Before  you begin using a medication, be sure to inform your doctor of any medical  conditions or allergies you may have, any medications you are taking, whether  you are pregnant or breast-feeding, and any other significant facts about your  health. These factors may affect how you should use this medication.
Heart problems: This  medication may increase heart rate and may affect how electrical impulses  travel through the heart muscle. If you have heart disease or an abnormal heart  rhythm (e.g., heart block or fast heart rate), discuss with your doctor how  this medication may affect your medical condition, how your medical condition  may affect the dosing and effectiveness of this medication, and whether any  special monitoring is needed.
Low blood sugar (hypoglycemia): This  medication may cause low blood sugar when it is used with sulfonylureas (e.g.,  glyburide, gliclazide) or insulin. If you are taking any of these types of  medications, discuss with your doctor how this medication may affect your  medical condition, how your medical condition may affect the dosing and  effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of  hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat,  headache, hunger, confusion, lightheadedness, weakness, and numbness or  tingling of the tongue or lips, contact your doctor. Your doctor may need to  adjust the dose of your medication(s).
Pancreatitis (inflammation of the  pancreas): Tirzepatide may cause pancreatitis that can be serious or life-threatening.  If you experience symptoms of pancreatitis such as severe and persistent  abdominal pain that may move to your back and may be accompanied by vomiting,  stop taking this medication and contact your doctor or get immediate medical  attention.
If you have previously had  pancreatitis, gallstones, or alcohol use problems, discuss with your doctor how  this medication may affect your medical condition, how your medical condition  may affect the dosing and effectiveness of this medication, and whether any  special monitoring is needed.
Risk of thyroid cancer: In rare  cases, people have developed thyroid cancer while using medications similar to tirzepatide.  People with a personal or family history of thyroid cancer or people who  have multiple endocrine neoplasia syndrome type 2 (a  disease where people have tumours in more than one gland in their body) should  not use this medication. If you develop difficulty swallowing or breathing,  hoarseness or notice a mass developing in your neck, contact your doctor as  soon as possible. 
Vision: Diabetic  retinopathy is a complication of diabetes that results from uncontrolled blood  glucose levels. When blood glucose levels are brought under control quickly,  symptoms of retinopathy may become worse for a short period of time. If you  experience vision changes with the use of tirzepatide, talk to your doctor.
Pregnancy: This medication should not be used during pregnancy unless the  benefits outweigh the risks. Perople who may become pregnant should use a  barrier method of birth control. Tirzepatide should be stopped at least 1 month  before a planned pregnancy. If you become pregnant while taking this  medication, contact your doctor immediately.
Breast-feeding: It is not known if tirzepatide passes into breast milk. If you are breast-feeding  and taking this medication, it may affect your baby. Talk to your doctor about  whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been  established for children.