Does Tirzepatide Cause Dizziness? The Blood Pressure Mechanism and When to Worry

Trust signals

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

Key Takeaways

• Tirzepatide causes dizziness in 6.2% to 8.1% of patients, primarily through blood pressure reduction and volume depletion from early rapid weight loss
• Most dizziness resolves within 4 to 6 weeks as the body adapts to lower baseline blood pressure and stabilized fluid balance
• Orthostatic hypotension (dizziness when standing) is the most common pattern, peaking during dose escalations and the first 8 weeks of treatment
• Persistent dizziness beyond 8 weeks, dizziness with chest pain, or dizziness with fainting requires immediate provider evaluation

Direct answer (40-60 words)

Yes, tirzepatide causes dizziness in approximately 6% to 8% of patients. The mechanism is dual: GLP-1 receptor activation causes mild vasodilation and blood pressure reduction, while early rapid weight loss causes volume depletion. Both lower blood pressure enough to trigger orthostatic dizziness, especially when standing quickly. Most cases resolve within 4 to 6 weeks.

Table of contents

1. The clinical data: how often dizziness actually happens
2. The dual mechanism: blood pressure and volume depletion
3. Orthostatic hypotension vs other causes of dizziness
4. The adaptation timeline: when dizziness peaks and when it resolves
5. What most articles get wrong about GLP-1 dizziness
6. The step-by-step protocol to stop dizziness without quitting treatment
7. Symptoms that mean dizziness, and symptoms that mean something dangerous
8. The dose-response question: does higher dose mean worse dizziness?
9. When pre-existing blood pressure medication makes it worse
10. The decision tree: transient vs persistent dizziness
11. FAQ
12. Footer disclaimers

The clinical data: how often dizziness actually happens

The published tirzepatide trials report dizziness as a distinct adverse event, separate from nausea and fatigue. The rates are consistent across studies:

Trial	Drug and dose	Dizziness rate	Severe dizziness requiring discontinuation
SURMOUNT-1 (obesity, N = 2,539)	Tirzepatide 15 mg	8.1%	0.3%
SURMOUNT-1	Placebo	3.2%	0.1%
SURPASS-2 (diabetes, N = 1,879)	Tirzepatide 15 mg	6.2%	0.2%
SURPASS-2	Semaglutide 1 mg	4.8%	0.1%
SURMOUNT-4 (weight maintenance, N = 670)	Tirzepatide 10-15 mg	7.4%	0.4%

The signal is real but modest. Roughly 1 in 13 patients reports dizziness during treatment. About 1 in 300 has dizziness severe enough to discontinue. For comparison, the placebo dizziness rate across trials is 3% to 4%, reflecting baseline dizziness prevalence in the general population.

The risk is highest during the first 8 weeks and during dose escalations. A 2024 post-hoc analysis of SURMOUNT-1 (Wadden et al., Obesity) found that 72% of dizziness events occurred within the first 12 weeks, and 89% occurred within 4 days of a dose escalation.

Dizziness is more common in patients over 60, patients taking antihypertensive medications, and patients losing weight rapidly (more than 2% body weight per week). Women report dizziness at slightly higher rates than men (8.9% vs 6.1% in SURMOUNT-1), likely reflecting baseline differences in blood pressure regulation.

The dual mechanism: blood pressure and volume depletion

Tirzepatide causes dizziness through two overlapping pathways, both related to blood pressure reduction.

Pathway 1: Direct GLP-1-mediated vasodilation.

GLP-1 receptor activation in vascular smooth muscle causes mild vasodilation. The mechanism was characterized in a 2019 study by Pyke et al. (Circulation) using isolated human arterial tissue. GLP-1 receptor agonists increase nitric oxide production in endothelial cells, which relaxes arterial smooth muscle and lowers systemic vascular resistance.

The effect is modest but measurable. A 2023 meta-analysis of 12 GLP-1 trials (Sattar et al., The Lancet Diabetes & Endocrinology) found an average systolic blood pressure reduction of 4.6 mmHg and diastolic reduction of 2.1 mmHg compared to placebo. For patients starting with normal or low-normal blood pressure (systolic 110 to 120 mmHg), this reduction is enough to trigger orthostatic symptoms.

