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Similar drugs currently available: Mounjaro, Ozempic, Rybelsus

What is Zepbound (tirzepatide)?

Zepbound is an injectable prescription medication that may help adults with obesity, or with excess weight (overweight) who also have weight-related medical problems, lose weight and keep it off. Zepbound should be used with a reduced-calorie diet and with an exercise plan. This medication is injected under the skin once per week.

Mechanism of Action and Usage

Zepbound (tirzepatide) targets receptors for two natural gut hormones: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones help regulate your appetite and how your body processes food. By mimicking these hormones, Zepbound (tirzepatide) can increase feelings of fullness and reduce your desire to eat, ultimately aiding in weight loss.As a GIP (Glucose-Dependent Insulinotropic Polypeptide) and GLP-1 (Glucagon-Like Peptide-1) receptor agonist, Zepbound’s active ingredient, tirzepatide, activates crucial receptors involved in metabolic regulation. This action reduces hunger and appetite, decreases caloric intake, and slows gastric emptying, thereby helping to manage overeating and snacking. Administered as a once-weekly subcutaneous injection, Zepbound is convenient and user-friendly, with adjustable dosages adjustable to fit individual patient needs, ensuring optimal treatment efficacy and minimal side effects.

Clinical Trials and Effectiveness

Several factors influence how much weight you lose with Zepbound, including your weight at the start, your diet and exercise habits, any other medications you take, any health problems you have, and the dose of Zepbound prescribed. In a study, people who took the highest recommended dose of Zepbound for almost a year and a half lost, on average, around 18% of their body weight compared to those who took a placebo. Talk to your doctor about how effective this medication might be for you.

Indications for Use

Zepbound can be prescribed for adults for long-term weight management (with diet and exercise) with a Body Mass Index (BMI) of 30 kg/m² or greater. It is also indicated for those with a BMI of 27 kg/m² or greater who are experiencing weight-related health conditions such as high blood pressure, high cholesterol, type 2 diabetes, and obstructive sleep apnea. Your doctor will review your medical history and assess your current health status to confirm if Zepbound is a suitable option for you.

Medication Storage Guidelines

It is crucial to store Zepbound properly in order to maintain its efficacy. The medication should be refrigerated consistently at temperatures ranging from 36°F to 46°F (2°C to 8°C). You should throw out and discard Zepbound if not used within 21 days after removing it from the refrigerator. Do not freeze Zepbound as this can compromise the medication’s integrity. Additionally, the medication should be protected from light, which could potentially degrade its active ingredients. These storage conditions help ensure that each dose of Zepbound retains its full therapeutic potential.

Dosage Information

The administration of Zepbound begins with a typical starting dose of 2.5 mg injected under the skin once a week. After 4 weeks or 1 month, your healthcare provider will raise the dose to 5 mg once a week. Depending on how you respond to the medication your healthcare provider may increase or decrease the dose. 

Side Effects

Common Side Effects

While Zepbound is an effective medication for weight management, it may cause some side effects, which are generally mild and manageable. These include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Stomach Pain
  • Indigestion 

Contact your doctor right away if these symptoms persist or worsen.

Serious Side Effects

In some cases, Zepbound can lead to more severe side effects, which require immediate medical attention. These include:

  • Pancreatitis: Severe pain in the upper stomach spreading to the back, accompanied by nausea and vomiting.
  • Gallbladder problems: Symptoms may include severe upper stomach pain, particularly after eating, and changes in stool color.
  • Hypoglycemia: Symptoms like headache, dizziness, weakness, and confusion, particularly in patients taking other diabetes medications.
  • Kidney problems: Indicated by reduced urine output, swelling in feet or ankles, and fatigue.
  • Allergic reactions: Signs include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

Patients experiencing these serious side effects should seek immediate medical care. It’s important for users of Zepbound to be aware of these potential risks and to communicate any unusual symptoms to their healthcare provider promptly.

