Zepbound is a brand-name subcutaneous injection. It’s prescribed for weight loss and weight management. Zepbound contains the active drug tirzepatide.
You’ll find key information about Zepbound below.
The Zepbound dosage your doctor prescribes will depend on how your condition responds to the drug or any side effects you may have.
The following information describes dosages that are commonly prescribed or recommended. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug form and strengths
Zepbound comes as a solution in a single-use subcutaneous injection pen. It’s available in six strengths:
- 2.5 milligrams per 0.5 milliliters (mg/mL)
- 5 mg/0.5 mL
- 7.5 mg/0.5 mL
- 10 mg/0.5 mL
- 12.5 mg/0.5 mL
- 15 mg/0.5 mL
Dosage for weight loss and weight management
Zepbound is approved for weight loss and weight management in certain adults.
The typical starting dose is 2.5 mg. You’ll inject this dose once per week for 4 weeks. After that, your doctor may increase your dosage to 5 mg once per week.
Your doctor may adjust your weekly dose of Zepbound until it provides the desired effect. Dose increases will be at least 4 weeks apart. The maximum recommended dosage of Zepbound is 15 mg once per week.
How to inject
Your doctor will show you or a caregiver how to inject Zepbound under the skin of your thigh or abdomen. If someone else is giving you the injection, the upper arm is also an optional injection site.
Each injection pen delivers one dose of Zepbound. You’ll use a new injection pen for each dose.
About injecting Zepbound
Below you’ll find information about key dosage issues.
- When to inject: You should inject Zepbound once per week at any time of day. Injecting the drug around the same day each week helps keep a steady level of the drug in your body. This helps Zepbound work effectively.
- If you miss a dose: If up to 4 days have passed since your missed dose, inject the missed dose as soon as you remember. Then continue your regular weekly dosing schedule. If more than 4 days have passed since your missed dose, skip it and wait for your next weekly dose. You should inject doses of Zepbound at least 3 days apart.
- Length of treatment: Zepbound is meant to be a long-term treatment. If you and your doctor determine that Zepbound is safe and effective for you, you’ll likely use it long term.
Do not inject more Zepbound than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.
What to do in case you inject too much Zepbound
If you think you’ve injected too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.
Zepbound can cause mild or serious side effects. The following lists contain some of the key side effects that may occur during Zepbound treatment. These lists do not include all possible side effects.
For more information about the possible side effects of Zepbound, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may concern or bother you.
Note: The FDA tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Zepbound, you can do so through MedWatch.
Mild side effects
Below is a partial list of mild side effects of Zepbound. To learn about other mild side effects, talk with your doctor or pharmacist or view Zepbound’sprescribing information.
Mild side effects of Zepbound can include:
- injection site reactions, such as bruising, itching, or pain around the injection area
- nausea or vomiting
- diarrhea or constipation
- indigestion or gastroesophageal reflux disease (GERD)
- abdominal pain
- hair loss
- low blood pressure
- mildly increased heart rate
- mild allergic reaction*
Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or do not go away, talk with your doctor or pharmacist.
* For more information about allergic reaction and Zepbound, see “Allergic reaction” below.
Serious side effects
Serious side effects from Zepbound aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- Acute (sudden) gallbladder disease, such as gallstones. Symptoms can include:
- abdominal pain
- nausea and vomiting
- Acute pancreatitis. Symptoms can include:
- pain in your abdomen or back
- nausea and vomiting
- Low blood sugar. Symptoms can include:
- Severe digestive problems, such as severe diarrhea, vomiting, or nausea. This may lead to dehydration and acute kidney injury. Symptoms can include:
- urinating a lesser amount than is typical
- swelling of the legs or ankles
- Suicidal thoughts or behaviors. These were not reported in clinical trials of Zepbound. However, this side effect occurred in clinical trials of weight loss drugs similar to Zepbound. Symptoms can include:
- Risk of thyroid cancer.*
- Severe allergic reaction.†
* Zepbound has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Zepbound precautions” section below.
† For details about allergic reaction and Zepbound, see “Allergic reaction” below.
As with most drugs, some people can have an allergic reaction after taking Zepbound. Mild allergic reaction at the injection site was a common side effect in clinical trials of this drug. Severe allergic reaction was not reported in clinical trials of this drug but has occurred since the drug was approved.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- difficulty breathing
Call your doctor right away if you have an allergic reaction to Zepbound, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
The FDA approves prescription drugs such as Zepbound to treat certain conditions.
Zepbound for weight loss and weight management
Zepbound is approved for weight loss and weight management in adults who have either:
- obesity (a body mass index [BMI] of 30 or higher), or
- overweight (a BMI of 27 or higher) and at least one health condition related to weight, such as high blood pressure, type 2 diabetes, or obstructive sleep apnea
Doctors typically will not prescribe Zepbound in the following situations:
- with other drugs that contain tirzepatide (the active ingredient in Zepbound), such as Mounjaro
- with glucagon-like peptide-1 receptor agonists, such as semaglutide (Ozempic, Rybelsus, Wegovy) or liraglutide (Saxenda, Victoza)
- with other weight loss products, such as phentermine (Adipex-P, Lomaira)
- if you’ve had pancreatitis (inflammation of the pancreas) in the past
You can refer to our weight management hub for details about weight loss and maintaining a weight that’s healthy for you.
