Can Zepbound Cause Tachycardia?
Yes, Zepbound (tirzepatide) causes a mild increase in heart rate, with mean elevations of 1-3 beats per minute compared to placebo, though this is not typically clinically significant tachycardia. 1
Heart Rate Effects of Zepbound
The FDA label for Zepbound clearly documents that treatment results in a small but measurable increase in heart rate:
- Mean heart rate increase: 1-3 beats per minute above baseline in pooled clinical trials 1
- Placebo-treated patients showed no increase in heart rate 1
- This modest elevation does not typically meet clinical criteria for tachycardia (>100 bpm at rest)
Clinical Context and Mechanism
The heart rate increase with Zepbound appears to be:
- Consistent across the patient population in weight management trials 1
- Dose-related, occurring across the 5 mg, 10 mg, and 15 mg dosing range 1
- Likely related to the drug's effects on metabolic rate and sympathetic tone, though the exact mechanism is not fully elucidated
Important Cardiovascular Considerations
While frank tachycardia is not a primary concern, Zepbound has other cardiovascular effects to monitor:
- Hypotension occurred in 1.6% of Zepbound-treated patients versus 0.1% on placebo 1
- Hypotension risk was higher (2.2%) in patients on concomitant antihypertensive medications 1
- Hypotension often occurred with gastrointestinal adverse events and dehydration 1
Clinical Monitoring Recommendations
Monitor heart rate at baseline and during treatment, particularly in patients with:
- Pre-existing cardiovascular disease 1
- Concurrent use of medications affecting heart rate 1
- History of arrhythmias or palpitations 1
Key Clinical Pitfall
The modest heart rate increase with Zepbound should not be confused with pathologic tachycardia. However, if a patient develops symptomatic tachycardia (palpitations, chest discomfort, heart rate >100 bpm), investigate other causes including: