Tirzepatide Diarrhea: Causes & How to Stop It

Key takeaways:

• Diarrhea is a common side effect of tirzepatide. In Zepbound^® clinical trials, 19 to 23 percent of people reported diarrhea.

• To reduce tirzepatide diarrhea, avoid fatty foods, alcohol, sweeteners, and triggering foods, like dairy and caffeine.

• If tirzepatide diarrhea doesn’t get better, reach out to your healthcare provider. A lower dose might help.
  

Like any medication, tirzepatide (Mounjaro^®, Zepbound^®) comes with potential side effects. One of the more uncomfortable ones is diarrhea.

You can minimize tirzepatide diarrhea by avoiding dairy and coffee, drinking plenty of water, and temporarily cutting back on fiber.

Below, we’ll cover why tirzepatide can cause diarrhea, how to stop it, and when it’s worth reaching out to a healthcare provider for advice.

The rumors are true: Tirzepatide can cause diarrhea. It’s a common side effect — and more common at higher doses.

Here’s how many people reported diarrhea in clinical trials on Zepbound^®, which contains tirzepatide and is approved by the Food and Drug Administration (FDA) for obesity and overweight.

Diarrhea is a common side effect of Mounjaro^®, too, which also contains tirzepatide and is FDA-approved for type 2 diabetes.

The good news is that Mounjaro^® and Zepbound^® side effects are usually mild to moderate. They typically happen during the dose escalation phase, which takes place during your first few weeks and months on the medication. And side effects tend to get better with time.

It’s not entirely clear why tirzepatide causes diarrhea.

Tirzepatide is in a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1s can reduce how much sugar (glucose) and fats (lipids) your intestines absorb, which might trigger bouts of diarrhea for some people.

Btw, tirzepatide is a GLP-1 and a glucose-dependent insulinotropic polypeptide (GIP). It’s unclear whether the medication could cause diarrhea in different ways than medications that only mimic GLP-1.

You can try to stop tirzepatide diarrhea by avoiding triggering foods and drinks and temporarily reducing your fiber intake.

Here’s more on what to do when you have tirzepatide-induced loose stools.

1. Avoid Trigger Foods and Drinks

Some foods and drinks can make tirzepatide diarrhea worse.

Avoid or limit:

• Fatty and greasy foods

• Dairy products, like milk, cheese, and yogurt

• Coffee

• Alcohol

• Soft drinks and sugary beverages

• Very cold or very hot foods

• Foods that contain sweeteners that end in “ol” (like maltitol, mannitol, sorbitol, and xylitol), such as chewing gum and candy

It’s worth keeping a food and symptom diary to figure out what makes diarrhea worse for you.

→ Read next: What to Eat on Mounjaro^®

2. Temporarily Reduce Your Fiber Intake

Fiber is usually a good thing. It can improve gut health and make you feel fuller for longer. Overall, a higher fiber intake can reduce chronic diarrhea.

But when diarrhea crops up, temporarily reducing your fiber intake can help harden your stool.

That means temporarily limiting high-fiber foods such as: 

• Fruits

• Veggies

• Nuts and seeds

• Legumes, like beans, chickpeas, and lentils

• Whole grains, like quinoa, brown rice, and wholemeal pasta

Again, you don’t need to cut out fiber forever — and you really shouldn’t. Gradually reintroduce fiber once your side effects improve.

3. Eat Easy-to-Digest Foods

What should you eat when you have Mounjaro^® or Zepbound^® diarrhea? Go for bland, easy-to-digest foods that are gentle on your gut.

That includes:

• Chicken

• Broth

• Rice

• Bananas and other very ripe, peeled fruit

• Plain toast

• Oatmeal

• Carrots

→ Related: Gut Health and Weight Loss: What’s the Connection?

4. Take Diarrhea Medications 

Over-the-counter (OTC) antidiarrheal medications include loperamide (Imodium^®) and bismuth subsalicylate (Pepto Bismol^®).

Check with your healthcare provider if you have a fever or bloody stools before taking OTC diarrhea medications.

