Zepbound stomach pain: What to expect and how to manage it

In this article:

• Can Zepbound cause stomach pain?
• Why might Zepbound cause stomach pain?
• How long does Zepbound stomach pain last?
• Other possible Zepbound side effects
• Tips for reducing and preventing Zepbound stomach pain
• When to see a doctor about Zepbound stomach pain

In this article

• Can Zepbound cause stomach pain?
• Why might Zepbound cause stomach pain?
• How long does Zepbound stomach pain last?
• Other possible Zepbound side effects
• Tips for reducing and preventing Zepbound stomach pain
• When to see a doctor about Zepbound stomach pain

GLP-1 medications like Ozempic and Mounjaro rose to fame for their ability to treat Type 2 diabetes, but their weight loss potential is what really skyrocketed their popularity. In the ensuing wave of similar drugs, Zepbound (tirzepatide) has shown a lot of promise for chronic weight management and has also been approved to treat obstructive sleep apnea (OSA) in people with obesity. But like other GLP-1 drugs, it may cause side effects for some patients, including gastrointestinal side effects. 

Can Zepbound cause stomach pain?

Yes. Zepbound’s most common side effects are gastrointestinal, including nausea, diarrhea, vomiting, constipation, and stomach pain. Clinical trials showed that 9% of patients taking 5–10 mg doses and 10% of patients taking 15 mg doses experienced abdominal pain, compared to just 5% taking a placebo. Other studies have backed up the prevalence of tirzepatide’s gastrointestinal effects as well.

But that doesn’t mean everyone who takes Zepbound will have stomach pain. Some people might not experience any gastrointestinal side effects at all.

Why might Zepbound cause stomach pain?

Zepbound mimics the effects of two related hormones: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). Both help to regulate and moderate the body’s digestion, which is why Zepbound can reduce appetite and slow the digestive process. This may include a delay in gastric emptying—how fast your stomach transfers food to the small intestine.

 “Some patients on Zepbound experience too much slowing, and they develop stomach pain, especially after eating a large meal,” says Jennifer Brown, MD, with MyObesityTeam. It may also cause side effects like bloating, indigestion, and stomach discomfort.

“Zepbound can also cause gall bladder or pancreas problems, so anyone who has severe stomach pain or pain that is associated with vomiting needs to see their doctor right away,” Dr. Brown says. In clinical studies, 0.2% of patients taking Zepbound experienced pancreatitis, while 1.1% experienced gallstones and 0.7% had gallbladder inflammation. 

Constipation is another common side effect of Zepbound, occurring in 11%–17% of clinical trial patients. This is another potential consequence of slowing down the digestive process, and it may lead to abdominal pain and discomfort.

How long does Zepbound stomach pain last?

​​“Usually, Zepbound-related stomach pain can be managed by making dietary changes,” Dr. Brown says. “The pain usually resolves after the patient has been on the medication for a couple of weeks.” Many Zepbound side effects will be more significant when you first start taking the drug, and they may get better as time goes on and your body grows accustomed to it. However, “sometimes, patients have a recurrence of the pain when the dose of Zepbound is increased,” she says.

Similarly, Randall Turner, DO, medical director at Able2Change says side effects typically occur when you first initiate Zepbound treatment or when you change the dose, and digestive side effects subside over a few days to weeks as the body adjusts.

In the short term, if the stomach pain stems from slowed gastric emptying, it will typically subside after the stomach clears out, which is typically just a few hours. Discomfort from constipation will usually last just as long as the constipation itself, often a few days, but potentially over multiple weeks. However, if constipation lasts longer than three weeks, it’s important to visit a healthcare provider.

Pancreatitis is unusual with Zepbound. But when it does occur, pancreatitis usually requires hospitalization. Gallstones might last for years without causing any symptoms. But gallstones can also lead to severe pain, infection, and other complications. So if your abdominal pain is severe or persistent while taking Zepbound, seek medical attention right away.

Other possible Zepbound side effects

Stomach pain is one of the most common Zepbound side effects, but it’s just one of several. According to Zepbound’s label, other possible common side effects include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Indigestion
• Injection site reactions
• Fatigue
• Allergic reactions
• Burping
• Hair loss
• Gastroesophageal Reflux Disease (GERD)
• Flatulence
• Abdominal distention
• Dizziness
• Low blood pressure
• Low blood sugar (hypoglycemia)

In addition to gallbladder disease and pancreatitis, rare but serious side effects may include thyroid tumors, kidney injury, very low blood sugar, and suicidal thoughts and behaviors.

RELATED: Does Zepbound cause headaches?

Tips for reducing and preventing Zepbound stomach pain

You can’t always prevent side effects, but you can do things to make them less likely or less severe. For Zepbound, here are some ways to potentially reduce gastrointestinal adverse reactions:

• Eat smaller, more frequent meals. Since the stomach empties more slowly when you’re taking Zepbound, large meals can cause it to overfill, increasing the risk of gastrointestinal side effects.
• Avoid spicy, greasy, or fatty foods. That plate of hot wings or fast food binge might be tempting, but they can also slow down digestion or further upset an already uneasy stomach.
• Stay hydrated. Water is essential to the digestive system, so you’ll want to keep it flowing to help everything run smoothly. It can also help prevent constipation, which is a potential cause of stomach pain.
• Try home remedies. Studies have shown that ginger has numerous gastrointestinal benefits, including calming an upset stomach, so ginger tea or adding ginger to food might be helpful. Certain studies have also shown that peppermint can help relieve IBS symptoms—although the research is more mixed.
• Ask about over-the-counter drugs: If your healthcare provider approves it, taking OTC antacids like Tums or other stomach medicines like Pepto-Bismol may help relieve gastrointestinal side effects.
• Consider your dosage: Zepbound has a few different doses, and healthcare providers typically start with the lowest (2.5 mg) and increase from there, helping the body acclimate slowly. But if you report stomach pain or other side effects to your healthcare provider, they may want to adjust the dosage.

RELATED: Zepbound interactions to avoid

When to see a doctor about Zepbound stomach pain

Stomach pain is a common side effect of Zepbound, and mild discomfort shouldn’t be a cause for alarm. However, there are certain circumstances when you should see a healthcare provider.

Per Dr. Turner, “You should seek medical care immediately if severe or persistent abdominal pain lasts over 24 hours, if the pain is sharp with nausea or vomiting, if the pain is in the upper-right abdomen with fever, if there are any signs of allergic reaction, or if there is hoarseness, difficulty swallowing, or breathing.”

For example, severe stomach pain that radiates to the back could be a sign of pancreatitis, which would warrant medical attention. Abdominal pain accompanied by jaundice and changes in urination could indicate kidney problems—another potentially serious side effect of Zepbound. Pain in the upper stomach plus fever, clay-colored stools, and jaundice may also be signs of gallbladder problems, which also require medical attention.

Stomach pain that’s especially severe or simply won’t go away is cause for concern, too. Even for milder gastrointestinal effects, if you find that they’re interfering with your daily life, it’s worth mentioning them to a healthcare professional.

Bottom line: Zepbound stomach pain is typically mild

A lot of people get stomach pain from Zepbound, and it’s usually temporary, mild, and manageable. So if you get your first injection and your stomach starts acting up, don’t panic: It’s a common reaction that will typically go away on its own. But that doesn’t mean you should completely ignore it either. If the stomach pain is severe, persistent, or accompanied by other concerning symptoms, it’s important to notify a healthcare provider. They can determine the cause, adjust the dosage, or find an alternative drug that works better for you.