What Else Can Tirzepatide Treat? Approved and Studied Uses

Tirzepatide, sold as Mounjaro and Zepbound, is FDA-approved for four uses: improving blood sugar control in type 2 diabetes, reducing the risk of major cardiovascular events in adults with type 2 diabetes at high risk (a Mounjaro indication added in August 2026), reducing excess body weight and keeping it off long term, and treating moderate-to-severe obstructive sleep apnea in adults with obesity ^[1][2]. The weight and sleep apnea indications sit on the Zepbound label; the diabetes and cardiovascular indications sit on the Mounjaro label ^[1][2].

Beyond those four, tirzepatide has produced positive results in clinical trials for heart failure with preserved ejection fraction, for slowing progression from prediabetes to type 2 diabetes, and for fatty liver disease (MASH) — but none of those is an FDA-approved use ^{[1][2][4][6][7]}. Conditions people often ask about, such as addiction, dementia, cancer, PCOS, kidney disease, and osteoarthritis, appear on neither label ^[1][2].

What is tirzepatide approved for right now?

Tirzepatide is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist, given as a subcutaneous injection once weekly ^[1][2]. Both brands received initial US approval in 2022, and both labels were revised in 08/2026 ^[1][2].

The current approved uses are:

• Mounjaro: as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus. The pediatric indication for patients 10 years of age and older was added in 12/2025 ^[2].
• Mounjaro: to reduce the risk of major adverse cardiovascular events — cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke — in adults with type 2 diabetes mellitus who are at high risk for these events. This indication was added in 08/2026 ^[2].
• Zepbound: in combination with a reduced-calorie diet and increased physical activity, to reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight in the presence of at least one weight-related comorbid condition ^[1].
• Zepbound: to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity ^[1].

The Zepbound label also carries a limitation of use: coadministration with other tirzepatide-containing products or with any GLP-1 receptor agonist is not recommended ^[1].

What is the difference between Mounjaro and Zepbound?

Mounjaro and Zepbound contain the same active drug, tirzepatide, in the same form: an injection given under the skin once weekly ^[1][2]. Both were initially approved in the United States in 2022, and both labels were revised in 08/2026 ^[1][2]. The difference is the approved use each label carries.

	Mounjaro	Zepbound
Active drug	Tirzepatide injection, subcutaneous, once weekly [2]	Tirzepatide injection, subcutaneous, once weekly [1]
Approved uses	Glycemic control in type 2 diabetes (adults and children 10 years and older); reduce major adverse cardiovascular events in adults with type 2 diabetes at high risk [2]	Weight reduction and long-term maintenance in adults with obesity or overweight plus a weight-related comorbid condition; moderate to severe OSA in adults with obesity [1]
Initial US approval	2022 [2]	2022 [1]
Label revised	08/2026 [2]	08/2026 [1]

There is no approved indication on either label for heart failure, kidney disease, MASH, PCOS, osteoarthritis, addiction, or cognitive problems ^[1][2].

Does tirzepatide do anything besides weight loss?

Yes. Weight loss is only part of the approved footprint. Zepbound carries a separate approval for obstructive sleep apnea in adults with obesity ^[1], and Mounjaro carries an approval for reducing major cardiovascular events in adults with type 2 diabetes at high risk ^[2]. In addition, researchers have studied tirzepatide in several conditions it is not approved to treat:

Condition	Key trial	Headline result	FDA-approved?
Obstructive sleep apnea	SURMOUNT-OSA [3]	Apnea events fell by 25.3 and 29.3 per hour vs 5.3 and 5.5 with placebo at 52 weeks	Yes — Zepbound [1]
Progression from prediabetes to type 2 diabetes	SURMOUNT-1 [6]	1.3% on tirzepatide vs 13.3% on placebo developed type 2 diabetes over 176 weeks	No [1][2]
Heart failure with preserved ejection fraction	SUMMIT [4]	9.9% vs 15.3% had cardiovascular death or worsening heart failure (HR 0.62)	No [1][2]
Fatty liver disease (MASH)	SYNERGY-NASH [7]	MASH resolved in 44%, 56%, and 62% by dose vs 10% with placebo	No [1][2]

Each of these is covered in detail below.

Is tirzepatide approved for sleep apnea, and what did the trials show?

