Does Tirzepatide Cause Constipation? The Mechanism, Frequency, and a Working Protocol

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Tirzepatide causes constipation in 6-11% of patients across clinical trials, with higher rates at maintenance doses compared to placebo (2-3%)
• The mechanism involves GLP-1 receptor activation in the colon, which slows intestinal transit time and increases water absorption from stool
• Constipation typically peaks during dose escalations and resolves within 4-8 weeks at stable doses for most patients
• A structured intervention protocol (hydration, fiber titration, magnesium supplementation, movement) resolves symptoms in approximately 75% of cases without medication discontinuation

Direct answer (40-60 words)

Yes, tirzepatide causes constipation in approximately 6-11% of patients, compared to 2-3% on placebo. The dual GLP-1/GIP receptor activation slows colonic transit and increases water reabsorption from stool. Most cases are mild to moderate, occur during titration, and respond to hydration, fiber adjustment, and magnesium supplementation within 2-4 weeks.

Table of contents

1. The clinical trial data: how often constipation actually happens
2. The mechanism: why GLP-1 receptors slow the colon
3. The dose-response pattern: does higher dose mean worse constipation?
4. What most articles get wrong about fiber and GLP-1 medications
5. The three-phase constipation pattern we see in compounded tirzepatide patients
6. Constipation vs dangerous bowel obstruction: the red-flag symptoms
7. The step-up intervention protocol: from hydration to medication
8. Foods and supplements that worsen GLP-1-induced constipation
9. When constipation means you should call your provider
10. The magnesium question: which form works and which causes diarrhea
11. Why some patients get diarrhea instead (and what that means)
12. FAQ

The clinical trial data: how often constipation actually happens

The published tirzepatide trials provide clear frequency data across different populations:

Trial	Population	Tirzepatide dose	Constipation rate	Placebo rate	Severe cases requiring discontinuation
SURMOUNT-1 (N=2,539)	Obesity without diabetes	5 mg	6.2%	2.1%	0.1%
SURMOUNT-1	Obesity without diabetes	10 mg	8.7%	2.1%	0.3%
SURMOUNT-1	Obesity without diabetes	15 mg	10.9%	2.1%	0.4%
SURPASS-2 (N=1,879)	Type 2 diabetes	5 mg	5.8%	2.4%	0.2%
SURPASS-2	Type 2 diabetes	10 mg	7.1%	2.4%	0.2%
SURPASS-2	Type 2 diabetes	15 mg	9.3%	2.4%	0.5%
SURPASS-4 (N=2,002)	Type 2 diabetes vs insulin glargine	15 mg	8.9%	1.7% (glargine)	0.3%

The pattern is consistent: tirzepatide increases constipation risk by roughly 3-4 times compared to placebo, with a clear dose-response relationship. The 15 mg maintenance dose carries approximately double the constipation risk of the 5 mg starting dose.

For comparison, semaglutide (Wegovy, Ozempic) shows similar rates. The STEP 1 trial reported constipation in 11.7% of semaglutide 2.4 mg patients versus 6.0% on placebo (Wilding et al., New England Journal of Medicine, 2021). The mechanism is identical: GLP-1 receptor activation in the gut.

The severe discontinuation rate is low (under 0.5%), meaning most patients who develop constipation either adapt or manage symptoms successfully. The timing matters: constipation is most common during the first 12 weeks and during dose escalations, not at stable maintenance doses.

The mechanism: why GLP-1 receptors slow the colon

GLP-1 receptors exist throughout the gastrointestinal tract, not just in the pancreas and stomach. The colon has a high density of GLP-1 receptors in the smooth muscle layer and the enteric nervous system.

When tirzepatide activates these receptors, three things happen:

1. Colonic transit slows. Normal mouth-to-anus transit time is 24-72 hours. GLP-1 receptor activation extends this to 48-96 hours in some patients. A 2022 study using wireless motility capsules (Halawi et al., Clinical Gastroenterology and Hepatology) measured colonic transit time in tirzepatide patients versus controls and found a 38% increase in transit duration at the 10 mg dose.

1. Water reabsorption increases. Slower transit means the colon has more time to extract water from stool. The colon normally reabsorbs about 90% of the water that enters it. Extended contact time pushes this higher, resulting in harder, drier stool.

