Zepbound (Tirzepatide): Uses, Side Effects, Cost
Zepbound is a weekly injection of tirzepatide made by Eli Lilly, first FDA approved in 2023, for weight loss and sleep apnea. List price is $499 to $1,086 per fill; self-pay starts at $299 per month. In the SURMOUNT-1 trial, people lost 20.9% of body weight on average.
- Active ingredient
- tirzepatide
- Manufacturer
- Eli Lilly
- How it is taken
- weekly injection
- First FDA approval
- 2023
- List price
- $499 to $1,086 per fill
- Self-pay from
- $299 per month
- Average weight loss in trials
- 20.9%
- Most common side effect
- Nausea 29% vs 8% on placebo
- FDA shortage
- Resolved December 19, 2024
Zepbound at a glance
Its half-life is 5 to 6 days. After 5.5 d, half is gone; after five half-lives (27.5 d), about 3% remains.
In SURMOUNT-1 over 72 weeks, 20.9% of body weight was lost, against 3.1% on placebo.
Prices each month in US dollars include the list price and self-pay offers. Each amount comes from the maker's price listing.
Sources: FDA label (DailyMed), Eli Lilly 1 2, cnbc.com.
Zepbound uses and forms
The FDA label includes Zepbound uses, forms, and warning details. Your dose is determined by the label and your prescriber.
| What the label says | |
|---|---|
| Approved use | For adults with obesity, or overweight adults with a weight-related condition, it supports long-term weight loss and weight maintenance when used with diet and activity. |
| Approved use | Moderate to severe obstructive sleep apnea is treated in adults with obesity. |
| Forms | Options: single-dose pen, multi-dose vial, KwikPen (4 doses), or single-dose vial |
| Strengths on the label | 2.5 mg, 5 mg, and 7.5 mg, plus 10 mg, 12.5 mg, and 15 mg |
| Boxed warning | The boxed warning notes thyroid C-cell tumors in rodents caused by it, and whether it causes the same in people is not known. You should not use it if you have MEN 2 or a personal or family history of medullary thyroid cancer (MTC). |
| Storage | At up to 86°F, a single-dose pen or vial may remain unrefrigerated for up to 21 days. Do not freeze. |
Sources: FDA label (DailyMed).
What the Zepbound trials showed
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 5 mg weekly | 15% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 10 mg weekly | 19.5% | 3.1% |
| SURMOUNT-1 | Adults with obesity or overweight, without diabetes | 72 weeks | Tirzepatide 15 mg weekly | 20.9% | 3.1% |
| SURMOUNT-2 | Adults with obesity or overweight who also have type 2 diabetes | 72 weeks | Tirzepatide 10 mg weekly | 12.8% | 3.2% |
| SURMOUNT-2 | Adults with obesity or overweight who also have type 2 diabetes | 72 weeks | Tirzepatide 15 mg weekly | 14.7% | 3.2% |
| SURMOUNT-5 | Adults with obesity, without type 2 diabetes | 72 weeks | Tirzepatide 10 or 15 mg weekly (Zepbound) | 20.2% | Not listed |
| SURMOUNT-5 | Adults with obesity, without type 2 diabetes | 72 weeks | Semaglutide 1.7 or 2.4 mg weekly (Wegovy) | 13.7% | Not listed |
Sources: FDA label (DailyMed), PubMed 1 2 3 4.
Zepbound side effects
How often each side effect showed up in the label's trials, versus placebo (a dummy treatment). Members of the weight management study group were adults with obesity or overweight.
| Side effect | Zepbound 5 mg | Zepbound 10 mg | Zepbound 15 mg | Placebo |
|---|---|---|---|---|
| Nausea | 25% | 29% | 28% | 8% |
| Diarrhea | 19% | 21% | 23% | 8% |
| Constipation | 17% | 14% | 11% | 5% |
| Vomiting | 8% | 11% | 13% | 2% |
| Abdominal Pain | 9% | 9% | 10% | 5% |
| Dyspepsia | 9% | 9% | 10% | 4% |
Sources: FDA label (DailyMed).
Among the label warnings are Hypoglycemia, Acute Pancreatitis, Risk of Thyroid C-Cell Tumors, Acute Kidney Injury from Volume Depletion, Severe Gastrointestinal Adverse Reactions, Hypersensitivity Reactions, Acute Gallbladder Disease, and, in Patients with Type 2 Diabetes Mellitus, Diabetic Retinopathy Complications.
Warnings from the label: FDA label on DailyMed.
Zepbound interactions
| Taken with | What the label says |
|---|---|
| Insulin or sulfonylureas | Taking it alongside insulin or a sulfonylurea, including glipizide or glimepiride, raises the chance of low blood sugar. Your doctor may then reduce the doses of these medicines. |
| Oral medicines | It slows stomach emptying, which may change how other pills are absorbed. |
| Birth control pills | Birth control pills may not work as well for a time when you take it. After you start and each time the dose goes up, choose a method that is not oral, or add a barrier method. |
| Warfarin and narrow-range drugs | Drugs such as warfarin, for which small changes in drug levels matter, need closer monitoring. |
Sources: FDA label (DailyMed).
Check a GLP-1 interaction
Zepbound cost and coverage
| How you pay | Price |
|---|---|
| List price before insurance | $499 to $1,086 per fill |
| Zepbound Savings Program (insured) | from $25 for up to a 3-month fill |
| Commercial plan that does not cover it | $299 per month |
| Self-pay: LillyDirect vial or KwikPen 2.5 mg | $299 per month |
| Self-pay: LillyDirect vial or KwikPen 5 mg | $399 per month |
| Self-pay: LillyDirect for 7.5 mg to 15 mg (refill within 45 days) | $449 per month |
| Self-pay: Standard price if you do not refill within 45 days | $499 a month ($7.5 mg) or $699 a month ($10 to $15 mg) |
| Self-pay via TrumpRx | $299 per month |
| Medicare GLP-1 Bridge (Zepbound KwikPen, eligible Part D) | $50 per month |
Prices checked in November 2026: pricinginfo.lilly.com, zepbound.lilly.com, Eli Lilly, TrumpRx, CMS.
Alternatives to Zepbound
| Medicine | Ingredient | How it is taken | Shared use | Trial weight loss | Self-pay from |
|---|---|---|---|---|---|
 Wegovy | semaglutide | weekly injection or daily tablet | weight loss | 14.9% | $149 per month |
 Foundayo | orforglipron | daily tablet | weight loss | 11.1% | $149 per month |
 Saxenda | liraglutide | daily injection | weight loss | 7.4% | Not listed |
The Zepbound label and studies
See the complete Zepbound DailyMed prescribing information.
Every Zepbound page
Side effects and safety
Interactions
Who it is for
How it compares with other drugs
Cost, savings and coverage
Getting a prescription
Living with it
- Stopping Zepbound
- Zepbound and Creatine
- Zepbound and Exercise
- Zepbound and Intermittent Fasting
- Zepbound and Keto
- Zepbound and Vitamins
- Zepbound Diet
- Zepbound Foods to Avoid (and Why They Trigger Nausea and Reflux)
- Zepbound Meal Plan
- Zepbound Not Working? The Checklist, in Order
- Zepbound Plateau
- Zepbound Protein Calculator
- Zepbound Reddit
- Zepbound Results
- Zepbound Reviews
- Zepbound Timeline