From the Guidelines
Patients taking terzepatide for indigestion relief should prioritize lifestyle modifications and consider over-the-counter antacids or H2 blockers for symptom management, as these approaches can help mitigate the delayed gastric emptying associated with GLP-1 receptor agonists. When managing indigestion in patients on terzepatide, it's crucial to consider the drug's mechanism of action, which slows gastric emptying, a common cause of digestive symptoms 1.
Non-Pharmacological Approaches
- Eating smaller, more frequent meals to reduce symptoms of indigestion
- Avoiding trigger foods that are fatty, spicy, or acidic
- Not lying down after eating to prevent reflux
- Maintaining a healthy weight to reduce pressure on the stomach
- Timing meals at least 2-3 hours before bedtime to allow for proper digestion
Pharmacological Options
- Over-the-counter antacids like Tums or Rolaids for quick relief of occasional symptoms
- H2 blockers such as famotidine (Pepcid) 20mg once or twice daily for persistent symptoms
- Proton pump inhibitors like omeprazole (Prilosec) 20mg daily for more severe cases
- Prokinetic agents like metoclopramide 5-10mg before meals to help with delayed gastric emptying, used cautiously due to potential side effects 1
It's essential to note that the side effects of terzepatide, including delayed gastric emptying, often improve within 4-8 weeks as the body adjusts to the treatment 1. If symptoms are severe or persistent, discussing adjustments to the terzepatide dose or schedule with a healthcare provider may be necessary, as slower dose escalation can improve tolerability while maintaining therapeutic benefits 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Options for Indigestion in Patients Taking Terzepatide
- The studies provided do not directly address the treatment options for indigestion in patients taking terzepatide 2, 3, 4, 5, 6.
- However, it is known that terzepatide, a glucagon-like peptide-1 (GLP-1) and glucagon receptor agonist, can cause gastrointestinal-related adverse events, including nausea, diarrhea, and vomiting 3, 4.
- For patients experiencing indigestion, the American Journal of Gastroenterology guidelines suggest that patients with dyspepsia should undergo testing for Helicobacter pylori (H. pylori) or an empiric trial of acid suppression with a proton pump inhibitor (PPI) 6.
- If initial acid suppression fails, it is reasonable to consider changing drug class or dosing, or applying the test-and-treat strategy before consideration of referral for esophagogastroduodenoscopy (EGD) 6.
- In patients who do respond to initial therapy, stopping treatment after 4-8 weeks is recommended, and if symptoms recur, another course of the same treatment is justified 6.
Gastrointestinal-Related Adverse Events with Terzepatide
- The most common adverse events with terzepatide are gastrointestinal-related, including nausea, diarrhea, and vomiting, and are mostly mild to moderate in severity 3, 4.
- These adverse events occur primarily during dose escalation and may lead to treatment discontinuation in some cases 3, 4.