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Contact your healthcare provider promptly if you experience: Persistent gastrointestinal symptoms : Severe nausea, vomiting, or diarrhea lasting more than 24 hours, particularly if accompanied by signs of dehydration (decreased urination, dizziness, dry mouth) Abdominal pain : Severe or persistent pain, especially in the upper abdomen radiating to the back, which may indicate pancreatitis Gallbladder symptoms : Right upper quadrant pain, particularly after meals, with or without fever and jaundice Hypoglycemia : Symptoms including shakiness, sweating, confusion, rapid heartbeat, or difficulty concentrating, especially if taking tirzepatide with insulin or sulfonylureas Kidney problems : Decreased urination, swelling in legs or feet, unusual fatigue, or confusion Mental health changes : New or worsening depression, suicidal thoughts, or unusual changes in mood or behavior Pregnancy : If you become pregnant or are planning pregnancy while taking tirzepatide, especially for weight management Seek emergency medical attention for: Severe allergic reactions : Difficulty breathing, facial or throat swelling, severe rash, or rapid heartbeat Severe abdominal pain : Particularly if accompanied by vomiting and inability to tolerate oral intake Vision changes : Sudden vision loss or blurred vision, which may indicate diabetic retinopathy complications Thyroid concerns : A lump or swelling in the neck, hoarseness, difficulty swallowing, or persistent cough Patients should maintain regular follow-up appointments for monitoring of glycemic control, weight, and potential adverse effects

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Increases in blood folate indices are similar in women of childbearing age supplemented with [6S]-5-methyltetrahydrofolate and folic acid