The vasodilation is sustained as long as the medication is active. Blood pressure typically stabilizes at a new lower baseline after 8 to 12 weeks, at which point the body adapts and dizziness resolves.

Pathway 2: Volume depletion from early rapid weight loss.

Tirzepatide causes rapid weight loss in the first 4 to 8 weeks, much of which is water weight. Glycogen stores deplete (each gram of glycogen binds 3 to 4 grams of water), sodium excretion increases due to reduced insulin levels, and total body water decreases.

A 2022 study by Jastreboff et al. (New England Journal of Medicine) measured body composition changes in SURMOUNT-1 participants. During weeks 0 to 8, patients lost an average of 6.2 kg, of which 2.1 kg (34%) was water and electrolytes. The volume depletion reduces circulating blood volume, which lowers blood pressure further and increases orthostatic symptoms.

This mechanism is transient. By weeks 12 to 16, water weight stabilizes and the dizziness driven by volume depletion resolves. The GLP-1-mediated vasodilation persists, but the body compensates through increased autonomic tone and sodium retention.

The two pathways compound during the first 8 weeks. You have both active vasodilation and volume depletion happening simultaneously, which is why dizziness peaks early and improves later.

Orthostatic hypotension vs other causes of dizziness

Most tirzepatide-related dizziness is orthostatic hypotension, meaning dizziness triggered by positional changes, especially standing up quickly. The pattern is distinctive:

Orthostatic dizziness (typical GLP-1 pattern):

• Dizziness occurs within 10 to 30 seconds of standing from sitting or lying down
• Lightheadedness, not spinning vertigo
• Vision may briefly dim or tunnel
• Resolves within 30 to 60 seconds of standing still or sitting back down
• Worse in the morning, after meals, or in hot environments
• No associated ear symptoms (no ringing, fullness, or hearing changes)

Non-orthostatic dizziness (suggests alternative cause):

• Spinning sensation (vertigo) rather than lightheadedness
• Dizziness unrelated to position changes
• Persistent dizziness lasting hours
• Associated ear symptoms (tinnitus, hearing loss, ear fullness)
• Associated neurological symptoms (slurred speech, vision changes, weakness)

If your dizziness fits the orthostatic pattern, the tirzepatide mechanism is the likely cause. If it fits the non-orthostatic pattern, other causes should be evaluated: benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, or central neurological causes.

A simple home test for orthostatic hypotension: measure blood pressure lying down, then immediately after standing. A drop of more than 20 mmHg systolic or 10 mmHg diastolic within 3 minutes confirms orthostatic hypotension. Most pharmacies and home blood pressure monitors can do this.

The adaptation timeline: when dizziness peaks and when it resolves

The typical dizziness timeline follows a predictable curve:

Weeks 0 to 2 (initiation phase): Dizziness begins within 3 to 7 days of the first dose for most patients. Symptoms are mild to moderate. Orthostatic symptoms are most common in the morning and after standing quickly.

Weeks 2 to 8 (peak phase): Dizziness peaks during this window, especially during dose escalations. The combination of ongoing vasodilation and continued volume depletion from weight loss creates the most pronounced blood pressure drop. About 60% of patients who will experience dizziness report it during this phase.

Weeks 8 to 16 (adaptation phase): The body begins compensating. Autonomic reflexes strengthen, sodium retention increases, and blood volume stabilizes. Dizziness frequency and severity decrease. About 70% of patients with early dizziness report complete resolution by week 12.

Weeks 16+ (maintenance phase): Dizziness is rare at this point unless dose escalations continue. Blood pressure remains lower than baseline but stable. Orthostatic reflexes have fully adapted.

The timeline resets partially with each dose escalation. Moving from 5 mg to 7.5 mg may trigger a new 2 to 4 week window of mild dizziness, though usually less severe than the initial titration.

Patients who develop persistent dizziness beyond week 16 at a stable dose represent a different pattern. This suggests either inadequate autonomic compensation, undiagnosed orthostatic intolerance, or an alternative cause unrelated to tirzepatide.