Zepbound and children
Zepbound is not FDA-approved for use in children. It’s unknown whether the drug is safe or effective for children.
Zepbound can interact with several other medications. It is not known to interact with supplements or foods.
Before starting Zepbound, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Interactions with medications
Below is a list of medications that can interact with Zepbound. This list does not contain all drugs that may interact with Zepbound. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Medications that can interact with Zepbound include:
- sulfonylureas, such as glyburide (Diabeta, Glynase) and glipizide (Glucotrol XL)
- insulin, such as insulin detemir (Levemir) and insulin aspart (Fiasp, NovoLog)
- birth control pills, such as ethinyl estradiol/norgestimate (Estarylla, Sprintec, others) and drospirenone/estetrol (Nextellis)
- warfarin (Jantoven)
Alcohol is not known to interact with Zepbound. It’s likely safe to consume alcohol during Zepbound treatment. If you have questions about how much alcohol is safe to drink during Zepbound treatment, talk with your doctor or pharmacist.
As with all medications, the cost of Zepbound can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Drug coupons: You can visit Optum Perks for price estimates of Zepbound. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
Financial and insurance assistance: If you need financial support to pay for Zepbound, or if you need help understanding your insurance coverage, help is available.
A savings card for Zepbound is available. For more information and to find out whether you’re eligible for support, visit the manufacturer’s website.
To learn more about saving money on prescriptions, check out this article.
Generic version. Zepbound is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.
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Other drugs are available for weight loss and weight management. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zepbound, talk with your doctor. They can tell you about other medications that may work well for you.
The following drugs are similar to Zepbound:
If you can become pregnant, consider the following information about pregnancy, birth control, and breastfeeding.
Zepbound and pregnancy
It’s not known whether Zepbound should be taken during pregnancy. Keep in mind that Zepound is prescribed for weight loss, and weight loss is typically not recommended during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before starting this medication.
If your doctor recommends treatment with Zepbound during pregnancy, consider joining the drug’s pregnancy registry. This registry will help collect information on the safety of Zepbound during pregnancy. You can learn more by calling 800-545-5979 or talking with your doctor.
Zepbound and birth control
It’s not known whether Zepbound treatment is safe during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zepbound.
It’s important to note that Zepbound may interact with birth control pills. The drug could make birth control pills less effective during the first 4 weeks of Zepbound treatment and for 4 weeks after each dose increase. (For details about this medication’s dosing, see the “Zepbound dosage” section above.)
If you take birth control pills, your doctor may recommend either:
- adding a barrier method of birth control, such as condoms, or
- switching to a non-oral birth control, such as the vaginal ring or patch
Your doctor can tell you whether it’s possible to switch back to your birth control pill at least 4 weeks after the last dose increase. If you have questions about this, talk with your doctor or pharmacist.
Zepbound and breastfeeding
It’s not known whether Zepbound should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before starting this medication.
Here are answers to some frequently asked questions about Zepbound.
How does Zepbound work?
Zepbound works by mimicking the action of certain hormones, called glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). GIP and GLP-1 activate certain receptors (binding sites) in the body that help regulate appetite.
By acting similarly to GIP and GLP-1, Zepbound reduces your appetite and food intake. In this way, Zepbound may help you lose weight and keep weight off after losing it.
To learn more about how Zepbound works, talk with your doctor or pharmacist.
Is Zepbound effective for weight loss?
Zepbound has been found effective for weight loss and weight management.
How does Zepbound compare with Wegovy?
Zepbound and Wegovy have some similarities and important differences.
Both Zepbound and Wegovy are approved for weight loss and weight management in certain adults. They’re prescribed with exercise and a low calorie diet. Wegovy is also approved for use in certain children, while Zepbound is not approved for children.
Zepbound and Wegovy contain different active drugs. Zepbound contains tirzepatide, and Wegovy contains semaglutide. Both drugs work in similar ways to help you lose weight and keep weight off after losing it.
For more information about how Zepbound compares with Wegovy, talk with your doctor or pharmacist.
This drug comes with several precautions.
FDA warning: Risk of thyroid cancer
This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Risk of thyroid cancer. In animal studies, tirzepatide (the active drug in Zepbound) increased the risk of thyroid cancer. However, it isn’t known for certain whether Zepbound increases this risk in humans. This is because animal studies do not always predict what will happen in humans.
To be safe, doctors are unlikely to prescribe Zepbound for people with factors that increase their risk of thyroid cancer. These include having either:
- a genetic (inherited) condition called multiple endocrine neoplasia syndrome type 2
- a personal or family history of medullary thyroid cancer
Your doctor can show you how to self-check for thyroid cancer. If you have symptoms during treatment with Zepbound, tell your doctor right away. Examples include a lump or swelling in the neck, hoarseness, and difficulty swallowing. They may order other tests to check for thyroid cancer.
To learn more about this warning, talk with your doctor.
Before starting Zepbound, discuss your health history with your doctor. Zepbound may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- diabetic retinopathy
- suicidal thoughts or behaviors
- digestive system problems, such as stomach paralysis
- kidney problems, such as kidney failure
- past allergic reaction to this or a similar drug
Note: For more information about the potential negative effects of Zepbound, see the “Zepbound side effects” section above.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.