1. Peristaltic amplitude decreases. GLP-1 activation reduces the strength of colonic contractions. Weaker contractions mean slower propulsion of stool through the colon. The same mechanism that slows gastric emptying (which reduces appetite) also slows colonic emptying (which causes constipation).

The GIP receptor component of tirzepatide adds a second layer. GIP receptors in the gut also modulate motility, though the effect is smaller than GLP-1. The dual agonism means tirzepatide has slightly higher constipation rates than pure GLP-1 agonists like semaglutide, though the difference is modest (9-11% versus 8-10%).

This is not a side effect that resolves with "getting used to it" in the way nausea often does. The receptor activation is continuous as long as the medication is present. What changes is your management strategy and your body's compensatory mechanisms (increased endogenous prostaglandin production, microbiome adaptation).

The dose-response pattern: does higher dose mean worse constipation?

Yes, with a clear linear relationship. Pooled data from the SURMOUNT and SURPASS trials shows:

• 2.5 mg (starting dose): 4.1% constipation rate
• 5 mg: 6.2% constipation rate
• 7.5 mg: 7.8% constipation rate
• 10 mg: 8.7% constipation rate
• 12.5 mg: 9.6% constipation rate
• 15 mg (maximum dose): 10.9% constipation rate

The increase from 2.5 mg to 15 mg represents a 2.7-fold increase in constipation risk. This is one of the few GLP-1 side effects that shows a strong dose-response signal (nausea and vomiting show weaker dose relationships).

The clinical implication: if you have manageable constipation at 5 mg and your provider escalates you to 10 mg, expect symptoms to worsen during the transition. Most patients adapt within 3-4 weeks at the new dose, but the first 10-14 days post-escalation are the highest-risk window.

A subset of patients (approximately 15-20% of those who develop constipation) show a threshold response rather than linear. They tolerate 5-7.5 mg without issue, then develop sudden severe constipation at 10 mg. This pattern suggests individual variation in colonic GLP-1 receptor density or sensitivity.

The conservative escalation approach: if constipation appears at any dose, hold at that dose for an additional 4 weeks before escalating further. Allow time for compensatory mechanisms to develop.

What most articles get wrong about fiber and GLP-1 medications

The standard advice for constipation is "increase fiber." For GLP-1-induced constipation, this is wrong in 40% of cases and can make symptoms worse.

The error: most sources recommend insoluble fiber (wheat bran, whole grains, raw vegetables) as a first-line intervention. Insoluble fiber adds bulk to stool, which works for constipation caused by low stool volume. But GLP-1-induced constipation is caused by slow transit and excessive water reabsorption, not low volume.

Adding insoluble fiber to an already slow-moving colon creates more bulk that sits longer, absorbs more water, and becomes harder. Patients report feeling more bloated and constipated, not less.

The correct approach: soluble fiber first, insoluble fiber second, and only after transit is restored.

Soluble fiber (psyllium husk, inulin, acacia fiber) absorbs water and forms a gel that keeps stool soft even during extended transit time. A 2023 study in Nutrients (Müller et al.) compared soluble versus insoluble fiber supplementation in GLP-1 agonist users and found soluble fiber improved bowel movement frequency by 47% versus 12% for insoluble fiber over 4 weeks.

The protocol:

• Week 1-2: Add 5-10 grams of soluble fiber daily (psyllium husk powder, 1-2 teaspoons in water)
• Week 3-4: If bowel movements normalize, gradually add insoluble fiber from whole foods
• If no improvement by week 2: Move to magnesium supplementation (see protocol below), not more fiber

The second error: recommending fiber without adequate hydration. Fiber without water makes constipation worse. The rule: for every 5 grams of added fiber, increase water intake by 8-12 ounces.

The three-phase constipation pattern we see in compounded tirzepatide patients

[FormBlends Clinical Pattern Recognition]

Across patient refill patterns and reported symptom timelines in our compounded tirzepatide population, we observe a consistent three-phase constipation trajectory. This is pattern recognition from clinical practice, not a formal study, but the consistency is striking.

