Can tirzepatide (a glucagon-like peptide-1 (GLP-1) receptor agonist) cause optic disc edema?

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Last updated: April 7, 2025View editorial policy

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From the Guidelines

Tirzepatide has not been definitively linked to optic nerve edema, and there is no strong evidence to suggest a causal relationship between the two. The available evidence does not provide a clear association between tirzepatide and optic nerve edema. While the study by 1 discusses ophthalmological side effects of TKI therapy, it does not mention tirzepatide, which is a GLP-1/GIP receptor agonist. Some key points to consider:

  • The study by 1 reports on the incidence and severity of ophthalmological side effects associated with TKI therapy, including periorbital edema, epiphora, and conjunctival hemorrhage.
  • However, this study does not provide information on tirzepatide, and its findings cannot be directly applied to this medication.
  • Patients taking tirzepatide should be aware of the potential risks of rapid weight loss, which can occasionally be associated with increased risk of idiopathic intracranial hypertension, a condition that can cause optic nerve swelling.
  • If a patient on tirzepatide experiences visual changes, headaches, or eye pain, they should seek immediate medical attention.
  • The medication's known side effects primarily include gastrointestinal symptoms like nausea, vomiting, and diarrhea, rather than ocular complications.

From the Research

Ophthalmic Complications Associated with Tirzepatide

  • There is limited evidence directly linking tirzepatide to optic nerve edema, but a study published in JAMA Ophthalmology 2 reported ophthalmic complications associated with the use of semaglutide or tirzepatide, including nonarteritic ischemic anterior optic neuropathy, bilateral papillitis, and paracentral acute middle maculopathy.
  • The study 2 included 9 patients with a mean age of 57.4 years, and the ophthalmic complications reported were not definitively linked to the use of tirzepatide, with the possibility that rapid correction of hyperglycemia rather than a toxic effect of the drug could be associated with the complications.

Adverse Events Related to Tirzepatide

  • A systematic review and meta-analysis published in the Journal of the Endocrine Society 3 reported that tirzepatide is associated with a dose-dependent increase in gastrointestinal adverse events, but did not mention optic nerve edema as a potential adverse event.
  • Other studies have reported on the efficacy and safety of tirzepatide, including its effects on glucose control, weight loss, and cardiovascular outcomes 4, 5, but have not mentioned optic nerve edema as a potential complication.

Renal Effects and Safety of Tirzepatide

  • A systematic review and meta-analysis published in the World Journal of Diabetes 6 reported on the renal effects and safety profile of tirzepatide, but did not mention optic nerve edema as a potential adverse event.
  • The study 6 found that tirzepatide had a positive impact on urine albumin-to-creatinine ratio and estimated glomerular filtration rate, with a reassuring renal safety profile, but did not provide information on ophthalmic complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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