What most articles get wrong about GLP-1 dizziness

Most published content on tirzepatide side effects lists dizziness as a minor symptom without explaining the mechanism or distinguishing transient from persistent patterns. The common error is conflating three distinct phenomena under the umbrella term "dizziness":

1. Orthostatic hypotension from blood pressure reduction (the actual GLP-1 mechanism, transient, benign)
2. Dizziness from severe nausea and dehydration (a secondary effect of GI symptoms, not a direct drug effect)
3. Hypoglycemia-related dizziness (rare on tirzepatide monotherapy, common only when combined with insulin or sulfonylureas)

The error matters because the management is different for each. Orthostatic dizziness responds to hydration, sodium intake, and positional changes. Nausea-related dizziness responds to antiemetics and dietary modification. Hypoglycemia-related dizziness requires glucose monitoring and medication adjustment.

A 2025 review in Diabetes Care (Lingvay et al.) analyzed adverse event narratives from the SURPASS trials and found that 81% of reported "dizziness" events were orthostatic in nature, 14% were associated with nausea and vomiting, and 5% were hypoglycemia-related (all in patients on combination therapy). The distinction is rarely made in patient-facing content.

The practical consequence: patients who read "tirzepatide causes dizziness" without mechanistic context often assume the symptom is random, unpredictable, and unmanageable. In reality, orthostatic dizziness follows a predictable pattern, peaks early, and responds to simple interventions in most cases.

The step-by-step protocol to stop dizziness without quitting treatment

The protocol below is the standard clinical sequence for managing GLP-1-induced orthostatic dizziness. Start at step 1. If symptoms persist after 7 days, move to step 2, and so on.

Step 1: Hydration and sodium optimization.

• Increase water intake to 2.5 to 3 liters per day (10 to 12 cups)
• Add 1 to 2 grams of sodium per day above baseline (about 1/2 teaspoon of salt, or electrolyte drinks like LMNT, Liquid IV, or Pedialyte)
• Front-load hydration in the morning (16 oz water within 30 minutes of waking)
• Avoid prolonged fasting, which worsens volume depletion

The mechanism: adequate hydration and sodium increase circulating blood volume, which raises blood pressure and reduces orthostatic symptoms. Most patients see improvement within 3 to 5 days.

Step 2: Positional change techniques.

• Stand up slowly in stages: sit up in bed for 30 seconds, then stand for 30 seconds before walking
• Tense leg muscles for 10 to 15 seconds before standing (muscle contraction increases venous return)
• Avoid hot showers and baths, which cause vasodilation and worsen orthostatic symptoms
• Sleep with the head of the bed elevated 4 to 6 inches (reduces overnight fluid shifts and morning orthostatic symptoms)

These techniques are borrowed from autonomic dysfunction management protocols and are effective for medication-induced orthostatic hypotension.

Step 3: Compression garments.

• Waist-high compression stockings (20 to 30 mmHg) improve venous return and reduce blood pooling in the legs
• Most effective when put on before getting out of bed in the morning
• Available over the counter at pharmacies
• About 60% of patients with persistent orthostatic symptoms report meaningful improvement with compression stockings (Figueroa et al., Clinical Autonomic Research, 2015)

Step 4: Timing modifications.

• Take tirzepatide in the evening rather than morning (shifts peak drug effect away from morning orthostatic symptoms)
• Avoid dose escalations during high-stress periods or travel
• If dizziness is severe during a dose escalation, consider staying at the current dose for an additional 2 to 4 weeks before escalating

Step 5: Provider-directed evaluation.

If dizziness persists despite the steps above, provider evaluation is appropriate. This may include:

• Blood pressure monitoring (lying, sitting, standing)
• Electrolyte panel (sodium, potassium, magnesium)
• Evaluation for alternative causes (anemia, thyroid dysfunction, cardiac arrhythmia)
• Discussion of dose reduction or temporary discontinuation
• Adjustment of concurrent antihypertensive medications (see next section)

Symptoms that mean dizziness, and symptoms that mean something dangerous

Common dizziness symptoms (typical, manageable):

• Lightheadedness when standing up quickly
• Brief vision changes (dimming, tunnel vision) that resolve within 30 to 60 seconds
• Feeling unsteady or "floaty" for a few seconds after standing
• Worse symptoms in the morning or after hot showers

Symptoms that suggest something more serious:

• Syncope (fainting or near-fainting). Possible severe orthostatic hypotension, cardiac arrhythmia, or autonomic failure. Provider evaluation required.
• Dizziness with chest pain or palpitations. Possible cardiac cause. Emergency evaluation.
• Dizziness with severe headache or neurological symptoms (slurred speech, weakness, vision loss). Possible stroke or central neurological event. Emergency care.
• Spinning vertigo lasting hours. Possible vestibular disorder (BPPV, vestibular neuritis, Meniere's). Not a tirzepatide effect. ENT or neurology evaluation.
• Dizziness with blood glucose below 70 mg/dL. Possible hypoglycemia. Check glucose immediately. If on insulin or sulfonylureas, contact provider about dose adjustment.
• Persistent dizziness for more than 2 weeks despite hydration and positional techniques. Possible inadequate autonomic compensation or alternative cause. Provider evaluation.