Yes. Zepbound is approved to treat moderate to severe obstructive sleep apnea in adults with obesity ^[1]. Separately, SURMOUNT-OSA — two phase 3 double-blind randomized controlled trials in adults with moderate-to-severe OSA and obesity — reported results in this population ^[3]. Trial 1 enrolled people not receiving positive airway pressure (PAP) at baseline; trial 2 enrolled people already on PAP therapy ^[3]. Participants were assigned 1:1 to the maximum tolerated dose of tirzepatide (10 mg or 15 mg) or placebo for 52 weeks ^[3].

At baseline, the mean apnea–hypopnea index (AHI) — the number of apneas and hypopneas per hour of sleep — was 51.5 events per hour in trial 1 and 49.5 in trial 2, with mean BMI of 39.1 and 38.7 respectively ^[3].

At week 52:

• Trial 1: AHI changed by −25.3 events per hour with tirzepatide vs −5.3 with placebo, a treatment difference of −20.0 events per hour (P<0.001) ^[3].
• Trial 2: AHI changed by −29.3 events per hour with tirzepatide vs −5.5 with placebo, a treatment difference of −23.8 events per hour (P<0.001) ^[3].

Tirzepatide also improved body weight, hypoxic burden, high-sensitivity C-reactive protein, systolic blood pressure, and patient-reported sleep outcomes compared with placebo ^[3]. The most frequent adverse events were gastrointestinal and mostly mild to moderate ^[3]. The Zepbound label lists maintenance dosages for OSA of 10 mg or 15 mg injected subcutaneously once weekly ^[1].

The trial was funded by Eli Lilly (ClinicalTrials.gov number NCT05412004) and published in the New England Journal of Medicine on June 21, 2024 ^[3].

Can tirzepatide prevent type 2 diabetes?

It is not approved for that, but a 3-year analysis of the SURMOUNT-1 trial showed a large reduction in progression from prediabetes to type 2 diabetes ^[6]. SURMOUNT-1 randomized 2,539 participants with obesity, of whom 1,032 also had prediabetes; the diabetes-prevention analysis covered the group with both conditions ^[6]. They received tirzepatide at 5 mg, 10 mg, or 15 mg once weekly, or placebo, for 176 weeks of treatment followed by a 17-week off-treatment period ^[6].

By week 176, 1.3% of tirzepatide-treated participants had received a diagnosis of type 2 diabetes vs 13.3% of those on placebo (hazard ratio 0.07; 95% CI 0.0 to 0.1; P<0.001) ^[6]. After the 17 weeks off treatment, 2.4% of the tirzepatide group and 13.7% of the placebo group had type 2 diabetes (hazard ratio 0.12; 95% CI 0.1 to 0.2; P<0.001) ^[6].

Weight change over the same period was −12.3% on the 5 mg dose, −18.7% on 10 mg, and −19.7% on 15 mg, vs −1.3% with placebo (P<0.001 for all comparisons) ^[6]. The most common adverse events were gastrointestinal, mostly mild to moderate, and occurred mainly during dose escalation in the first 20 weeks; no new safety signals were identified ^[6]. The trial was funded by Eli Lilly (NCT04184622) ^[6]. Neither US label includes an indication for prediabetes or diabetes prevention ^[1][2].

Can tirzepatide treat heart failure?

Not as an approved use. Heart failure does not appear on either the Mounjaro or Zepbound label ^[1][2]. But the SUMMIT trial, published in the New England Journal of Medicine on November 16, 2024, produced positive results in heart failure with preserved ejection fraction ^[4].

SUMMIT randomized 731 patients with heart failure, an ejection fraction of at least 50%, and a BMI of at least 30, to tirzepatide (up to 15 mg subcutaneously once weekly) or placebo for at least 52 weeks; median follow-up was 104 weeks ^[4].

• The composite of cardiovascular death or a worsening heart-failure event occurred in 36 patients (9.9%) on tirzepatide vs 56 (15.3%) on placebo (hazard ratio 0.62; 95% CI 0.41 to 0.95; P=0.026) ^[4].
• Worsening heart-failure events alone occurred in 8.0% vs 14.2% (hazard ratio 0.54; 95% CI 0.34 to 0.85); cardiovascular death occurred in 2.2% vs 1.4% (hazard ratio 1.58; 95% CI 0.52 to 4.83) ^[4].
• On the Kansas City Cardiomyopathy Questionnaire clinical summary score, the tirzepatide group improved 19.5 points vs 12.7 with placebo at 52 weeks, a between-group difference of 6.9 (95% CI 3.3 to 10.6; P<0.001) ^[4].
• Adverse events, mainly gastrointestinal, led 6.3% of the tirzepatide group and 1.4% of the placebo group to stop the trial drug ^[4].

