Hormonal
Tirzepatide can cause rare, idiosyncratic hepatocellular injury presenting as asymptomatic or symptomatic aminotransferase elevation, which resolves upon drug discontinuation.
If you are taking tirzepatide and develop persistent abdominal pain, nausea, or dark urine, do not assume it is just a standard side effect. Request liver enzyme testing (ALT/AST) immediately. If elevated, stopping the medication typically resolves the injury, but early detection prevents severe liver damage.
This case documents hepatocellular injury specific to tirzepatide despite previous tolerance of glucagon-like peptide-1 receptor agonist therapy. Clinician awareness is important since initial symptoms may be mild and attributed to common gastrointestinal side effects associated with tirzepatide. Early diagnosis and drug discontinuation resulted in resolution.
Why this rating
Based on a single case report and a small table of post-marketing case reports; lacks controlled trial data for this specific adverse event.
Source
Tirzepatide-Induced Liver Injury: A Rare Complication
Lauren Spaeth et al. · AACE Endocrinology and Diabetes · 2025
DOI 10.1016/j.aed.2025.11.009
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