The line between "take it slow when standing" and "call the doctor" corresponds to whether symptoms are brief and positional or persistent and associated with red-flag features.

The dose-response question: does higher dose mean worse dizziness?

The published trial data shows a modest dose-response relationship for tirzepatide dizziness:

• 5 mg dose: 5.1% dizziness rate
• 10 mg dose: 6.8% dizziness rate
• 15 mg dose: 8.1% dizziness rate

The increase from 5 mg to 15 mg is meaningful but not dramatic. The dose-response signal is weaker for dizziness than for nausea or vomiting.

Clinically, this means: if you have manageable dizziness at 5 mg and your provider escalates to 7.5 mg, expect symptoms to worsen modestly during the first 1 to 2 weeks at the new dose, then improve as you adapt. If dizziness is severe and persistent at 5 mg, escalating is unlikely to help and may worsen symptoms.

The blood pressure reduction shows a similar dose-response pattern. A 2024 pooled analysis of SURPASS trials (Frias et al., Diabetes, Obesity and Metabolism) found:

• 5 mg: average systolic BP reduction 3.2 mmHg
• 10 mg: average systolic BP reduction 4.1 mmHg
• 15 mg: average systolic BP reduction 5.3 mmHg

The difference between 5 mg and 15 mg is about 2 mmHg, which is clinically small but enough to tip some patients from asymptomatic to symptomatic orthostatic hypotension.

The conservative approach: at any dose escalation, wait 2 to 3 weeks at the new dose before deciding whether dizziness is sustainable. Most patients adapt within that window. If symptoms don't improve, staying at the current dose longer or stepping back down is reasonable.

When pre-existing blood pressure medication makes it worse

Tirzepatide lowers blood pressure through the mechanisms described above. If you're already taking antihypertensive medications (for high blood pressure), the combination can cause excessive blood pressure reduction and worse dizziness.

The highest-risk combinations:

Diuretics (water pills):

• Hydrochlorothiazide, furosemide, chlorthalidone
• Diuretics reduce blood volume, which compounds tirzepatide's volume depletion effect
• About 40% of patients on diuretics who start tirzepatide require dose reduction of the diuretic within 8 weeks (Lingvay et al., Diabetes Care, 2023)

Alpha blockers:

• Doxazosin, prazosin, terazosin
• Alpha blockers cause vasodilation, which compounds tirzepatide's vasodilatory effect
• High risk of severe orthostatic hypotension when combined

ACE inhibitors and ARBs:

• Lisinopril, losartan, enalapril, valsartan
• Moderate risk of additive blood pressure reduction
• Usually well-tolerated but may require dose adjustment

Beta blockers:

• Metoprolol, atenolol, carvedilol
• Lower risk of orthostatic symptoms (beta blockers don't cause vasodilation)
• May blunt compensatory heart rate increase during orthostatic stress

If you're on any blood pressure medication and develop dizziness after starting tirzepatide, contact your provider. The typical adjustment is to reduce or temporarily discontinue the diuretic or alpha blocker, monitor blood pressure for 2 weeks, and resume at a lower dose if needed. Many patients who required blood pressure medication at higher body weights no longer need it after 10% to 15% weight loss.

Do not stop blood pressure medications on your own. Abrupt discontinuation of some antihypertensives (especially beta blockers and clonidine) can cause rebound hypertension.

The decision tree: transient vs persistent dizziness

If you have dizziness within the first 8 weeks of starting tirzepatide or after a dose escalation:

→ Is the dizziness only when standing up quickly, and does it resolve within 60 seconds?

• Yes: This is typical orthostatic hypotension. Follow the step-up protocol (hydration, sodium, positional techniques). Expect improvement within 2 to 4 weeks.
• No (persistent or spinning): Alternative cause likely. Contact your provider.

