Hormonal
Tirzepatide exacerbates orthostatic intolerance and causes marked tachycardia in patients with Postural Orthostatic Tachycardia Syndrome (POTS).
If you have POTS and are considering tirzepatide, discuss your specific heart rate response risks with your doctor. This case suggests that standard dosing might cause severe tachycardia in POTS patients, so a lower starting dose (e.g., 2.5 mg) and close monitoring of heart rate and orthostatic symptoms are critical to prevent exacerbation.
Prescription of tirzepatide may exacerbate symptoms of orthostatic intolerance and cause marked tachycardia in patients with POTS.
Why this rating
Single case report (n=1), though the mechanism is biologically plausible and supported by cited literature.
Source
Exacerbation of Postural Orthostatic Tachycardia Syndrome With Tirzepatide Prescribed for Weight Loss
Eric T. Hedge et al. · JACC Case Reports · 2025
DOI 10.1016/j.jaccas.2025.105430
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