Warnings and Precautions

Before Starting Zepbound

Before initiating treatment with Zepbound, it is important to have a comprehensive discussion with your healthcare provider. This conversation should encompass a thorough review of your medical history, current health status, and any medications or supplements you are currently taking. Here are some key points to consider:

  • Medical History Disclosure: It’s crucial to share your complete medical history with your healthcare provider. Special attention should be given to any history of pancreas or kidney problems, as Zepbound can affect these organs.
  • Severe Stomach Issues: If you have severe stomach problems, including gastroparesis (slow stomach emptying) or difficulty digesting food, discuss these with your doctor. Zepbound slows gastric emptying, which could exacerbate these conditions.
  • Diabetic Retinopathy: Patients with a history of diabetic retinopathy should exercise caution. Inform your healthcare provider as Zepbound may have implications for this condition.

Pregnancy and Breastfeeding

  • Pregnancy: Zepbound is not recommended during pregnancy. Weight loss during pregnancy can be harmful to the fetus. If you become pregnant while on Zepbound, discontinue use and contact your healthcare provider immediately.
  • Breastfeeding: The safety of Zepbound during breastfeeding is not established. Discuss with your healthcare provider if you are breastfeeding or plan to breastfeed. They may advise on alternative feeding methods for your baby during treatment.

Thyroid Cancer Risk

  • Boxed Warning: Zepbound carries a boxed warning about the potential risk of thyroid cancer. This is the most serious warning from the FDA. The active ingredient in Zepbound, tirzepatide, has been shown to cause thyroid tumors in animal studies.
  • Family History of Thyroid Cancer: If you or any family member has had medullary thyroid carcinoma (MTC) or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), Zepbound should not be used due to the increased risk of thyroid cancer.
  • Symptoms Monitoring: Be vigilant for symptoms of thyroid cancer, including a lump or swelling in the neck, hoarseness, difficulty swallowing, or shortness of breath. Report any such symptoms to your healthcare provider immediately.

Mental Health Considerations

  • Depression and Suicidal Thoughts: If you have a history of depression or suicidal thoughts, it’s important to discuss this with your healthcare provider. Monitor any changes in mood or behavior and report them promptly.

Allergic Reactions

  • Past Allergic Reactions: If you have had an allergic reaction to tirzepatide or any of the ingredients in Zepbound, avoid using this drug. Allergic reactions can be severe and require immediate medical attention.

Other Considerations

  • Kidney Function Monitoring: Regular monitoring of kidney function is recommended, as Zepbound can affect kidney health, particularly in patients with pre-existing kidney conditions.
  • Gastrointestinal Health: Zepbound may cause severe stomach problems. If you experience persistent or severe abdominal pain, nausea, or vomiting, contact your healthcare provider.
  • Low Blood Sugar Risk: If used with other diabetes medications like insulin or sulfonylureas, Zepbound can increase the risk of hypoglycemia. Monitor blood sugar levels closely and report any instances of unusually low blood sugar.

General Precautions

  • Regular Medical Reviews: Keep all scheduled appointments with your healthcare provider and undergo any recommended tests to monitor your body’s response to Zepbound.
  • Lifestyle Modifications: While taking Zepbound, continue to follow any dietary and exercise recommendations made by your healthcare provider to maximize the medication’s effectiveness and minimize side effects.

These warnings and precautions are essential for the safe and effective use of Zepbound. Patients should have an open and ongoing dialogue with their healthcare providers to ensure they are using Zepbound appropriately and to monitor for any potential adverse effects or complications.

Drug Interactions

Understanding Interactions with Zepbound

Zepbound, due to its mechanism of action, can potentially interact with a variety of medications, supplements, and herbal products. These interactions can affect how Zepbound or the other medications work and may increase the risk of side effects.

Key Points on Drug Interactions

  • Digestive System Impact: Zepbound slows down the digestive process, which can affect the absorption and effectiveness of other medications. This is particularly important for drugs that require rapid absorption or have a narrow therapeutic index.
  • Medication Review: Provide your healthcare provider with a comprehensive list of all medications you are currently taking. This includes prescription drugs, over-the-counter medications, herbal supplements, and vitamins.
  • Birth Control: Zepbound may reduce the effectiveness of birth control pills, potentially resulting in an unplanned pregnancy. Therefore, it is recommended to use an additional contraceptive method for four weeks after beginning Zepbound and for four weeks following each dose increase.
  • Dosage Adjustments: Based on your medication list, your healthcare provider may adjust the dosages of your current medications or suggest alternative treatments to minimize interaction risks.
  • Monitoring for Interactions: Regular monitoring may be necessary to check for any adverse interactions, especially when starting Zepbound or adding new medications to your regimen.
  • Consultation with Pharmacist: In addition to your healthcare provider, consulting with a pharmacist can provide additional insights into potential drug interactions and how to manage them.