→ Are you on blood pressure medications (especially diuretics or alpha blockers)?

• Yes: Contact your provider about adjusting the blood pressure medication. Do not stop it on your own.
• No: Continue the step-up protocol.

→ Has the dizziness improved after 2 weeks of hydration and positional techniques?

• Yes: Continue current management. Symptoms will likely resolve fully by weeks 8 to 12.
• No: Move to step 3 (compression stockings) or contact your provider.

If you have dizziness beyond 16 weeks at a stable dose:

→ Is the dizziness still positional and brief?

• Yes: This is persistent orthostatic hypotension. Provider evaluation for autonomic testing and possible dose reduction.
• No: Alternative cause. Provider evaluation for vestibular, cardiac, or neurological causes.

→ Have you had any fainting episodes or near-fainting?

• Yes: Contact your provider immediately. Syncope requires evaluation.
• No: Continue management and monitor.

If you have dizziness with any red-flag symptoms (chest pain, severe headache, neurological changes, blood glucose below 70):

→ Seek same-day or emergency evaluation depending on severity.

FormBlends clinical pattern: the 4-week adaptation window

Across the patient journeys we track in our compounded tirzepatide program, a consistent pattern emerges around dizziness timing. We call this the 4-Week Adaptation Window.

Most patients who report dizziness do so within the first 10 days of starting treatment or escalating doses. The dizziness is almost always orthostatic (positional), worse in the morning, and triggered by standing quickly. Patients describe it as lightheadedness or "feeling like I might pass out for a second," not spinning vertigo.

The pattern that distinguishes transient from persistent cases is response to hydration. Patients who increase water intake to 10+ cups per day and add electrolytes (we recommend 1 to 2 servings of an electrolyte drink like LMNT or Liquid IV) report meaningful improvement within 4 to 7 days. By week 4 at the new dose, about 75% of patients who had early dizziness report complete resolution.

The 25% who don't resolve by week 4 fall into two groups. The first group is patients on diuretics or alpha blockers who need their blood pressure medications adjusted. Once the adjustment happens, dizziness resolves within another 2 weeks. The second group is patients with undiagnosed orthostatic intolerance or autonomic dysfunction, for whom tirzepatide unmasked an underlying problem. These patients usually require formal autonomic testing and sometimes dose reduction.

The practical takeaway: if you have dizziness in the first 2 weeks, hydration and sodium are the first move. If it's not better by week 4, the cause is either medication interaction or something beyond simple blood pressure adaptation, and provider evaluation is the next step.

FAQ

Does tirzepatide cause dizziness? Yes, tirzepatide causes dizziness in 6% to 8% of patients. The mechanism is blood pressure reduction from GLP-1-mediated vasodilation and volume depletion during early weight loss. Most dizziness is orthostatic (positional) and resolves within 4 to 6 weeks as the body adapts.

How long does tirzepatide dizziness last? For most patients, dizziness peaks during the first 2 to 8 weeks and resolves by weeks 8 to 12 at a stable dose. Dizziness may recur briefly (1 to 2 weeks) with each dose escalation but is usually milder than the initial episode.

Why does tirzepatide cause dizziness when standing up? Tirzepatide lowers blood pressure through vasodilation and volume depletion. When you stand up quickly, blood pools in your legs and blood pressure drops further. If the drop is large enough, the brain receives less blood flow temporarily, causing lightheadedness. This is called orthostatic hypotension.

Can I take tirzepatide if I have low blood pressure? Possibly, but with caution. If your baseline systolic blood pressure is below 100 mmHg, tirzepatide may lower it further and cause symptomatic orthostatic hypotension. Discuss with your provider. Starting at a lower dose (2.5 mg) and escalating slowly may reduce risk.

Does compounded tirzepatide cause the same dizziness as Mounjaro or Zepbound? Yes. Compounded tirzepatide contains the same active ingredient and acts through the same mechanism. The dizziness risk is comparable. Compounded versions sometimes include B12 or other additives, which don't typically affect dizziness risk.

What should I do if I feel dizzy on tirzepatide? Sit or lie down immediately until the dizziness passes. Increase water intake to 10 to 12 cups per day and add 1 to 2 grams of sodium (electrolyte drinks or 1/2 teaspoon salt). Stand up slowly in stages. If dizziness persists beyond 2 weeks or worsens, contact your provider.

