Tirzepatide Constipation: How Common It Is and What the Label Says
The short answer
Constipation is a labelled tirzepatide side effect. The Zepbound label lists it in 11% to 17% of people on 5 to 15 mg against 5% on placebo, and the Mounjaro label 6% to 7% against 1%. Most gastrointestinal events occurred during dose escalation. Tell a prescriber if stomach problems are severe or do not go away.
Constipation is one of the labelled side effects of tirzepatide, the drug in Mounjaro and Zepbound. The labels give the numbers, and they differ depending on who was studied. This page lays out those numbers and what the labels tell patients to do. It is a research reference, not medical advice: severe or persistent stomach symptoms are a reason to call a prescriber.
How common is constipation on tirzepatide?
| Label and population | 5 mg | 10 mg | 15 mg | Placebo |
|---|---|---|---|---|
| Zepbound, adults with obesity (SURMOUNT-1 and -2 pooled) | 17% | 14% | 11% | 5% |
| Mounjaro, adults with type 2 diabetes (placebo-controlled pool) | 6% | 6% | 7% | 1% |
Sources: the Zepbound label and the Mounjaro label, both revised August 2026. Two things stand out. The rate is several times higher than on placebo in both groups, and in the Zepbound table it did not climb with the dose: it was highest at 5 mg. Diarrhea is also common, and the Zepbound label lists both, so some people have one, some the other, and some alternate.
When does it happen?
In the SURMOUNT-5 head-to-head trial, the most common adverse events with both tirzepatide and semaglutide were gastrointestinal, mostly mild to moderate, and mostly during dose escalation (NEJM 2025). That points to the weeks around each step up in dose, covered in the tirzepatide dosage guide. The labels do not give a separate time course for constipation itself.
What the label tells patients to do
The Zepbound Medication Guide lists constipation among the most common side effects, and the label gives these instructions on stomach and fluid problems:
- Tell your healthcare provider if you have stomach problems that are severe or will not go away.
- Drink fluids to help reduce the chance of dehydration. Tell your provider right away if nausea, vomiting or diarrhea does not go away.
- Stop the drug and call your provider right away for severe pain in the stomach area that will not go away, which can signal pancreatitis, and for symptoms of gallbladder problems such as upper abdominal pain, fever, jaundice or clay-colored stools.
The label does not name a laxative, fiber target or other specific remedy for constipation. What to try, and whether to slow the dose escalation, is a conversation for a prescriber or pharmacist who knows your other medicines. The label also notes that tirzepatide can slow stomach emptying.
How it compares with semaglutide
The Wegovy label lists constipation too: in its 72-week obesity trials, 19% on 2.4 mg and 20% on 7.2 mg reported it against 8% on placebo (Wegovy label). A 2025 network meta-analysis of 39 studies in adults without diabetes, 33,354 people in all, found nausea, vomiting, diarrhea and constipation the most common gastrointestinal effects across GLP-1 drugs, and linked semaglutide and liraglutide with higher constipation risk (Int J Obes 2025). Populations and trial designs differ, so none of these numbers are a ranking. A fuller side-by-side is in Zepbound vs Wegovy.
Related side effects
For the rest of the profile see tirzepatide side effects, does tirzepatide make you tired and tirzepatide and alcohol. If you are drawing doses from a vial, the calculator below turns vial strength and water volume into a syringe mark.
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Does tirzepatide cause constipation?
Yes, it is a labelled side effect. The Zepbound label lists constipation in 17%, 14% and 11% of adults on 5, 10 and 15 mg against 5% on placebo, and the Mounjaro label lists 6%, 6% and 7% against 1%.
Does constipation get worse at higher tirzepatide doses?
Not in the Zepbound label table, where it was 17% at 5 mg, 14% at 10 mg and 11% at 15 mg. In the Mounjaro table it rose slightly, from 6% to 7%. Overall gastrointestinal events cluster around dose increases.
When should I call a doctor about stomach problems on tirzepatide?
The Medication Guide says to tell your provider about stomach problems that are severe or will not go away, to call right away for nausea, vomiting or diarrhea that does not go away, and to stop the drug and call right away for severe stomach-area pain that will not go away.
Is constipation more common on semaglutide or tirzepatide?
The labels cannot answer that because they come from different trials. Wegovy lists constipation at 19% on 2.4 mg against 8% on placebo; Zepbound lists 11 to 17% against 5%. No head-to-head constipation comparison is in the labels.
Sources (checked 6 November 2026)
- Zepbound prescribing information and Medication Guide, Eli Lilly, revised 8/2026, DailyMed. Checked 6 November 2026.
- Mounjaro prescribing information, Eli Lilly, revised 8/2026, DailyMed. Checked 6 November 2026.
- Wegovy prescribing information, Novo Nordisk, revised 6/2026. Checked 6 November 2026.
- Aronne et al, Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5), New England Journal of Medicine, 2025. Checked 6 November 2026.
- Ismaiel et al, Gastrointestinal adverse events associated with GLP-1 RA in non-diabetic patients with overweight or obesity: a systematic review and network meta-analysis, International Journal of Obesity, 2025. Checked 6 November 2026.
Label figures are from the Zepbound and Mounjaro labels revised August 2026. Labels and trial records change; the leaflet in your box and your prescriber come first. Educational content, not medical advice.