Safety information
The honest fine print
GLP-1 medications are effective, and like all medicine, they come with some risks. Here's what you should know.
Do not take a GLP-1 if…
- You or a family member have had medullary thyroid carcinoma (MTC)
- You or a family member have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- You've had a serious allergic reaction to tirzepatide or another GLP-1 medication
- You are pregnant, breastfeeding, or planning to become pregnant
A history of pancreatitis, gallbladder disease, diabetic retinopathy, severe gastrointestinal disease, or kidney disease doesn't automatically rule you out, but it requires a careful conversation with a licensed provider first.
Common side effects
Most side effects are digestive, are most noticeable when starting or increasing a dose, and improve with time. Starting low and increasing slowly — which is exactly how we dose — keeps them manageable for most people.
- Nausea (most common, especially when starting or increasing a dose)
- Vomiting or diarrhea
- Constipation
- Stomach pain or indigestion
- Decreased appetite (expected — it's part of how the medication works)
- Fatigue
- Injection-site reactions (redness, itching, or irritation)
Serious warnings
These are uncommon, but you should know them before you start — and know exactly when to stop and call. We review all of this with you during the consent process.
Thyroid C-cell tumors
In rodent studies, tirzepatide-class medications caused thyroid C-cell tumors. It is not known whether this happens in humans. Because of this risk, you should not use these medications if you or a family member have had medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider right away about any lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
Pancreatitis
Inflammation of the pancreas has been reported. Stop the medication and seek care immediately for severe abdominal pain that doesn't go away, with or without vomiting, especially if it radiates to your back.
Gallbladder problems
Gallstones and gallbladder inflammation have been reported, particularly with substantial weight loss. Watch for pain in your upper right abdomen, fever, yellowing of the skin or eyes, or clay-colored stools.
Low blood sugar (hypoglycemia)
Risk increases if you take other diabetes medications such as insulin or sulfonylureas. Symptoms include shakiness, sweating, confusion, rapid heartbeat, and dizziness. Tell us about every medication you take.
Kidney problems
Dehydration from nausea, vomiting, or diarrhea can worsen kidney function. Stay hydrated, and tell your provider if you can't keep fluids down.
Vision changes
Rapid improvement in blood sugar has been associated with temporary worsening of diabetic retinopathy in some patients, and any sudden vision change deserves prompt attention. Report new or worsening vision problems right away.
Severe allergic reactions
Seek emergency care for swelling of the face, lips, tongue, or throat, difficulty breathing, severe rash, or rapid heartbeat after a dose.
Stomach paralysis (gastroparesis)
GLP-1s slow stomach emptying by design, and in some people this becomes severe. Persistent vomiting or feeling full long after small meals should be reported promptly.
When in doubt, reach out
If you experience severe abdominal pain, persistent vomiting, a neck lump or hoarseness, signs of an allergic reaction, or anything that frightens you — stop the medication and seek medical care. For emergencies, call 911. For everything else, contact your provider through the practice and we'll sort it out together.
This page is a plain-language summary, not a complete list of risks and not a substitute for medical advice. You'll receive and sign a full informed consent before any prescription, and your provider will answer every question before you start.
Questions about any of this? Email us (no medical details, please) or read the FAQ.