after stopping; the Zepbound® label describes the withdrawal trial as Study 4 [2].
In SURMOUNT-4, people who had taken tirzepatide for 36 weeks were randomly switched to placebo or kept on treatment: over the next 52 weeks, weight changed by +14.0% on placebo vs −5.5% on continued tirzepatide [9].
Stopping, pausing or restarting is a decision to make with your prescriber.
Tirzepatide, pregnancy and birth control
Slower stomach emptying can make a birth-control pill less effective, so the Mounjaro® and Zepbound® labels single out the first 4 weeks of treatment and the 4 weeks after every dose step-up. In those windows they suggest a contraceptive that is not swallowed, or a barrier method alongside the pill; non-oral hormonal methods are not expected to be affected [1][2].
The Zepbound® label also says to stop when a pregnancy is recognized [2].
Should I mention tirzepatide before surgery or sedation?
Yes, according to the labels. They describe rare postmarketing reports of food or liquid getting into the lungs (pulmonary aspiration) under general anesthesia or deep sedation in people taking GLP-1 receptor agonists, even when they had followed fasting instructions. They say the data are not enough to recommend whether to change fasting or pause the medicine, and asks patients to tell their healthcare providers before any planned surgery or procedure [1][2].
Can I drink alcohol while taking tirzepatide?
None of these labels mentions drinking alcohol [1][2]. Two related facts come from general medical sources: heavy alcohol use is one of the most common causes of pancreatitis [4], which the labels list as a serious risk [1][2]; and drinking too much alcohol without enough food can cause low blood sugar in people with diabetes [5]. How alcohol fits with your treatment is a question for your prescriber.
Is hair loss listed for tirzepatide?
The Zepbound® label lists hair loss in 4–5% vs 1% on placebo, more often in women (7.1% vs 1.3%) and associated with weight reduction [2].
In Mounjaro®, hair loss is not in the clinical-trial tables; “alopecia” appears only in the postmarketing section, where neither frequency nor cause can be reliably established [1].
MedlinePlus describes a usually temporary kind of shedding (telogen effluvium) that can follow major physical stress, illness, surgery or crash diets [8].
Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. PepLabo is not affiliated with this company. This page is not medical advice; percentages come from clinical-trial tables in the label and do not predict what you will experience.
When to get help
| Sign | Who to contact | How fast | Source |
|---|---|---|---|
| Swelling of the lips, tongue, face or throat, struggling to breathe or swallow, fainting or a racing pulse | Emergency services. According to the guide, tirzepatide should be stopped and urgent medical help sought. | Emergency | Mounjaro® and Zepbound® Medication Guides [1][2]; MedlinePlus [7] |
| Belly pain that is severe and does not ease, whether or not you vomit; it can reach through to the back | Your healthcare provider right away; the guide says to stop using tirzepatide. If you cannot reach them, urgent care. | Emergency | Mounjaro® and Zepbound® Medication Guides [1][2]; NIDDK [4] |
| Ongoing nausea, vomiting or diarrhea, or dehydration signs such as feeling very thirsty, a dry mouth, urinating less than usual, dark urine or dizziness | Your healthcare provider, right away: fluid loss can lead to kidney problems. | Today | Mounjaro® and Zepbound® Medication Guides [1][2]; MedlinePlus [6] |
| Pain in the upper stomach, fever, yellowing of the skin or eyes, or clay-colored stools | Your healthcare provider (gallbladder problems). | Today | Mounjaro® and Zepbound® Medication Guides [1][2] |
| Shakiness, sweating, confusion, blurred vision or a fast heartbeat; the risk is higher alongside insulin or a sulfonylurea | Follow the low-blood-sugar plan from your healthcare provider; the guide asks you to discuss it before starting. | Today | Mounjaro® and Zepbound® Medication Guides [1][2]; MedlinePlus [5] |
| A new neck lump or swelling, a hoarse voice, difficulty swallowing or breathlessness | Your healthcare provider (thyroid section of the guide). | Today | Mounjaro® and Zepbound® Medication Guides [1][2] |
| Changes in vision during treatment | Your healthcare provider. | Today | Mounjaro® and Zepbound® Medication Guides [1][2] |
| A planned surgery or a procedure with anesthesia or deep sedation | Tell every healthcare provider involved that you use this medicine, before the procedure. | At your next appointment | Mounjaro® and Zepbound® Medication Guides [1][2] |
| Mild nausea, constipation, heartburn or other common side effects that you can manage | Mention them at your next appointment; a dated log helps. | At your next appointment | Common reactions: label section 6 [1][2] |
