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Gastrointestinal: Abdominal distention, bowel/bladder dysfunction (after intrathecal administration), elevation in serum liver enzyme levels, hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestines (particularly in patients with inflammatory bowel disease), ulcerative esophagitis

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Who should consider tirzepatide with B12 and who should avoid it Ideal candidates for tirzepatide with B12 include adults with obesity (BMI ≥30) or overweight with comorbidities (BMI ≥27 with conditions like type 2 diabetes, hypertension, or dyslipidemia)