We report the case of a 53-year-old woman with type 2 diabetes and bulimia nervosa who developed prolonged paralytic ileus after self-injecting tirzepatide 7.5 mg, 10 mg, and 15 mg on three consecutive days. Tirzepatide had been prescribed for diabetes treatment. However, the excessive self-administration resulted in paralytic ileus. No mechanical obstruction was found, and the condition resolved after three weeks of conservative therapy, including gastrointestinal decompression and prokinetic agents. Because tirzepatide has a long half-life, an overdose may cause the persistent suppression of intestinal motility. Misunderstanding about drug effects may lead to an overdose, thus requiring careful instruction and medication management.
Asada et al. (2026) studied this question.