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At this stage, exogenous insulin like Tresiba becomes necessary regardless of other medications being used

Anxiety or "jitteriness." Difficulty sleeping

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6 Adverse Reactions The following serious adverse reactions are described below or elsewhere in the prescribing information: Risk of Thyroid C-cell Tumors [see Warnings and Precautions (5.1)] Acute Pancreatitis [see Warnings and Precautions (5.2)] Hypoglycemia with Concomitant Use of Insulin Secretagogues or Insulin [see Warnings and Precautions (5.3)] Hypersensitivity Reactions [see Warnings and Precautions (5.4)] Acute Kidney Injury Due to Volume Depletion [see Warnings and Precautions (5.5)] Severe Gastrointestinal Adverse Reactions [see Warnings and Precautions (5.6)] Diabetic Retinopathy Complications in Patients with a History of Diabetic Retinopathy [see Warnings and Precautions (5.7)] Acute Gallbladder Disease [see Warnings and Precautions (5.8)] Pulmonary Aspiration During General Anesthesia or Deep Sedation [see Warnings and Precautions (5.9)] The most common adverse reactions, reported in 5% of patients treated with MOUNJARO are nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, and abdominal pain

Gastrointestinal side effects are the most commonly reported adverse reactions to tirzepatide, affecting a significant proportion of patients, particularly during treatment initiation and dose titration

Myoglobin is toxic to kidneys and can cause acute kidney injury or failure