5. Eat Smaller, More Frequent Meals

Eating smaller meals more regularly can help you avoid digestive discomfort and potentially reduce gastrointestinal side effects like diarrhea. So, instead of eating three main meals a day, try eating six smaller meals.

Plus, eat only when you’re truly hungry and stop before you get overfull.

These habits can keep bowel movements in check and minimize other gastrointestinal side effects of tirzepatide, like nausea.

6. Follow Your Dose Escalation Schedule

Starting on a low dose of tirzepatide that gradually increases reduces your chances of diarrhea and other side effects like nausea, vomiting, abdominal pain, and constipation — although you might be hoping for some constipation right about now.

Your healthcare provider will probably prescribe a starting dose of 2.5 mg of Mounjaro^® or Zepbound^® that increases every four weeks in 2.5-mg increments.

7. Reach Out to Your Healthcare Provider

If tirzepatide diarrhea doesn’t improve, reach out to your prescribing healthcare provider.

They may recommend:

• A lower dose of tirzepatide

• Staying on your current dose for longer, if you’re in the dose escalation phase

• Diarrhea medications

• Lifestyle changes

• A different weight loss medication, like semaglutide (Ozempic^®, Wegovy^®), metformin, or topiramate

Note: Make Sure to Drink Enough Water 

You lose a lot of fluids when you have diarrhea, so it’s crucial to hydrate regularly. Take small sips of water throughout the day, and eat foods with a high water content, like soups, broths, and whole fruit. Adding electrolytes to your water might help too.

Once diarrhea passes, make sure you’re still staying hydrated.

You should see a medical provider about tirzepatide diarrhea if your diarrhea is severe or if it’s not improving.

Reach out to a healthcare professional if you have diarrhea and:

• A fever of 102 °F or higher

• Blood or pus in your stool

• Stool that’s black or looks like tar

• Severe rectum or stomach pain

• Signs of dehydration, like extreme thirst, dark-colored pee, and dizziness

Always get medical advice about any worrying gastrointestinal symptoms.

If you get tirzepatide through Hers, don’t forget you’ve got unlimited access to your Care Team. You can discuss side effects, get advice, and get tweaks to your treatment plan if needed, at no extra cost.

Tirzepatide diarrhea isn’t guaranteed, but it’s a common side effect because of the drug’s effects on the digestive system. Luckily, tirzepatide side effects tend to get better as your body adjusts.

Here’s what to keep in mind in the meantime:

• Tirzepatide diarrhea is common. You’re far from alone with this particular side effect. Up to 23 percent of people reported diarrhea in Zepbound^® clinical trials.

• Make sure you drink enough water. It’s tough when you’re not feeling your best, but dehydration can happen quickly when you’re losing fluids through diarrhea. Sip water throughout the day, and eat foods high in water, like broth.

• Avoid trigger foods. Avoid fatty foods, alcohol, caffeine, and dairy, especially when diarrhea crops up. Temporarily reducing fiber can also help. Slowly reintroduce fiber once diarrhea passes.

Finally, reach out to your healthcare provider if tirzepatide diarrhea doesn’t get better. There are medications to help, lower doses, and different weight loss medications that may suit your body better.

Get answers to frequently asked questions about tirzepatide diarrhea below.

How long does tirzepatide diarrhea last?

How long tirzepatide diarrhea lasts varies from person to person. Diarrhea from Wegovy^® (another GLP-1 medication) can last an average of three days at a time. You might find diarrhea happens when you first start Mounjaro^® or Zepbound^®, and when your dose increases.

How to prevent diarrhea from tirzepatide?

You can try to prevent diarrhea from tirzepatide by following your dose escalation schedule, avoiding overeating, and eating easy-to-digest foods. 

Does Mounjaro^® cause diarrhea? 

Yes, Mounjaro^® can cause diarrhea. In clinical trials, 12 percent of people taking 5 mg of Mounjaro^® reported diarrhea. Diarrhea was more common in higher doses — 17 percent of people taking 15 mg of Mounjaro^® reported diarrhea.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards.