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Zepbound ® (tirzepatide) injection
2.5 mg/ 5 mg/ 7.5 mg/ 10 mg/ 12.5 mg/ 15 mg
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
Can Zepbound® (tirzepatide) be used in patients with thyroid diseases other than thyroid cancer?
Tirzepatide is contraindicated in patients with MEN 2 or a personal or family history of MTC. Eli Lilly and Company has not studied the efficacy and safety of tirzepatide in patients with other thyroid diseases.
See important safety information, including boxed warning, in the attached prescribing information.
Use in Patients With Thyroid Disease/Abnormalities
Tirzepatide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).1
There is no information on the use of tirzepatide in people with thyroid disease/abnormalities, including hypothyroidism or hyperthyroidism, because this has not been studied by Eli Lilly and Company.
Patients were excluded from the SURMOUNT studies for overweight/obesity if they had
- thyroid-stimulating hormone (TSH) level outside of the range of 0.4–6.0 mIU/L at the screening visit, or
- a serum calcitonin level of
- ≥20 ng/L at Visit 1, if eGFR ≥60 mL/min/1.73 m2, or
- ≥35 ng/L at Visit 1, if eGFR <60 mL/min/1.73 m2.2-6
Participants receiving treatment for hypothyroidism could be included in the SURMOUNT studies, provided their thyroid hormone replacement dose had been stable for at least 3 months and their TSH at screening fell within the abovementioned range.2-6
Participants with subclinical hypothyroidism were excluded if the investigators thought it likely that they might require initiation of thyroid hormone replacement during the study.2-6
Please refer to Zepbound (tirzepatide) prescribing information for any contraindications or additional information on whether to use tirzepatide in patients with thyroid diseases/abnormalities. Lilly cannot provide recommendations beyond the approved prescribing information. The healthcare practitioner may use the patient’s prior medical history and concomitant medications, and other individual factors when developing a treatment plan. The healthcare practitioner should consider potential risks and benefits of treatment options and monitor appropriately.
Enclosed Prescribing Information
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1Zepbound [package insert]. Indianapolis, IN: Eli Lilly and Company; 2026.
2Jastreboff AM, Aronne LJ, Ahmad NN, et al; SURMOUNT-1 Investigators. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038
3Garvey WT, Frias JP, Jastreboff AM, et al; SURMOUNT-2 investigators. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402(10402):613-626. https://doi.org/10.1016/S0140-6736(23)01200-X
4Wadden TA, Chao AM, Machineni S, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023;29(11):2909-2918. https://doi.org/10.1038/s41591-023-02597-w
5Aronne LJ, Sattar N, Horn DB, et al; SURMOUNT-4 Investigators. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA. 2024;331(1):38-48. https://doi.org/10.1001/jama.2023.24945
6Malhotra A, Grunstein RR, Fietze I, et al; SURMOUNT-OSA Investigators. Tirzepatide for the treatment of obstructive sleep apnea and obesity. N Engl J Med. 2024;391(13):1193-1205. https://doi.org/10.1056/NEJMoa2404881
Date of Last Review: January 07, 2026