Recognizing and Responding to Overdose

An overdose of Zepbound can lead to serious health complications. Recognizing the symptoms and responding promptly is crucial.

Symptoms of Overdose

  • Severe Nausea and Vomiting: Excessive nausea and vomiting can be a sign of an overdose, leading to dehydration and electrolyte imbalances.
  • Hypoglycemia: Symptoms of low blood sugar, such as dizziness, shaking, sweating, confusion, or loss of consciousness, can occur with an overdose, especially if used with other diabetes medications.
  • Other Symptoms: Look out for any other unusual symptoms or severe reactions that are not typical for you.

Immediate Steps in Case of Overdose

  • Seek Medical Attention: If you suspect an overdose, seek immediate medical attention. This is crucial, especially if severe symptoms are present.
  • Inform Healthcare Providers: Provide emergency responders and healthcare providers with information about the overdose, including when Zepbound was taken and how much.
  • Poison Control Consultation: Contact a poison control center for additional guidance on managing the overdose.
  • Follow-Up Care: After initial treatment for an overdose, follow-up care may be necessary to ensure no long-term effects have occurred.

Being aware of the potential for drug interactions and the signs of an overdose can help ensure the safe use of Zepbound. Always maintain open communication with your healthcare providers about all medications and supplements you are taking, and do not hesitate to seek medical attention if you suspect an overdose.

Alternative Medications

Exploring Options Beyond Zepbound

While Zepbound is an effective medication for weight loss, there are several other alternatives available in the market. Each of these medications has its unique mechanism of action and may be suitable for different individuals based on their health status, weight loss goals, and medical history.

Common Alternatives

  • Mounjaro: Similar to Zepbound, Mounjaro contains tirzepatide and is used primarily for type 2 diabetes management but also shows effectiveness in weight loss.
  • Semaglutide: Available under brand names like Ozempic and Wegovy, semaglutide is another GLP-1 receptor agonist used for both diabetes and weight loss.
  • Phentermine: A well-known appetite suppressant, phentermine is used for short-term weight loss in conjunction with diet and exercise.
  • Wegovy: Specifically approved for weight management, Wegovy is a higher dose of semaglutide and is used for chronic weight management.
  • Saxenda: Another GLP-1 receptor agonist, Saxenda is used for weight management in adults and has a different dosing regimen compared to Zepbound.

It’s important to consult with a healthcare provider to determine which medication is most suitable for your specific needs and weight loss goals.

Zepbound Cost & Discounts

Shop for Zepbound at Competitive Prices

The cost of prescription medications, including Zepbound, can vary significantly depending on factors like health insurance coverage. In many cases, U.S. health insurance plans do not cover certain medications, leading individuals to seek more budget-friendly options. The retail price to purchase Zepbound can be quite high, often posing a financial challenge for many looking to purchase it at their local pharmacy.

Zepbound Coupons

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Frequently Asked Questions

Zepbound is used for chronic weight management in adults with excess weight (overweight) who also have weight-related medical problems such as high blood pressure, high cholesterol, type 2 diabetes, and obstructive sleep apnea. Zepbound should be used with a low calorie diet and an exercise plan.

Zepbound is available in the form of a single-use injectable pen in the following six strengths:
  • 2.5 milligrams in 0.5 milliliters of liquid solution (2.5 mg/0.5 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.

The recommended starting dose of Zepbound is 2.5 mg injected subcutaneously once a week. Depending on the individual’s response and tolerability, the dose may be increased in increments to 5 mg, 10 mg, or 15 mg once weekly. It’s important to follow the dosing schedule prescribed by your healthcare provider and not to adjust the dose without medical consultation.