The trial was funded by Eli Lilly (NCT04847557) ^[4].

Does tirzepatide lower heart attack and stroke risk?

Yes, in one defined group: Mounjaro is approved to reduce the risk of major adverse cardiovascular events — cardiovascular death, non-fatal heart attack, or non-fatal stroke — in adults with type 2 diabetes who are at high risk for these events ^[2]. There is no cardiovascular indication on the Zepbound label ^[1].

The evidence comes from SURPASS-CVOT, an active-comparator, double-blind noninferiority trial in patients with type 2 diabetes and atherosclerotic cardiovascular disease, published in the New England Journal of Medicine on December 17, 2025 ^[5]. Patients were randomized 1:1 to weekly tirzepatide (up to 15 mg) or dulaglutide (1.5 mg); there was no placebo arm ^[5].

Of 13,299 patients randomized, 134 were later excluded, leaving a modified intention-to-treat population of 6,586 in the tirzepatide group and 6,579 in the dulaglutide group ^[5]. Their mean age was 64.1 years, 29.0% were women, mean BMI was 32.6, mean HbA1c was 8.4%, and mean diabetes duration was 14.7 years ^[5].

A primary end-point event (cardiovascular death, myocardial infarction, or stroke) occurred in 801 patients (12.2%) on tirzepatide vs 862 (13.1%) on dulaglutide — hazard ratio 0.92 (95.3% CI 0.83 to 1.01; P=0.003 for noninferiority; P=0.09 for superiority) ^[5]. The noninferiority margin was 1.05 for the upper limit of the confidence interval, and an upper limit below 1.00 would have indicated superiority ^[5]. In other words, the trial showed tirzepatide was not worse than dulaglutide, but it did not statistically prove it was better ^[5]. Adverse events were similar between groups, with more gastrointestinal events on tirzepatide ^[5]. The trial was funded by Eli Lilly (NCT04255433) ^[5].

Does tirzepatide treat fatty liver disease (MASH)?

Not as an approved use — MASH appears on neither label ^[1][2]. But the SYNERGY-NASH trial, a phase 2 dose-finding study published in the New England Journal of Medicine on June 8, 2024 (updated September 4, 2025), showed promising results ^[7].

The trial randomized 190 participants with biopsy-confirmed MASH and stage F2 or F3 (moderate or severe) fibrosis to once-weekly tirzepatide at 5 mg, 10 mg, or 15 mg, or placebo, for 52 weeks; 157 had biopsy results that could be evaluated at week 52 ^[7].

• MASH resolution without worsening of fibrosis occurred in 10% of the placebo group vs 44% on 5 mg, 56% on 10 mg, and 62% on 15 mg (P<0.001 for all three comparisons vs placebo) ^[7].
• Improvement of at least one fibrosis stage without worsening of MASH occurred in 30% of the placebo group vs 55%, 51%, and 51% on the three tirzepatide doses ^[7].

The most common adverse events were gastrointestinal and mostly mild or moderate ^[7]. The authors concluded that larger and longer trials are needed to further assess tirzepatide for MASH ^[7]. The trial was funded by Eli Lilly (NCT04166773) ^[7].

What about addiction, dementia, cancer, PCOS, kidney disease, and osteoarthritis?

None of these appears as an indication on either FDA label ^[1][2]. No study results for tirzepatide in these conditions are included in the material cited on this page, so no numbers can be reported for any of them. Until a use appears on an FDA label, prescribing for that purpose would be off-label, and none of these conditions has an approved tirzepatide indication ^[1][2].

How does tirzepatide compare with semaglutide?

The clearest label-level differences that can be stated from the prescribing information: tirzepatide acts at both the GIP receptor and the GLP-1 receptor ^[1][2], and Zepbound carries an approved indication for obstructive sleep apnea ^[1]. The Zepbound label also states that coadministration with any GLP-1 receptor agonist is not recommended ^[1].

A head-to-head trial comparing tirzepatide with semaglutide for obesity treatment has been published ^[8], but its specific results are not included in the material cited on this page, so no percentages from that comparison can be reported. Whether tirzepatide or semaglutide is better for a given person is a question for a prescriber.

Who should not take tirzepatide, and what safety limits apply?

Both labels carry a boxed warning: in rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures, and it is unknown whether the drug causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans ^[1][2]. Tirzepatide is contraindicated in people with a personal or family history of MTC, or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in anyone with known serious hypersensitivity to tirzepatide or the product’s excipients ^[1][2]. The labels state that routine monitoring of serum calcitonin or thyroid ultrasound is of uncertain value for early MTC detection ^[1][2].

