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Gastrointestinal effects lead: nausea, diarrhea, constipation, and vomiting, dose-dependent and clustered during escalation, mostly mild. Tirzepatide also produces a modest chronic heart-rate rise with a larger escalation-phase peak. Oral-contraceptive absorption can fall after starting and after each increase, so use backup or non-oral contraception for 4 weeks each time. What is known about concurrent metformin and tirzepatide use

Additionally, it occupies GIP receptors and mimics the action of the GIP hormone to enhance insulin release and promote fat breakdown

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But high dose Vitamin C IV therapy helps a lot

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Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension