Tirzepatide linked to rare drug-induced liver injury in a 76-year-old patient | Research

The takeaway

A 76-year-old woman developed biopsy-confirmed drug-induced liver injury after 8 weeks of tirzepatide use, representing one of the few reported cases of this rare side effect.

Biopsy-confirmed DILI
Rare drug-induced liver injury developed after 8 weeks of tirzepatide use in an elderly patient

What the researchers found

Biopsy-confirmed drug-induced liver injury developed after 8 weeks of tirzepatide use in a 76-year-old woman with concurrent 16-pound weight loss. Mechanism unknown.

Why it matters

As tirzepatide is prescribed to millions for diabetes and obesity, even rare side effects must be documented. Liver injury awareness is critical for early detection and intervention.

The numbers in context

76-year-old woman. 8 weeks of tirzepatide. 16-pound weight loss. Elevated liver enzymes. Biopsy-confirmed DILI.

How the study worked

Single case report with liver biopsy confirmation of DILI.

Who was studied

One elderly woman on tirzepatide

What this study cannot tell us

Single case; cannot establish incidence or definitive causation. Other potential causes of liver injury may not have been fully excluded. Mechanism unknown.

How to read the evidence

Single case report with biopsy confirmation—lowest evidence level but important for safety monitoring.

When this study was published

Published in 2025; contributes to post-marketing safety surveillance for tirzepatide.

The bigger picture

Post-marketing pharmacovigilance for GLP-1/GIP drugs is essential as use scales rapidly. Rare hepatotoxicity signals require ongoing monitoring and reporting.

Questions still open

What is the true incidence of tirzepatide-related liver injury?
Does rapid weight loss contribute to liver enzyme elevation independent of drug toxicity?
Are there predisposing factors for GLP-1/GIP drug hepatotoxicity?

Common questions

Can tirzepatide damage the liver?

Very rarely. This case report is one of only a few documented instances of tirzepatide causing liver injury. A liver biopsy confirmed the damage. While millions take tirzepatide safely, patients should report symptoms like jaundice, dark urine, or upper abdominal pain to their doctor.

Should I get liver tests while on tirzepatide?

There is no routine recommendation for liver monitoring with tirzepatide, as liver injury is very rare. However, if you experience symptoms suggesting liver problems (yellowing skin, unusual fatigue, dark urine), seek medical attention promptly.

Read the original research

Tirzepatide-Induced Liver Injury: A Rare Medication Side Effect.

ACG case reports journal, 12(4), e01661

View on PubMed ↗Publisher’s paper ↗

Citation

Phox, Meagan; Thesing, John; Kilgore, W Ransom; Alderson, Joel. (2025). Tirzepatide-Induced Liver Injury: A Rare Medication Side Effect.. ACG case reports journal, 12(4), e01661. https://doi.org/10.14309/crj.0000000000001661