Pronunciation: ZEHP-bownd
Generic name: tirzepatide
Brand names: Zepbound, Mounjaro
Dosage forms: injection, for subcutaneous use (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg,15 mg per 0.5 mL in single-dose pen), ... show all 2 dosage forms (2.5 mg/0.5 ml, 5 mg/0.5 ml in single-use vials)
Drug class: GLP-1 Agonists (Incretin Mimetics)

Medically reviewed by Melisa Puckey, BPharm. Last updated on Dec 21, 2024.

What is Zepbound?

Zepbound (tirzepatide) is an FDA-approved medicine used for weight loss and weight management to help you lose weight and keep weight off, and it is also used for obstructive sleep apnea (OSA) with obesity. Zepbound works by reducing your appetite and making you feel full more quickly and for a longer period of time, so you eat less and lose weight. Zepbound for weight loss and sleep apnea is given as a once-weekly injection under the skin and should be used together with diet and exercise. 

When Zepbound was used for weight loss patients lost an average of 48 lbs, or 20.9% of their body weight, compared to 7.1 lb, or 3.1%, for a placebo over 72 weeks in clinical (Study 1).

When Zepbound was used for obstructive sleep apnea 42% of adults had no sleep apnea or mild, non-symptomatic OSA after 1 year of treatment, compared to 16% using placebo (SURMOUNT-OSA phase 3 clinical trials). Zepbound obstructive sleep apnea patients also had a average weight loss of 45 lbs (18% of their body weight).

Zepbound is FDA-approved for chronic weight management in adults with: 

• obesity (with a BMI of 30 kg/m2 or greater) 
• overweight (with a BMI of 27 kg/m2 or greater) and also have weight-related medical problems such as high blood pressure (hypertension), high cholesterol (dyslipidemia), type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease. 

Zepbound is FDA-approved to treat:

• obstructive sleep apnea (OSA) that is moderate to severe adults with obesity.

How Does Zepbound Work?

Zepbound works like two natural hormones in our bodies, called GIP and GLP-1, which help control appetite, blood sugar levels, and digestion. When Zepbound binds to GIP and GLP-1 receptors, it slows the rate food passes through your body, making you feel full longer, and the pancreas releases more insulin, lowering the amount of sugar your liver makes. This helps helps weight loss and may also lower blood sugar levels. Zepbound is a GIP and GLP-1 receptor agonist. Zepbound's mechanism of action is by activating both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) hormone receptors.

Zepbound vs Mounjaro - what is the difference?

Mounjaro is used for type 2 diabetes and Zepbound is used for weight loss, weight management and sleep apnea, but they both contain the same active ingredient and are both made by Eli Lilly and Company. They are both given as weekly injections under the skin and are available as single-dose pens in the same strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg per 0.5 mL. Zepbound is also available as single-dose vials.

What are the side effects of Zepbound?

Common Zepbound side effects

The most common Zepbound side effects include constipation, diarrhea, indigestion (dyspepsia), abdominal pain, burping, tiredness (fatigue), hair loss, reflux, hypersensitivity reactions, injection site reactions, feeling sick (nausea), and vomiting, which affected 5% or more patients in clinical trials.

Serious Zepbound side effects

Serious Zepbound side effects include severe gastrointestinal disease, acute kidney damage, gallbladder disease, acute pancreatitis (inflamed pancreas), serious allergic reactions, low blood sugar levels (hypoglycemia), diabetic retinopathy issues in type 2 diabetics, suicidal behavior or thoughts, and food or liquid getting into the lungs during anesthesia or deep sedation.

Stop using this medicine and get emergency medical help if you have:

• signs of an allergic reaction: hives; difficulty breathing; feeling light-headed; swelling of your face, lips, tongue, or throat; or
• pancreatitis with symptoms of severe pain in your upper stomach spreading to your back, nausea, and vomiting.

