Constipation on a GLP-1: 24 percent on Wegovy and falling as the Zepbound dose rises
Constipation reached 24 percent on Wegovy 2.4 mg and fell from 17 to 11 percent as Zepbound went from 5 mg to 15 mg, in the clinical trials printed on their FDA labels. GLP Chart read both labels on DailyMed, revised June and August 2026.
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| Label and dose | Who was in the trial | On the drug | On placebo |
|---|---|---|---|
| Wegovy 2.4 mg (June 2026 label) | adults with obesity or overweight, n=2,116 | 24% | 11% (n=1,261) |
| Wegovy 2.4 mg (June 2026 label, dose-comparison trials) | adults with obesity in the two clinical trials comparing the maintenance doses, n=304 | 19% | 8% (n=303) |
| Wegovy 7.2 mg (June 2026 label, dose-comparison trials) | adults with obesity in the two clinical trials comparing the maintenance doses, n=1,311 | 20% | 8% (n=303) |
| Zepbound 5 mg (August 2026 label) | adults with obesity or overweight, n=630 | 17% | 5% (n=958) |
| Zepbound 10 mg (August 2026 label) | adults with obesity or overweight, n=948 | 14% | 5% (n=958) |
| Zepbound 15 mg (August 2026 label) | adults with obesity or overweight, n=941 | 11% | 5% (n=958) |
| Ozempic 0.5 mg (June 2026 label) | adults with type 2 diabetes, n=260 | 5% | 1.5% (n=262) |
| Ozempic 1 mg (June 2026 label) | adults with type 2 diabetes, n=261 | 3.1% | 1.5% (n=262) |
| Mounjaro 5 mg (August 2026 label) | adults with type 2 diabetes, n=237 | 6% | 1% (n=235) |
| Mounjaro 10 mg (August 2026 label) | adults with type 2 diabetes, n=240 | 6% | 1% (n=235) |
| Mounjaro 15 mg (August 2026 label) | adults with type 2 diabetes, n=241 | 7% | 1% (n=235) |
The one GI reaction that does not climb with the dose
Zepbound's table reads 17 percent at 5 mg, 14 percent at 10 mg and 11 percent at 15 mg. It falls by six points across the ladder while nausea and diarrhea rise across the same three columns. Ozempic does the same thing, 5 percent at 0.5 mg down to 3.1 percent at 1 mg.
Mounjaro is close to flat at 6 and 7 percent. Wegovy's high-dose table reads 19 percent at 2.4 mg and 20 percent at 7.2 mg, a one-point move where nausea moved four.
Read the placebo column before you read anything else. 11 percent of the placebo arm in the Wegovy trials reported constipation and 5 percent did in the Zepbound trials. Both arms were on a reduced-calorie diet, and the placebo column is what that produced on its own.
What a slower ladder costs
Neither label says what the slower route costs. On some programs the lower dose is the cheaper one and on others the price does not move at all.
| Drug | Cheapest program we track | At the maintenance dose | At the top dose it publishes |
|---|---|---|---|
| Wegovy | Knownwell | $299 a month | Publishes one figure only |
| Zepbound | Sam's Club Member Health | $399 a month | $449 a month, with refills inside 45 days |
LifeMD charges $200 a month more at the top of its ladder than at the dose you stay on. Ask the program what it charges at each dose before you agree to climb.
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What the labels tell a prescriber
- Zepbound's label says what its constipation row counts, and Wegovy's counts constipation alone, so the two figures are not counting the same thing. Zepbound's note reads:
The label counts constipation and hard stool in this row.
Zepbound label, section 6.1 and Wegovy label, section 6.1 - No label in this set names a laxative, a stool softener or a fiber target. Polyethylene glycol and magnesium appear on none of them.Wegovy, Zepbound, Ozempic and Mounjaro labels
- Neither weight-management label prints an instruction aimed at constipation anywhere in its dosage section. The two dose sentences the weight-management labels carry are general. Wegovy's reads:
If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks.
Zepbound's reads:If patients do not tolerate a maintenance dosage, consider a lower maintenance dosage.
Wegovy label, section 2 and Zepbound label, section 2
How long it lasts
Neither weight-management label prints how long constipation lasts. Zepbound's duration sentence covers nausea, vomiting and diarrhea, and Wegovy's label prints no duration sentence at all. In the pooled STEP 1 to 3 trials constipation was reported by 24.2 percent against 11.1 percent on placebo, and that paper published no duration either.Wharton 2022, DOI 10.1111/dom.14551
What a dose change costs
Both weight-management labels answer a tolerability problem the same way, by slowing the ladder or stepping back down. What that does to the bill depends on the program. Shed lists $199 a month, the same figure at every dose. Strut Health lists $149 a month, with auto-refill. Medvi lists $299 a month, after $179 for the first month. None of the three sets its price by the dose, so holding a step costs the same as taking it.
Frequently asked questions
How common is constipation on a GLP-1?
Wegovy's label puts it at 24 percent at 2.4 mg against 11 percent on placebo. Zepbound's puts it at 17 percent at 5 mg, 14 percent at 10 mg and 11 percent at 15 mg, against 5 percent on placebo. On both labels it is the second or third most reported reaction after nausea.
Does it get worse at a higher dose?
Not on tirzepatide. Zepbound's own table falls from 17 percent at 5 mg to 11 percent at 15 mg. Ozempic falls too, from 5 percent at 0.5 mg to 3.1 percent at 1 mg. Mounjaro is close to flat at 6 percent and 7 percent, and Wegovy reads 19 percent at 2.4 mg against 20 percent at 7.2 mg.
What is in the label's constipation row?
Zepbound's label says the row counts constipation and hard stool together. Wegovy's label lists constipation on its own. The two figures are not a clean comparison.
Does the label say what to do about it?
Not for this reaction specifically. What both weight-management labels give the prescriber is the dose lever. Wegovy's says to consider delaying escalation for 4 weeks if a dose is not tolerated. Zepbound's says to consider a lower maintenance dosage. Anything beyond that is a conversation with the prescriber.
Does staying on a lower dose cost less?
On some programs, yes. Others charge one price at every dose, so holding a step changes the clinical picture and not the bill.
Every dosage sentence on this page is written to a prescriber, not to you. Holding a dose, dropping back or stopping changes what the drug is doing. Take the label language to the appointment.
Sources
Evidence checked August 31, 2026
Every figure above is taken from the document beside it, the FDA label or the trial that produced it, so you can read the source instead of trusting us. No clinician reviews these pages. What that means.
- The 24 percent Wegovy figure, the 19 against 20 percent reading at 2.4 mg and 7.2 mg, and the tolerability sentence about delaying escalationFDA prescribing information for Wegovy, injection and tablets (DailyMed, revised June 2026)
- The Zepbound rates at 5 mg, 10 mg and 15 mg, the note that the row counts hard stool as well as constipation, and the sentence about considering a lower maintenance dosageFDA prescribing information for Zepbound (DailyMed, revised August 2026)
- The Ozempic rates at 0.5 mg and 1 mg in adults with type 2 diabetesFDA prescribing information for Ozempic injection (DailyMed, revised June 2026)
- The Mounjaro rates at 5 mg, 10 mg and 15 mg in adults with type 2 diabetesFDA prescribing information for Mounjaro (DailyMed, revised August 2026)
- The share of patients reporting constipation in the pooled trials, and its placebo comparatorWharton S et al. Diabetes Obes Metab 2022;24(1):94-105