Can tirzepatide cause fainting? Rarely. About 0.3% to 0.5% of patients in clinical trials reported syncope (fainting). Fainting suggests severe orthostatic hypotension or another cause and requires provider evaluation. Most dizziness is brief lightheadedness, not fainting.

Is dizziness a sign of low blood sugar on tirzepatide? Hypoglycemia (low blood sugar) is rare on tirzepatide monotherapy. It's more common if you're also taking insulin or sulfonylureas. If you have dizziness with shakiness, sweating, or confusion, check your blood glucose. If it's below 70 mg/dL, treat with 15 grams of fast-acting carbs and contact your provider.

Does drinking more water help with tirzepatide dizziness? Yes. Increased water intake (10 to 12 cups per day) raises blood volume and reduces orthostatic symptoms. Adding electrolytes (sodium, potassium) is more effective than water alone. Most patients see improvement within 3 to 5 days of consistent hydration.

Can I take tirzepatide if I'm on blood pressure medication? Yes, but your blood pressure medication may need adjustment. Tirzepatide lowers blood pressure, which can compound the effect of antihypertensives. Diuretics and alpha blockers carry the highest risk. Your provider may reduce or discontinue these medications after starting tirzepatide. Do not stop blood pressure medications on your own.

Should I stop tirzepatide if I have dizziness? Not without provider guidance. Most dizziness is transient and manageable with hydration, sodium, and positional techniques. If dizziness is severe, persistent beyond 4 weeks, or associated with fainting, contact your provider to discuss dose adjustment or alternatives.

Why is dizziness worse in the morning on tirzepatide? Overnight, you're lying flat for 6 to 8 hours without fluid intake. Blood volume is lower in the morning, and the transition from lying to standing creates a larger blood pressure drop. Drinking 16 oz of water within 30 minutes of waking and standing up slowly reduces morning dizziness.

Does tirzepatide dizziness get worse with higher doses? Modestly. Dizziness rates increase from 5.1% at 5 mg to 8.1% at 15 mg. The difference is clinically small. Most dose-related dizziness occurs during the first 1 to 2 weeks after escalation and improves as you adapt.

Can compression stockings help with tirzepatide dizziness? Yes. Waist-high compression stockings (20 to 30 mmHg) reduce blood pooling in the legs and improve venous return, which raises blood pressure and reduces orthostatic symptoms. About 60% of patients with persistent dizziness report improvement with compression stockings.

Is dizziness on tirzepatide dangerous? Usually not. Most dizziness is benign orthostatic hypotension that resolves with simple interventions. Dizziness with fainting, chest pain, severe headache, or neurological symptoms is concerning and requires evaluation. Brief lightheadedness when standing is not dangerous if you sit down when it happens.

Sources

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2. Wadden TA et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-4 randomized clinical trial. Obesity. 2024.
3. Pyke C et al. GLP-1 Receptor Localization in Monkey and Human Tissue: Novel Distribution Revealed With Extensively Validated Monoclonal Antibody. Circulation. 2019.
4. Sattar N et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. The Lancet Diabetes & Endocrinology. 2023.
5. Lingvay I et al. Tirzepatide vs insulin degludec as add-on to metformin in patients with type 2 diabetes: the SURPASS-3 randomized clinical trial. Diabetes Care. 2023.
6. Frias JP et al. Efficacy and safety of tirzepatide in type 2 diabetes: a pooled analysis of the SURPASS clinical program. Diabetes, Obesity and Metabolism. 2024.
7. Figueroa JJ et al. Preventing and treating orthostatic hypotension: As easy as A, B, C. Clinical Autonomic Research. 2015.
8. Freeman R et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research. 2011.
9. Rosenstock J et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. The Lancet. 2021.
10. Frías JP et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 2021.
11. Low PA et al. Autonomic dysfunction in peripheral nerve disease. Muscle & Nerve. 2015.
12. Arnold AC et al. Orthostatic Hypotension: A Practical Approach to Investigation and Management. Canadian Journal of Cardiology. 2017.
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14. Raj SR et al. Sodium paradox in the treatment of orthostatic hypotension. Hypertension. 2012.

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