Call your doctor at once if you have:

• severe stomach problems, if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting, or you may feel the pain from your abdomen to your back;
• eye side effects or vision changes, including blurry vision or blurred vision;
• signs of a thyroid tumor symptoms may include swelling or a lump in your neck, trouble swallowing, a hoarse voice, or if you feel short of breath;
• gallbladder problem with symptoms including chalky-colored stools, stomach pain after eating, nausea, heartburn, bloating, and severe upper stomach pain that may spread to your back;
• low blood sugar symptoms may include headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or
• kidney problems with little or no urination, swelling in your feet or ankles, feeling tired or short of breath.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Related/similar drugs

How much weight is lost on Zepbound?

Patients on Zepbound (tirzepatide) 5mg weekly lost 16.1 kg (35.5 lb) on average after 72 weeks. For Zepbound 10mg weekly dose, the average weight loss was 22.2 kg (48.9 lb), and for Zepbound 15mg weekly dose average weight loss was 23.6 kg (52.0 lb) over 72 weeks. Patients who used a placebo lost 2.4 kg (5.3 lb) over the 72 weeks. These results are from the clinical trial SURMOUNT-1, NCT04184622. Individual results may vary. Learn more.

Warning

Call your doctor immediately if you have thyroid tumor symptoms, such as a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

In studies with rats, tirzepatide, and medicines that work in the same way caused thyroid tumors, including thyroid cancer. It is not known whether Zepbound will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people.

You should not use this medicine if you, or you have a family history of a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Keep all appointments with your doctor and the laboratory. Your doctor may order certain tests to check your body's response to this medicine.

Limitations of Use

Using this medicine with other tirzepatide containing products or any GLP-1 receptor agonist is not recommended. 

The safety and efficacy of using this medicine with other products for weight management have not been established. 

Tirzepatide has not been studied in patients with a history of pancreatitis. 

Before using this medicine

You should not use Zepbound if you:

• are allergic to the tirzepatide or any ingredients contained in this medicine; see ingredients at the bottom of this page.
• have a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or
• multiple endocrine neoplasia type 2 (tumors in your glands).

Tell your doctor if you have ever had:

• pancreas problems;
• kidney disease;
• a severe stomach problem such as problems with digesting food or slowed emptying of your stomach (gastroparesis); or
• are planning surgery or other procedure that uses anesthesia or deep sedation
• diabetic retinopathy (a diabetes complication that affects the eyes).

Pregnancy

Tell your healthcare provider if you are pregnant, you become pregnant, or plan to become pregnant while using this medicine. It is not known if this medicine will harm your unborn baby.

Tell your doctor if you become pregnant while taking this medicine. There will be a pregnancy exposure registry for women who have taken Zepbound during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry or you may contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979).

Zepbound can make birth control pills less effective. Ask your doctor about other birth control options such as an injection, implant, skin patch, vaginal ring, condom, diaphragm, cervical cap, or contraceptive sponge. If you take birth control pills, you may need to use additional birth control methods for 4 weeks after starting this medicine, and for 4 weeks each time, the dose is raised.

Breastfeeding

Tell your healthcare provider if you are breastfeeding or plan to breastfeed while using this medicine. It is not known whether Zepbound passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby while using this medicine.

How should I use Zepbound?

Zepbound is usually given once a week and can be given with or without meals at any time of the day. Zepbound is injected under the skin (subcutaneously) using a pre-filled pen or a single-dose vial with a syringe. It may be injected into the thigh, abdomen, or upper arm rotating injection site with each dose.

Your doctor will usually start you on a low dose, which will gradually increase, but not more than once every 4 weeks.

You may change the day of the week you use this medicine as long as there is at least three days between doses.

Caregivers or patients should be trained on proper injection techniques. When using single-dose vials, a 1 mL syringe capable of measuring a 0.5 mL dose must be used for dose administration.

You should follow the directions on your prescription label carefully and ask your pharmacist or doctor to explain any part you do not understand. It is important to use this medicine exactly as directed. Do not use more or less of this medicine or more often than your doctor prescribes.

Zepbound Dosing Information

Usual adult zepbound dose for weight loss

Initial dose: 2.5 mg under the skin (subcutaneously) once a week.

After 4 weeks: The dosage should be increased to 5 mg subcutaneously once a week.

