Key takeaways
- Zepbound (tirzepatide) is an injectable medication used for weight loss and managing obstructive sleep apnea (OSA) in adults with obesity. It’s a dual GIP and GLP-1 receptor agonist.
- Your doctor will start you on 2.5 milligrams (mg) injected once weekly for 4 weeks, then increase your dosage every 4 weeks until you reach a maintenance dose of 5 mg, 10 mg, or 15 mg.
- Zepbound is injected under your skin once per week on the same day each week, at any time of day, with or without food. If you miss a dose and it’s been more than 4 days (96 hours), skip it and take your next dose at the usual time.
Overview
Zepbound is an injectable medication that’s used to help with weight loss and long-term weight management. It can also treat obstructive sleep apnea (OSA) in adults with obesity. It’s what’s known as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.
Like other GLP-1s, you’ll usually start Zepbound at a very low dosage that’s increased, or “titrated”, at regular intervals until you’re at a maintenance dosage. Let’s take a look at how Zepbound’s dosage is determined.
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Boxed warning: Risk of thyroid cancer
Zepbound has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
In animal studies, the active ingredient in Zepbound (tirzepatide) was found to cause thyroid tumors. However, animal studies don’t always predict what will happen in humans, so it’s still unknown whether Zepbound can cause thyroid cancer in humans.
Due to the possible risk, your doctor will likely not prescribe Zepbound if:
• you or someone in your family has ever had a type of thyroid cancer called medullary thyroid cancer
• you have a condition called multiple endocrine neoplasia type 2
What are the dosages of Zepbound?
Your doctor will generally start by prescribing a low dose of Zepbound and adjust it over time, typically every 4 weeks, to reach the right amount for you in a process known as titration.
Starting with a low dose allows your body to get used to the medication and reduces the risk of gastrointestinal side effects from Zepbound. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following table shows the basics of Zepbound’s dosing schedule. All strengths are listed in milligrams (mg) per 0.5 milliliter (mL) of solution.
| Zepbound’s form | Zepbound’s strengths | Starting dosage | Typical maintenance dosage | Maximum dosage |
|---|---|---|---|---|
| liquid solution inside prefilled single-dose injection pens, single-dose vials, single-use KwikPens, or multidose vials | • 2.5 mg • 5 mg • 7.5 mg • 10 mg • 12.5 mg • 15 mg | 2.5 mg injected once weekly for 4 weeks | 5 mg, 10 mg, or 15 mg injected once weekly | 15 mg injected once weekly |
How to use Zepbound
Zepbound comes as a liquid solution inside prefilled, single-dose injection pens, single-dose vials, and single-use KwikPens. It also comes in multidose vials.
All forms are used to administer the drug as a subcutaneous injection, which is an injection under your skin. Your doctor or another healthcare professional will show you how to give yourself these injections at home.
You’ll inject Zepbound once per week, on the same day each week. You can inject your dose at any time of day, with or without food.
You can inject Zepbound in your thigh, belly, or the back of your upper arm, but if you want to inject into your upper arm, someone else will need to administer the injections. To avoid irritating your skin, inject your doses in a different spot each week.
For more detailed instructions on how to use Zepbound, see the printed medication guide that comes with your medication. The manufacturer’s website also has more instructions, including a video on how to inject Zepbound.
For information on the expiration, storage, and disposal of Zepbound, talk with your doctor or pharmacist.
Medical perspective
What are some tips for success when giving yourself a GLP-1 injection?
“When giving yourself a subcutaneous injection, rotate the injection site each time by using different areas such as the abdomen, thigh, or upper arm. Let the medication reach room temperature before injecting to help reduce discomfort.”
What to do if you miss a dose
If you miss a dose of Zepbound, inject it as soon as you remember. But if it’s been more than 4 days (96 hours) since you were supposed to inject it, skip the missed dose. Then, inject your next dose at its usual time.
You should not inject two doses at once to make up for a missed dose. And do not inject two doses within 3 days (72 hours) of each other, as this can increase your risk of side effects.
If you’re not sure whether you should take a missed dose, talk with your doctor or pharmacist.
Pro tip: If you need help remembering to inject your dose, consider using a medication reminder such as a reminder app downloaded to your phone.
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Get free cardWhat to do if you take too much Zepbound
Never inject more Zepbound than your doctor prescribes, as this can lead to harmful effects.
Call your doctor right away if you think you’ve injected too much Zepbound. You can also call 800-222-1222 to reach Poison Help or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) or go to the nearest emergency room immediately.
Frequently asked questions
Here are answers to some commonly asked questions about Zepbound’s dosage.
Is Zepbound used long term?
Yes, Zepbound is usually a long-term treatment. If you and your doctor determine that it’s safe and effective for you, you’ll likely use it long term.
How long does Zepbound take to work?
Zepbound starts working in your body after your first dose, but it may be a few weeks before you start losing weight. Your calorie intake and exercise routine will also affect weight loss.
Your doctor will monitor you during treatment to check whether your weight management plan is working. Talk with them if you have other questions about what to expect from your Zepbound treatment.
Learn more about what to expect in the first month of treatment.
Do I need to increase my dosage?
Typically, the starting dosage of Zepbound isn’t strong enough to have a large effect on your body. This is to allow your body to get used to the medication. Your doctor will aim to increase your dosage every 4 weeks.
However, if you’re still experiencing severe side effects after 4 weeks, they may not increase your dosage until these side effects reduce. There’s no rush to take the maximum dosage of the medication, and you don’t need to increase your dose until you feel ready.
Online care for Zepbound
If a doctor has prescribed a GLP-1, it’s important to take the medication as directed for as long as your doctor recommends. However, some people might face barriers to accessing these drugs, including high costs and access to healthcare appointments.
Online care may make getting treatment easier. With Optum Perks Online Care, for example, you can get a refill of a weight loss prescription or get help with an existing prescription.
With this service, you can submit an online form answering a few questions about your condition, and a licensed healthcare professional will respond soon after — without the need to make an in-person appointment.
Summary
The Zepbound dosage you’ll take will be determined by your doctor. They’ll typically start you on the lowest possible dose, then increase it every 4 weeks until you reach a maintenance dose.
If you have any questions about your dosage, speak with your doctor for more advice.
Learn more about how GLP-1s work.
Disclaimer: While Optum Perks strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses.