Does Mounjaro Cause Hiccups?
Hiccups are not a documented adverse effect of tirzepatide (Mounjaro) in clinical trials or post-marketing surveillance data.
Evidence from Clinical Trials and Safety Data
The most common adverse events with tirzepatide are gastrointestinal, including nausea (17-31%), diarrhea (12-23%), vomiting (12%), constipation (12-18%), and decreased appetite (10-12%) 1, 2, 3, 4.
In the comprehensive SURPASS trial program involving thousands of patients, hiccups were not reported among the documented adverse events 3, 5, 4.
A recent real-world safety analysis of 65,974 FAERS reports from 2022 to Q1 2025 identified the most common adverse events as incorrect dose administration, injection-site reactions, gastrointestinal issues (nausea, vomiting, diarrhea), and off-label use—but hiccups were not among the reported adverse effects 6.
Documented Adverse Event Profile
The established safety profile of tirzepatide includes:
Gastrointestinal effects: Nausea, diarrhea, vomiting, constipation, and decreased appetite are the predominant side effects, typically mild-to-moderate and most pronounced during initial dose escalation (first 20 weeks) 1, 2, 3, 4.
Injection-site reactions: Pain and other local reactions at injection sites are commonly reported 6.
Serious but rare complications: Pancreatitis, acute kidney injury (particularly during dose escalation in patients with renal impairment), cholelithiasis, and severe constipation/small bowel obstruction have been documented 1, 7, 8.
Cardiovascular effects: Elevated heart rate and tachycardia have been noted, with recommendations for monitoring and potential beta-blocker use if symptomatic 1, 2.
Clinical Considerations
If a patient reports hiccups while taking tirzepatide, consider alternative etiologies such as gastroesophageal reflux disease (GERD), gastric distension from delayed gastric emptying (a known pharmacologic effect of GLP-1 receptor agonists), rapid eating, or unrelated causes 7, 2.
Tirzepatide delays gastric emptying as part of its mechanism of action, which could theoretically contribute to gastric distension and secondary hiccups, though this has not been established in the literature 7, 2.
Assess for dehydration from gastrointestinal side effects (nausea, vomiting, diarrhea), as this can cause various symptoms including potential diaphragmatic irritation 7.
Monitoring Recommendations
Evaluate patients monthly during the first 3 months of dose escalation and quarterly thereafter for adverse effects 1, 2.
If persistent hiccups occur, investigate other causes including GERD, medication interactions, metabolic disturbances, or neurologic conditions rather than attributing them directly to tirzepatide 7.