Zepbound promotes weight loss by mimicking the effects of two gut hormones, GLP-1 and GIP. These hormones, naturally released after eating, signal fullness and satisfaction. By acting like these hormones, Zepbound increases feelings of fullness and reduces hunger, leading to decreased calorie intake. This, combined with a healthy diet and exercise, contributes to weight loss.

The active ingredient in Zepbound is tirzepatide, a GIP and GLP-1 receptor agonist.

Zepbound is administered as a subcutaneous injection once a week. You can inject Zepbound at any time of day, with or without food. To maintain consistent medication levels in your body, aim to inject it at the same time on the same day each week.

The typical starting dose is 2.5 mg injected subcutaneously once weekly, which can be increased based on individual response and tolerability.

It’s important to consult with a healthcare provider before combining Zepbound with other weight loss medications due to potential interactions.

Zepbound should be used alongside a reduced-calorie diet. Specific dietary recommendations should be discussed with a healthcare provider.

Common side effects include nausea, diarrhea, vomiting, constipation, abdominal discomfort, and injection site reactions.

Serious side effects can include thyroid tumors, pancreatitis, gallbladder problems, low blood sugar, and severe allergic reactions. If you experience these or notice any changes please contact your healthcare provider. 

While Zepbound is not primarily a diabetes medication, its safety in people with diabetes should be discussed with a healthcare provider.

The amount of weight you can lose while you’re taking Zepbound depends on many things. Clinical trials showed an average weight loss of 18% after nearly 1.5 years (72 weeks) for those taking the highest recommended dose. It’s important to note that this is an average, and individual experiences may vary depending on factors like starting weight, diet, and exercise habits. For a more personalized estimate of how long it might take to see results with Zepbound, it’s crucial to consult with a healthcare provider. They can assess your individual situation and offer guidance on realistic expectations for your weight loss journey.

Zepbound is not recommended during pregnancy or breastfeeding due to potential risks. Contact your healthcare provider right away if you become pregnant while you’re taking Zepbound.

Zepbound is similar to Ozempic and Wegovy (both semaglutide) in that they’re GLP-1 receptor agonists that promote weight loss by influencing appetite. However, Zepbound works by mimicking two gut hormones (GLP-1 and GIP) compared to Ozempic/Wegovy’s single target (GLP-1). Both medications require a doctor’s prescription and work best with diet and exercise.

If you miss a dose of Zepbound, take the missed dose as soon as possible within 4 days (96 hours) after the missed dose. If more than 4 days have passed, skip the missed dose and take your next dose on the regularly scheduled day. Do not take 2 doses of Zepbound within 3 days (72 hours) of each other.

The cost of Zepbound can vary, and insurance coverage depends on individual plans. In the U.S., it can cost as much as $1,000 per month.

There may be patient assistance programs available. It’s best to check with the manufacturer or your healthcare provider for current programs.

Yes, Zepbound carries a potential risk of thyroid tumors, including cancer. This is why it’s not recommended for people with a personal or family history of such conditions. While less concerning, Zepbound may also cause temporary hormonal side effects like nausea, vomiting, and diarrhea, which typically subside as your body adjusts. It’s important to discuss any side effects with your doctor.

Keep unused Zepbound (tirzepatide) pens refrigerated and in their original container to shield the medication from light. Do not freeze the pens, as this can damage the medication. The pens can be stored at room temperature for up to 21 days, but they must be discarded after this period. Additionally, once the pens have been brought to room temperature, do not return them to the refrigerator.

Zepbound is FDA-approved for long-term weight management, but long-term safety data is still being collected. Studies haven’t shown new side effects beyond those seen in shorter use. Common side effects like nausea might persist but often lessen over time. The potential risk of thyroid tumors needs further investigation in long-term studies.

Sean Moshrefi, PharmD, MS

Sean Moshrefi, PharmD, MS, is a licensed pharmacist based in California. He holds a Doctor of Pharmacy degree from the University of California, San Francisco (UCSF) and a Master of Science in Regulatory Sciences from the University of Southern California (USC). With expertise in medical writing and medical communications, Sean adeptly provides written and verbal drug information to healthcare professionals and patients, contributing significantly to the healthcare landscape and empowering healthcare professionals and patients alike with actionable insights.