The medications most commonly linked to sulfur burps are GLP-1 drugs used for diabetes and weight loss, including Ozempic, Wegovy, Mounjaro, and Zepbound. Proton pump inhibitors (PPIs) and other acid-reducing medications can also trigger them through a different mechanism. In both cases, the culprit is hydrogen sulfide, the same gas that gives rotten eggs their smell, produced when food sits too long in the digestive tract and ferments.
GLP-1 Medications Are the Most Common Cause
GLP-1 receptor agonists slow down how quickly your stomach empties after a meal. That’s part of how they work: food stays in your stomach longer, so you feel full and eat less. But when food lingers too long, bacteria start to ferment it, and that fermentation produces hydrogen sulfide gas. The result is burps with a distinct sulfur or rotten-egg smell.
Clinical trials have documented this side effect across several GLP-1 medications. Wegovy (semaglutide) has the highest reported rate, with about 7% of adults on the 2.4 mg dose experiencing burping. Zepbound (tirzepatide) comes in around 4 to 5% across its dosage range. Ozempic (semaglutide injection) affects roughly 1 to 3% of patients depending on the dose, and the oral form (Rybelsus) affects about 2% at the 14 mg dose. Mounjaro (tirzepatide) lands around 2 to 3%.
Liraglutide, sold as Victoza for diabetes and Saxenda for weight loss, belongs to the same drug class and carries the same risk. The pattern is consistent: any medication that significantly delays stomach emptying creates conditions for bacterial fermentation and sulfur gas.
Acid-Reducing Medications and the Bacterial Connection
Proton pump inhibitors like omeprazole and pantoprazole work by drastically reducing stomach acid production. That’s helpful for acid reflux and ulcers, but chronic use can push stomach acid levels too low, a condition called hypochlorhydria. H2 blockers (like famotidine) and even regular antacid use can contribute to the same problem over time.
Your stomach acid does more than digest food. It also kills off bacteria before they reach your small intestine. When acid levels drop, bacteria that would normally be kept in check can multiply in the upper digestive tract, a condition known as small intestinal bacterial overgrowth, or SIBO. These bacteria feast on undigested food and produce hydrogen sulfide as a byproduct. The specific bacteria involved include species of Fusobacterium, Clostridium, Escherichia, and Desulfovibrio, all of which convert sulfur-containing amino acids into hydrogen sulfide gas.
Low stomach acid also makes you more vulnerable to overgrowth of H. pylori, a bacterium linked to chronic stomach inflammation and ulcers, which can further disrupt digestion and contribute to gas production.
Why Some People Get Sulfur Burps and Others Don’t
Not everyone on these medications will develop sulfur burps. Your individual gut bacteria play a major role. People with higher populations of sulfate-reducing bacteria, particularly Desulfovibrio species, produce more hydrogen sulfide from the same amount of fermented food. Diet matters too: foods high in sulfur-containing amino acids (eggs, meat, cruciferous vegetables like broccoli and cabbage) give those bacteria more raw material to work with.
The combination of a sulfur-rich diet and a medication that slows digestion or reduces stomach acid creates the ideal conditions for sulfur burps. This is why two people on the same dose of the same medication can have very different experiences.
How to Reduce Sulfur Burps While on Medication
If a GLP-1 medication is causing sulfur burps, eating smaller meals can help. Less food in the stomach means less material sitting around fermenting. Reducing sulfur-heavy foods, particularly eggs, red meat, dairy, garlic, and cruciferous vegetables, cuts down on the raw ingredients bacteria use to produce hydrogen sulfide.
Eating slowly and avoiding carbonated drinks can reduce how much air you swallow, which contributes to burping in general. Staying upright after meals helps your stomach empty more efficiently, even when a medication is slowing the process down.
For sulfur burps linked to acid-reducing medications, the situation is more nuanced. If you’ve been on a PPI for a long time and sulfur burps are a new development, it may signal that your stomach acid has dropped low enough to allow bacterial overgrowth. This is worth discussing with your prescriber, since there are strategies for adjusting acid-suppressing treatment or addressing overgrowth directly.
Signs That Sulfur Burps Need Attention
Occasional sulfur burps on their own are more of a nuisance than a health concern. But sulfur burps that become frequent or start interfering with your eating habits deserve a closer look, especially if they’re accompanied by chest or abdominal pain, unexplained weight loss, fever, persistent nausea or vomiting, or ongoing diarrhea. These combinations can point to conditions like bacterial overgrowth, a stomach infection, or a medication side effect that’s worth addressing rather than tolerating.