Tirzepatide-Associated Biliary Injury: Mechanistic Insights and Clinical Implications

Author(s)	Dr. Sonia Devidas Pawaskar, Dr. Rahul Devidas Pawaskar, Dr. Jeedhu Radhakrishnan, Dr. Jagannath Kulkarni
Country	India
Abstract	Tirzepatide, a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagonlike peptide-1 (GLP-1) receptor agonist, has demonstrated unprecedented efficacy in glycemic control and weight reduction, with HbA1c reductions of 1.24–2.58% and weight loss of 5.4–11.7 kg in the SURPASS clinical trial program. However, emerging evidence indicates an increased incidence of biliary complications, particularly in patients with prior bariatric surgery. This comprehensive analysis synthesizes clinical data, mechanistic pathophysiology, and pharmacological mechanisms underlying tirzepatide-associated gallbladder dysfunction, with emphasis on recognition of severe complications such as gallbladder perforation. We present an integrated assessment of this rare but life-threatening adverse effect and propose evidence-based clinical surveillance protocols
Keywords	Tirzepatide; gallbladder perforation; cholecystitis; GLP-1 receptor agonist; biliary disease; bariatric surgery; dual GIP/GLP-1 agonist
Field	Medical / Pharmacy
Published In	Volume 8, Issue 2, March-April 2026
Published On	2026-03-23

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