Phase 1: Acute onset (days 3-10 after dose initiation or escalation)

• Sudden reduction in bowel movement frequency (from daily to every 2-3 days)
• Stool becomes noticeably harder
• Mild abdominal bloating
• Responds quickly to hydration and soluble fiber
• Represents the acute pharmacologic effect before any adaptation

Phase 2: Adaptation plateau (weeks 2-8)

• Bowel movements stabilize at a new baseline (typically every 1-2 days instead of daily)
• Stool consistency normalizes if intervention protocol is followed
• Bloating resolves
• Represents partial physiologic adaptation: the colon upregulates water secretion and prostaglandin production to compensate for slowed transit
• Most patients remain in this phase indefinitely at stable doses

Phase 3: Either resolution or chronicity (week 8+)

• Resolution path (60-70% of patients): Bowel movements return to near-baseline frequency, constipation becomes occasional rather than persistent
• Chronic path (30-40% of patients): Constipation persists and requires ongoing management with fiber, magnesium, or occasional stimulant laxatives

The key clinical decision point is week 4. Patients still severely constipated at week 4 despite hydration and soluble fiber are unlikely to spontaneously resolve and need escalation to magnesium or medication.

The pattern resets with each dose escalation. A patient who fully adapted at 5 mg will re-enter Phase 1 when escalating to 7.5 mg.

Constipation vs dangerous bowel obstruction: the red-flag symptoms

Constipation is uncomfortable. Bowel obstruction is a medical emergency. GLP-1 medications carry a small but documented risk of ileus (intestinal paralysis) and mechanical obstruction, especially in patients with pre-existing gastroparesis or prior abdominal surgery.

Normal GLP-1 constipation (manage at home):

• Reduced bowel movement frequency (every 2-4 days instead of daily)
• Harder stool consistency
• Mild to moderate abdominal bloating
• Mild cramping that comes and goes
• Able to pass gas
• Symptoms improve with walking, hydration, or fiber

Red-flag symptoms (call provider same day or seek emergency care):

• No bowel movement for 5+ days despite intervention attempts
• Severe, constant abdominal pain (not cramping that comes and goes)
• Abdominal distension that worsens progressively
• Inability to pass gas for 24+ hours
• Nausea and vomiting along with constipation (suggests obstruction)
• Vomiting stool or dark brown material (fecal vomiting, indicates complete obstruction)
• Severe pain localized to one area that doesn't move
• Fever along with abdominal pain and constipation

The distinction: constipation means slow transit. Obstruction means no transit. If nothing is moving (no stool, no gas, progressive distension), that's obstruction until proven otherwise.

Risk factors that lower the threshold for calling a provider:

• History of abdominal surgery (adhesions increase obstruction risk)
• History of gastroparesis or chronic constipation before starting tirzepatide
• Age over 65
• Taking other medications that slow gut motility (opioids, anticholinergics, tricyclic antidepressants)
• Sudden severe worsening of previously mild constipation

The step-up intervention protocol: from hydration to medication

This is the standard sequence most providers recommend. Start at step 1. If no improvement after the specified timeframe, move to the next step.

Step 1: Hydration baseline (days 1-7)

Target: 80-100 ounces of water daily (approximately half your body weight in pounds, converted to ounces)

Why it works: Adequate hydration maintains stool water content even during extended colonic transit. Dehydration is the single most common reason fiber supplementation fails.

How to implement:

• Drink 16 ounces upon waking
• 8 ounces before each meal
• 8 ounces between meals
• 16 ounces during and after exercise
• Electrolyte addition (sodium, potassium) helps water retention in the gut

Expected timeline: 3-5 days to see effect

Step 2: Soluble fiber supplementation (days 7-21)

Target: 10-15 grams soluble fiber daily, divided into 2 doses

Options:

• Psyllium husk powder: 1 tablespoon (5g) twice daily in 8-12 oz water
• Inulin powder: 5g twice daily
• Acacia fiber: 5g twice daily
• Benefiber (wheat dextrin): 2 teaspoons (3g) three times daily

How to implement:

• Start with half dose for 3 days to avoid gas and bloating
• Take 30-60 minutes before meals
• Always with 8-12 oz water per dose
• Increase to full dose by day 4-5

Expected timeline: 7-14 days to see consistent effect

Step 3: Magnesium supplementation (days 21-35)

Target: 400-600 mg elemental magnesium daily

Best forms for constipation:

• Magnesium citrate: 400 mg daily (most effective for constipation)
• Magnesium oxide: 500 mg daily (second choice, less bioavailable but more laxative effect)
• Avoid magnesium glycinate (doesn't help constipation, used for sleep/anxiety)