Other warnings on the labels include severe gastrointestinal reactions (the drugs are not recommended in severe gastroparesis), acute kidney injury from volume depletion, acute gallbladder disease, acute pancreatitis, hypersensitivity reactions, hypoglycemia when combined with insulin or an insulin secretagogue, progression of diabetic retinopathy, and pulmonary aspiration during general anesthesia or deep sedation ^[1][2]. On the Zepbound label, the suicidal behavior and ideation warning was removed in 02/2026, and a diabetic retinopathy warning was added in 08/2026 ^[1].

The labels state that tirzepatide may cause fetal harm in pregnancy, and Zepbound should be discontinued when pregnancy is recognized ^[1][2]. Females using oral contraceptives are advised to switch to a non-oral method or add a barrier method for 4 weeks after starting treatment and for 4 weeks after each dose escalation ^[1][2]. Because tirzepatide delays gastric emptying, it can affect the absorption of oral medications ^[1][2].

The most common adverse reactions reported in at least 5% of Zepbound-treated patients include nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection-site reactions, fatigue, eructation, hair loss, and gastroesophageal reflux disease ^[1]. A KwikPen should never be shared between patients, even with a new needle ^[1][2].

Can children take tirzepatide?

For one use only. Mounjaro is approved to improve glycemic control in pediatric patients 10 years of age and older with type 2 diabetes, an indication added in 12/2025 ^[2]. The Mounjaro label lists a maximum dosage of 10 mg subcutaneously once weekly in pediatric patients, compared with 15 mg in adults ^[2]. Zepbound’s weight and sleep apnea indications are for adults ^[1].

The bottom line

Tirzepatide’s approved footprint is specific: glycemic control and cardiovascular event reduction in type 2 diabetes (Mounjaro), and weight reduction with long-term maintenance plus obstructive sleep apnea in adults with obesity (Zepbound) ^[1][2]. Heart failure, diabetes prevention, and MASH have positive trial results but no approval ^{[1][2][4][6][7]}. Everything else people ask about is neither approved nor supported by results cited on this page ^[1][2].

This page is information, not medical advice. Decisions about starting, stopping, or using tirzepatide for any condition belong with a prescriber who knows the full medical history. Suspected adverse reactions can be reported to Eli Lilly at 1-800-545-5979 or to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch ^[1][2].

Sources

1. US Food and Drug Administration. Zepbound (tirzepatide) injection prescribing information.
2. US Food and Drug Administration. Mounjaro (tirzepatide) injection prescribing information.
3. New England Journal of Medicine. Tirzepatide for the treatment of obstructive sleep apnea and obesity.
4. New England Journal of Medicine. Tirzepatide for heart failure with preserved ejection fraction and obesity.
5. New England Journal of Medicine. Cardiovascular outcomes with tirzepatide versus dulaglutide in type 2 diabetes.
6. New England Journal of Medicine. Tirzepatide for obesity treatment and diabetes prevention.
7. New England Journal of Medicine. Tirzepatide for metabolic dysfunction-associated steatohepatitis with liver fibrosis.
8. New England Journal of Medicine. Tirzepatide as compared with semaglutide for the treatment of obesity.
9. The Lancet. Efficacy and safety of tirzepatide in children and adolescents with type 2 diabetes (SURPASS-PEDS): a randomised, double-blind, placebo-controlled, phase 3 trial.
10. Diabetes, Obesity and Metabolism. Relative efficacy of GLP-1 and GLP-1/GIP receptor agonists in the prevention of alcohol-use disorders using a target trial emulation approach. 2026.
11. ScienceDirect. GLP-1 receptor agonist use and cancer risk in obese nondiabetic adults.
12. Diabetes Research and Clinical Practice. Target trial emulations for tirzepatide, semaglutide and SGLT2-inhibitors for dementia in patients with type 2 diabetes: real world evidence from a retrospective cohort study.
13. ConscienHealth. Lilly withdraws tirzepatide application to FDA for heart failure. May 3, 2025.
14. ClinicalTrials.gov. A study of tirzepatide (LY3298176) on the reduction on morbidity and mortality in adults with obesity. NCT05556512.
15. ClinicalTrials.gov. A master protocol of multiple agents in adults with metabolic dysfunction-associated steatotic liver disease (SYNERGY-Outcomes). NCT07165028.
16. PR Newswire. FDA approves Lilly’s Mounjaro (tirzepatide) to reduce cardiovascular risk in adults with type 2 diabetes. August 28, 2026.