Rhabdomyolysis Associated with the Use of Tirzepatide

Tirzepatide is one of the commonly used combined glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) agonists for weight loss in recent years. There are significant advantages of these medications for weight reduction, improved glycaemic control and cardiorenal benefits. However, these medications come with serious adverse events and need closer monitoring once they are initiated.

We present a case of a 35-year-old female with no comorbidities taking tirzepatide for weight loss. She developed severe rhabdomyolysis that required hospitalisation; muscle biopsy revealed necrotising myopathy. Her rhabdomyolysis resolved after stopping tirzepatide and conservative management with intravenous fluids. Since no other contributing factor could be identified, we believe tirzepatide may have increased her risk of rhabdomyolysis.

In patients presenting with rhabdomyolysis, consideration should be given to GLP-1 agonists as a potential contributing factor for the development of rhabdomyolysis.

Clinicians need to be aware of unusual side effects of glucagon-like peptide-1 (GLP-1) agonists like rare occurrence of rhabdomyolysis potentially associated with the use of tirzepatide.Risks versus benefits of these medications should be discussed in detail with patients before prescribing.Close patient follow-up and monitoring for adverse events is necessary, especially after prescribing relatively newer medications such as GLP-1 agonists with evolving knowledge of adverse event profile.