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Consider avoiding alcohol entirely if: You are in the first 2 to 4 weeks of starting tirzepatide You just increased your dose within the past week You have type 2 diabetes on insulin or sulfonylureas You have a history of pancreatitis You have liver disease You tend toward binge drinking Moderate, careful drinking is likely acceptable if: You are on a stable maintenance dose Your GI side effects have settled You do not have diabetes or other high-risk conditions You stick to 1 to 2 standard drinks maximum You eat a full meal beforehand You hydrate aggressively before, during, and after The most important principle is this: assume your tolerance has changed

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