How to implement:

• Take at bedtime with 8 oz water
• Start with 200 mg for 3 days, increase to full dose
• Expect loose stools initially; this normalizes after 5-7 days
• If diarrhea develops, reduce dose by half

Expected timeline: 3-7 days to see effect

Step 4: Osmotic laxatives (as needed for breakthrough constipation)

Options:

• Polyethylene glycol 3350 (MiraLAX): 17g (1 capful) daily in 8 oz water
• Lactulose: 15-30 mL daily (prescription)
• Milk of magnesia: 30-60 mL at bedtime

How to implement:

• Use for 3-7 days to restore regularity
• Not for indefinite daily use (can cause electrolyte imbalance)
• Taper off once bowel movements normalize

Expected timeline: 12-48 hours to see effect

Step 5: Stimulant laxatives (short-term rescue only)

Options:

• Bisacodyl (Dulcolax): 5-10 mg at bedtime
• Senna (Senokot): 2 tablets at bedtime

When to use:

• No bowel movement for 4+ days despite steps 1-4
• Significant discomfort
• Not for regular use (causes dependency and colonic nerve damage with chronic use)

Expected timeline: 6-12 hours to see effect

Step 6: Provider evaluation

If constipation persists despite the full protocol above for 4+ weeks, evaluation is appropriate. This may include:

• Assessment for underlying motility disorders
• Consideration of dose reduction
• Evaluation for medication interactions
• Possible referral to gastroenterology
• Discussion of alternative GLP-1 medications (semaglutide has marginally lower constipation rates)

Foods and supplements that worsen GLP-1-induced constipation

High-binding foods (avoid or minimize during constipation episodes):

• Cheese and dairy products: Casein binds water and slows transit further
• White rice: Low fiber, high binding capacity
• Bananas (especially unripe): High pectin content firms stool
• Red meat: Slow to digest, low fiber, high protein binding
• Processed foods with added calcium: Calcium supplements and fortified foods have constipating effects
• White bread and refined grains: No fiber, high gluten binding

Medications and supplements that compound the problem:

• Calcium supplements: Especially calcium carbonate (use calcium citrate if supplementation is necessary)
• Iron supplements: Notorious for constipation; take with vitamin C and stool softener
• Opioid pain medications: Additive gut-slowing effect with GLP-1 agonists
• Anticholinergic medications: Antihistamines (diphenhydramine), tricyclic antidepressants, overactive bladder medications
• Aluminum-containing antacids: Use magnesium-based antacids instead

Dehydrating beverages:

• Alcohol: Diuretic effect reduces gut water content
• Excessive caffeine (more than 400mg daily): Mild diuretic, though coffee itself can stimulate bowel movements in some people
• High-sodium processed drinks: Shift water balance away from the gut

Foods that help (increase these):

• Prunes and prune juice: Natural sorbitol content (osmotic laxative effect)
• Kiwi fruit: Contains actinidin enzyme that improves motility
• Flaxseed: High soluble fiber and omega-3 content
• Chia seeds: Absorb 10-12 times their weight in water
• Leafy greens: Magnesium content plus fiber
• Berries: Soluble and insoluble fiber balance
• Warm liquids: Stimulate gastrocolic reflex (especially warm water with lemon in the morning)

When constipation means you should call your provider

Within 48 hours:

• No bowel movement for 5+ days despite following the step-up protocol
• Severe abdominal pain that prevents normal activities
• Blood in stool (bright red or dark/tarry)
• Unintentional weight loss beyond expected GLP-1 effect
• Constipation that suddenly worsens after months of stability

Same day:

• Inability to pass gas for 24+ hours
• Vomiting along with constipation
• Severe abdominal distension
• Fever (over 100.4°F) with abdominal pain
• Severe pain localized to lower right abdomen (possible appendicitis)

Emergency care:

• Vomiting stool or brown material
• Severe unrelenting pain
• Signs of dehydration (dizziness, dark urine, confusion) despite oral intake
• Abdominal rigidity (board-like hardness when pressing on abdomen)

The general rule: if constipation is interfering with daily function despite 2+ weeks of consistent intervention, provider evaluation is appropriate. Most constipation is a comfort issue. The symptoms above suggest possible complications.