Further dose increases: After at least 4 weeks on the current dose the dosage may be increased in 2.5 mg increments.

Recommended maintenance dose: 5 mg, 10 mg, or 15 mg injected subcutaneously once weekly.

Maximum dose: 15 mg subcutaneously once a week.

Usual adult Zepbound dose for obstructive sleep apnea

Initial dose: 2.5 mg under the skin (subcutaneously) once a week.

After 4 weeks: The dosage should be increased to 5 mg subcutaneously once a week.

Further dose increases: After at least 4 weeks on the current dose the dosage may be increased in 2.5 mg increments.

Recommended maintenance dose: 10 mg to 15 mg injected subcutaneously once weekly.

Maximum dose: 15 mg subcutaneously once a week.

Zepbound Products

Zepbound single-dose pens:

• 2.5 mg/0.5 mL single-dose pen
• 5 mg/0.5 mL single-dose pen
• 7.5 mg/0.5 mL single-dose pen
• 10 mg/0.5 mL single-dose pen
• 12.5 mg/0.5 mL single-dose pen
• 15 mg/0.5 mL single-dose pen.

Zepbound single-dose vials:

• 2.5 mg/0.5 mL single-dose vial
• 5 mg/0.5 mL single-dose vial.
• 7.5 mg/0.5 mL, 10 mg/0.5 mL, 12.5 mg/0.5 mL, and 15 mg/0.5 mL single-dose vials may be available in the future.

What should I do if I miss a dose?

Take the missed dose as soon as you remember it within 4 days after the missed dose. However, if more than 4 days have passed, skip the missed dose and continue your regular dosing schedule. Do not inject two doses within 3 days of each other.

What should I do in case of an overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at Poison Help If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What is the cost of Zepbound?

Zepbound coupons, savings cards, or cost.

The Zepbound cost varies depending on your insurance plan and which pharmacy you use.

A Zepbound coupon or Zepbound savings card may be available that you could be eligible for. Ask your doctor or pharmacist if you qualify, or click on this link for Zepbound Coupons and our price guide.

With the Zepbound coupon or Zepbound savings card, people with insurance may be eligible to pay as low as $25 for a one-month or three-month prescription. Those who are commercially insured but without coverage for Zepbound may be eligible for savings for a one-month prescription of Zepbound. Governmental beneficiaries are excluded and terms and conditions do apply.

Zepbound single-dose vials are a more cost-effective option for self-pay patients. They are available through LillyDirect with a valid, on-label electronic prescription from their health care provider.

Learn more: Zepbound cost with or without insurance

Interactions

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Birth control pills may not work as well while receiving this medicine. Your doctor may suggest you use another form of birth control for 4 weeks after starting this medicine and for 4 weeks after each dose change. Talk to your healthcare provider about the best birth control methods that may be right for you while using this medicine.

Taking Zepbound with other medicines to treat diabetes, like insulin or sulfonylureas, may increase your risk of hypoglycemia. Talk to your doctor and pharmacist about low blood sugar and how to manage it.

Zepbound slows gastric emptying and so may change the absorption of other oral medicines that you take. Your doctor will monitor patients on oral medications that have a narrow therapeutic index (e.g., warfarin) or medicines that are dependent on threshold concentrations, while being treated with Zepbound.

This list is not complete. Many other drugs may interact with this medicine, including prescription and over-the-counter medicines, vitamins, and herbal products.

Storage

• Store in the refrigerator between 36⁰F to 46⁰F (2⁰C to 8⁰C).
• Do not freeze. Do not use if frozen.
• Store the single-dose pens in the original carton until use to protect them from light.
• If needed, each single-dose pen can be stored at room temperature up to 86⁰F (30⁰C) for up to 21 days.

Ingredients

Active ingredient: tirzepatide

Inactive ingredients: sodium chloride, sodium phosphate dibasic heptahydrate, and water for injection. Hydrochloric acid solution and/or sodium hydroxide solution may have been added to adjust the pH.

Zepbound Eli Lilly Company

Zepbound Eli Lilly and Company.

Marketed by: Lilly USA, LLC Indianapolis, IN 46285, USA.

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