Everything you need to know about Zepbound dosage

For many medications, you don’t need to think too much about adjusting your dose — it’s the same whether you’ve never taken it before or you’ve taken it a dozen times. But the protocol is far less simple for GLP-1 weight-loss medications like Zepbound. Read on for all the details on the different doses — plus, what to do if you miss one, take too much, or need to change your medication schedule.

Typical Zepbound dosing schedule

There are six different doses of Zepbound, which is the brand name of the GLP-1 medicine tirzepatide approved for weight loss: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. “To start, you’ll take the smallest dose of 2.5 mg for four weeks and gradually scale up,” says Dr. Michelle Ponder, M.D., an endocrinologist and assistant professor of medicine at Duke University School of Medicine. Slowly increasing the amount helps your body adjust to the medication and reduces the risk of side effects, including stomach pain, diarrhea, and nausea. (Find a full list of side effects on Zepbound’s site.)

About once a month, your healthcare provider will check on your progress. If you’re tolerating the medication well and not losing weight drastically, you may be advised to move up to the next higher dose, as higher doses are associated with more weight loss. It’s not recommended to increase the dosage by more than 2.5 mg at one time.

If you’re having minimal side effects and losing weight at a good pace, you’ll likely remain on the same dosage. “The goal is one to two pounds a week,” says Ponder. Dropping pounds too quickly can put you at risk for muscle or bone loss, she adds.

Potential Zepbound dosage chart

Here’s an example of a Zepbound dosing schedule for someone who tolerates the medication and is able to reach the maximum amount. That said, your specific dosing may look different. “Many people on Zepbound don’t need to take the highest dose,” says Dr. Rachel Pessah-Pollack, M.D., an endocrinologist and clinical professor of medicine at NYU Grossman School of Medicine. You may also go more slowly, staying on a certain dose for months before changing to a higher dose.

What strengths does Zepbound come in?

Zepbound is available in two forms: a pen and vial. The pen is available in all six strengths: 2.5 mg, 5 mg, 7.5 mg. 10 mg, 12.5 mg, and 15 mg. No matter the dose amount, each single-use disposable pen contains 0.5 mL of solution including sodium, water, and a stabilizer.

Zepbound is offered in vial form as well, which was introduced as a more affordable option (the pens are expensive to manufacture). According to Eli Lilly and Company, Zepbound vials cost at least 50 percent less than GLP-1 medications in pre-filled pens. Currently, there are two strengths available as vials: 2.5 mg and 5 mg.

How many doses are in a Zepbound pen?

Each Zepbound single-use pen is prefilled with one dose of medicine, says Pessah-Pollack. It has a built-in needle to inject it beneath the skin. After using the pen, make sure you dispose of it in a FDA-cleared sharps disposal container or a labeled heavy-duty plastic container with a lid.

How many doses are in a Zepbound vial?

Each Zepbound vial contains one dose of medicine. You’ll fill a syringe with 0.5 mL of the solution and inject it below the skin. After using the vial and needle once, you’ll dispose of them in a FDA-cleared sharps disposal container or a labeled heavy-duty plastic container with a lid.

Forms of Zepbound (tirzepatide)

Zepbound is a clear liquid medicine that’s available either in prefilled, injectable pens or single-use vials. The active drug in Zepbound is called tirzepatide. Because Zepbound is a new medication, it’s under patent and there are no generic versions. Tirzepatide is also the active medication in Mounjaro, which is FDA approved as a treatment for type 2 diabetes.

Until recently, there was a tirzepatide shortage because of the high demand. During shortages, the FDA allows compounding pharmacies to make versions of the drug under certain circumstances. Talk to your healthcare provider to find out if tirzepatide is still in shortage and if a compounded version may be right for you.

How to use Zepbound

After you pick up your Zepbound prescription, keep it in its original box and store it in the refrigerator. To take Zepbound, you’ll inject the medicine on the same day once a week. First, examine your Zepbound pen or vial to make sure it’s not expired and the solution is clear. Then choose the area you want to inject: You can do it in your thigh or abdomen area, or have someone else inject it in the back of your upper arm. You can use the same area of your body each week, but pick a different injection site each time to avoid injection site reactions like rashes, swelling, redness, or pain.

If you’re using a pen, wash your hands, remove the plastic cover, and place the pen on your skin at the injection site. Unlock and press the injection button for up to 10 seconds. Listen for two clicks: The first click means that the injection has started, and the second signals that it’s finished.

If you have a vial, wash your hands and wipe down the rubber stopper with an alcohol swab. Press the syringe into the vial and draw 0.5 mL of solution. Inject the medicine into your skin, leaving the needle in for at least five seconds. If you’re prescribed a vial, talk to your healthcare team about the correct way to give yourself Zepbound.

What happens if you miss a dose of Zepbound?

If you miss a dose and it’s within four days (96 hours) of the time you were supposed to take it, give yourself the dose as soon as possible and then go back to your normally scheduled injections. If it’s been more than four days, skip that dose and take your next dose when you normally would. You don’t want to take two doses of Zepbound within three days (72 hours) of each other, since that can lead to side effects like nausea, vomiting, and stomach pain.

What to do if you overdose on Zepbound

If you give yourself two or more doses of Zepbound within 72 hours, call your healthcare provider right away if you experience serious side effects, such as severe nausea, vomiting, low blood sugar, or abdominal pain. You may need to go to urgent care or the emergency room for treatment.

Can you change your Zepbound dose date?

You can easily switch your dose date as long as there are three days (72 hours) between your doses. So if you want to switch from taking Zepbound on Mondays to taking it on Friday, take it as usual on Monday and then take your next dose four days later. Going forward, you can continue taking your weekly doses on Friday.

The bottom line

If you take Zepbound for weight loss, you’ll start with the lowest dose, 2.5 mg, for four weeks. From then on, your healthcare provider will instruct you on if you need to go up in dose or stay on your current one. You may stay on your current dose if you’re losing one to two pounds a week and have minimal side effects. People’s bodies react differently, so you’ll work with your team to find the right dosage schedule for you.