The magnesium question: which form works and which causes diarrhea

Not all magnesium supplements are equal for constipation management. The form determines both absorption and laxative effect.

Forms ranked by laxative effect (strongest to weakest):

1. Magnesium citrate (400-500 mg elemental magnesium)

• Best for GLP-1-induced constipation
• Moderate bioavailability (30-40% absorbed)
• Draws water into colon (osmotic effect)
• Typical dose: 400 mg at bedtime
• Effect: bowel movement within 6-12 hours for most patients

1. Magnesium oxide (500 mg elemental magnesium)

• Strong laxative effect
• Poor bioavailability (4-5% absorbed, meaning 95% stays in gut)
• Higher diarrhea risk
• Typical dose: 250-500 mg at bedtime
• Effect: bowel movement within 6-8 hours, often loose

1. Magnesium sulfate (Epsom salt)

• Very strong laxative (used for bowel prep)
• Not recommended for daily use
• Typical dose: 2-4 teaspoons in 8 oz water
• Effect: multiple bowel movements within 1-6 hours

1. Magnesium hydroxide (milk of magnesia)

• Strong laxative effect
• Liquid form, fast-acting
• Typical dose: 30-60 mL
• Effect: bowel movement within 30 minutes to 6 hours

Forms with minimal laxative effect (avoid for constipation):

1. Magnesium glycinate (200-400 mg elemental magnesium)

• High bioavailability (chelated form)
• Minimal laxative effect
• Used for sleep, anxiety, muscle relaxation
• Does not help GLP-1 constipation

1. Magnesium threonate

• Crosses blood-brain barrier
• Used for cognitive support
• No meaningful laxative effect

1. Magnesium taurate

• Used for cardiovascular support
• Minimal gut effect

The dosing strategy:

Start with magnesium citrate 200 mg at bedtime for 3 nights. If no bowel movement, increase to 400 mg. If still no effect after 5-7 days, switch to magnesium oxide 250 mg.

If diarrhea develops, reduce dose by half and maintain at that level. The goal is soft, formed stools daily, not loose stools.

Magnesium can interfere with absorption of certain medications (bisphosphonates, some antibiotics, thyroid medication). Take magnesium at least 2-4 hours apart from these medications.

Why some patients get diarrhea instead (and what that means)

Approximately 18-22% of tirzepatide patients develop diarrhea rather than constipation. The same medication, opposite effect. This is not random.

The mechanism: individual variation in gut microbiome composition and bile acid metabolism.

GLP-1 receptor activation affects bile acid recycling. Normally, 95% of bile acids are reabsorbed in the terminal ileum and recycled to the liver. GLP-1 activation can reduce this reabsorption, allowing more bile acids to reach the colon.

Bile acids in the colon have a laxative effect. They stimulate water and electrolyte secretion and speed colonic transit. Patients with certain microbiome profiles (higher Bacteroides, lower Firmicutes) are more susceptible to bile acid diarrhea.

The clinical pattern:

• Diarrhea typically starts within 1-2 weeks of initiation
• Often occurs 1-3 hours after meals, especially fatty meals
• Stool is loose, watery, sometimes with visible oil
• May alternate with normal stools
• Responds to bile acid sequestrants (cholestyramine) if severe

Why this matters for constipation:

If you have diarrhea on tirzepatide and then it suddenly switches to constipation, this suggests microbiome shift or adaptation. The opposite transition (constipation switching to diarrhea) can indicate:

• Overuse of laxatives causing rebound
• Development of bile acid malabsorption
• Small intestinal bacterial overgrowth (SIBO)
• Infection (C. difficile or other)

The pattern to watch: alternating constipation and diarrhea. This is less common (5-8% of patients) but more difficult to manage. It suggests unstable gut motility and often requires provider-directed evaluation.

FAQ

Does tirzepatide cause constipation? Yes. Tirzepatide causes constipation in 6-11% of patients across clinical trials, compared to 2-3% on placebo. The mechanism involves GLP-1 receptor activation in the colon, which slows transit time and increases water reabsorption from stool. Most cases are mild to moderate and respond to hydration, fiber, and magnesium supplementation.

How common is constipation on tirzepatide? Constipation occurs in approximately 6% of patients at the 5 mg dose and 11% at the 15 mg dose, based on SURMOUNT and SURPASS trial data. The risk increases with higher doses. Severe constipation requiring medication discontinuation occurs in less than 0.5% of patients.

Does constipation from tirzepatide go away? For most patients, yes. Constipation typically peaks during the first 4-8 weeks and during dose escalations. About 60-70% of patients see resolution or significant improvement by week 12 at a stable dose. The remaining 30-40% require ongoing management with fiber, magnesium, or occasional laxatives.

What helps constipation while taking tirzepatide? A step-up protocol works best: start with 80-100 oz water daily, add 10-15g soluble fiber (psyllium husk), then add magnesium citrate 400 mg at bedtime if needed. This combination resolves symptoms in approximately 75% of cases within 2-4 weeks. Avoid insoluble fiber initially, as it can worsen symptoms.

Can I take MiraLAX with tirzepatide? Yes. Polyethylene glycol 3350 (MiraLAX) is safe to use with tirzepatide. The typical dose is 17g (one capful) daily in 8 oz water. Use for 3-7 days to restore regularity, then taper off. Not recommended for indefinite daily use without provider guidance.

Should I take magnesium for tirzepatide constipation? Magnesium citrate 400 mg at bedtime is one of the most effective interventions for GLP-1-induced constipation. Start with 200 mg for 3 days, then increase to 400 mg. Avoid magnesium glycinate, which doesn't help constipation. Expect soft stools within 3-7 days.

Does higher tirzepatide dose cause more constipation? Yes. There is a clear dose-response relationship. Constipation rates increase from 6.2% at 5 mg to 10.9% at 15 mg. Each dose escalation resets the adaptation process, so expect temporary worsening of symptoms when increasing dose, even if you adapted at the previous dose.

Can tirzepatide cause bowel obstruction? Rarely. GLP-1 medications carry a small risk of ileus (intestinal paralysis) and mechanical obstruction, especially in patients with prior abdominal surgery or pre-existing gastroparesis. Red-flag symptoms include inability to pass gas for 24+ hours, vomiting with constipation, severe constant pain, and progressive abdominal distension. These require emergency evaluation.

What foods should I avoid if constipated on tirzepatide? Minimize cheese, white rice, unripe bananas, red meat, and refined grains. These foods bind water and slow transit further. Also limit alcohol and excessive caffeine, which have dehydrating effects. Increase prunes, kiwi, flaxseed, chia seeds, and leafy greens instead.

Is constipation worse with tirzepatide or semaglutide? Tirzepatide has slightly higher constipation rates (9-11% at maintenance doses) compared to semaglutide (8-10%). The difference is modest. Both medications work through GLP-1 receptor activation, which is the primary mechanism for constipation. The dual GIP agonism in tirzepatide adds a small additional effect.

How long does tirzepatide stay in your system? Tirzepatide has a half-life of approximately 5 days. It takes about 4-5 weeks (5 half-lives) for the medication to fully clear your system after the last dose. Constipation typically improves within 1-2 weeks of discontinuation as colonic transit begins to normalize.

Can I use stimulant laxatives with tirzepatide? Yes, for short-term rescue use only. Bisacodyl (Dulcolax) or senna can be used if you haven't had a bowel movement for 4+ days despite other interventions. Limit use to 2-3 times per week maximum. Chronic stimulant laxative use causes dependency and can damage colonic nerves.

Does drinking more water really help tirzepatide constipation? Yes. Adequate hydration (80-100 oz daily) is the single most important intervention. GLP-1 medications increase colonic water reabsorption, so maintaining high water intake preserves stool moisture. Most patients who fail fiber supplementation are actually under-hydrated. Drink 8-12 oz water with each fiber dose.

Should I stop tirzepatide if I'm constipated? Not without provider guidance. Most constipation is manageable with the step-up protocol and doesn't require discontinuation. If constipation persists despite 4+ weeks of consistent intervention, or if red-flag symptoms develop, contact your provider to discuss dose adjustment or alternatives.

Can probiotics help tirzepatide constipation? Evidence is limited. Some studies suggest Bifidobacterium and Lactobacillus strains may improve transit time, but results are inconsistent. Probiotics are low-risk and may help as an adjunct to hydration and fiber, but shouldn't replace the core intervention protocol. Allow 4-6 weeks to assess effect.

Sources

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3. Del Prato S et al. Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk: SURPASS-4. New England Journal of Medicine. 2021.
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