GLP-1 diarrhea and constipation: what the labels report
Both are common on semaglutide and tirzepatide. The trial rates from each label, when they tend to happen, and what the labels say about fluids.
How common they are
Wegovy's trials reported diarrhea in 30% of people on semaglutide 2.4 mg (16% on placebo) and constipation in 24% (11% on placebo). Zepbound's reported diarrhea in 19% to 23% across doses (8% on placebo) and constipation in 11% to 17% (5% on placebo).
| Placebo | On the drug | |
|---|---|---|
| Diarrhea, Wegovy | 16% | 30% |
| Constipation, Wegovy | 11% | 24% |
| Diarrhea, Zepbound (5 / 10 / 15 mg) | 8% | 19% / 21% / 23% |
| Constipation, Zepbound (5 / 10 / 15 mg) | 5% | 17% / 14% / 11% |
Share of trial participants reporting it, from each label's adverse reactions table.
Fluids
Both labels warn that nausea, vomiting and diarrhea can lead to dehydration and, in some cases, kidney problems. Wegovy's Medication Guide: "It is important for you to drink fluids to help reduce your chance of dehydration."
When the label says to call
Both labels tell people to contact their healthcare provider if stomach problems are severe or won't go away. Wegovy's Medication Guide adds: "It is important for you to drink fluids to help reduce your chance of dehydration. Tell your healthcare provider right away if you have nausea, vomiting, or diarrhea that does not go away." Persistent or severe abdominal pain, sometimes reaching through to the back, is listed as a possible sign of pancreatitis.
Keeping a record
Noting which days it happens, and how that lines up with your dose day, shows whether it is settling. In PepMe, add it to the Journal note; your doses are logged on the same timeline.
Sources
- Wegovy (semaglutide) prescribing information, revised 08/2025 (FDA)
- Zepbound (tirzepatide) prescribing information, revised 08/2026 (Eli Lilly)
Trial figures describe groups of people, not what will happen to you. PepMe keeps a record of what you log; it never suggests what to take. Talk to your prescriber about anything here.