How to navigate the Zepbound shortage

The GLP-1 weight-loss medication Zepbound makes headlines for two things: Its ability to help people lose a significant amount of weight and the fact that it’s almost always in short supply. Approved by the FDA in late 2023, Zepbound has been on the FDA’s list of drug shortages ever since, meaning there’s not always enough of the drug to fill all of the prescriptions.

This short supply can be frustrating if you’re taking Zepbound for weight loss. To help you sort through the confusion, experts spell out the reasons behind the national Zepbound shortage and what you should do if your pharmacy is out of stock.

Is there a shortage of Zepbound?

The FDA reports that there’s currently a shortage of tirzepatide, the active ingredient in Zepbound. This is true even though Eli Lilly, the manufacturer of Zepbound, reports that all doses of the medication should now be available (Zepbound is available in four doses: 2.5mg, 5mg, 10mg, and 15mg). A note: While this is true at the time of publication, things can change—visit the FDA tracker for the latest shortage information.

But this scenario can change monthly: While shortages of GLP-1 medications, such as Zepbound, are ongoing, the exact drugs and doses that are out of stock fluctuate, says Dr. Michelle Ponder, M.D., an endocrinologist and assistant professor of medicine at Duke University School of Medicine. It depends on when shipments of the drug are released.

Why is there a shortage of Zepbound?

Put simply, there’s not enough supply to meet the high demand, says Dr. Deborah Horn, D.O., medical director at the University of Texas Center of Obesity Medicine and Metabolic Performance, and a clinical associate professor of surgery at the University of Texas Medical School at Houston. Since its FDA approval in 2023, Zepbound has grown and grown in popularity, with an estimated 130,000 new prescriptions being written each week.

That’s largely because of the growing research showing GLP-1 medications, such as Zepbound, really work for weight loss. Zepbound can help adults with overweight or obesity lose an average of 21 percent of their body weight in a little over a year. What’s more, trials are revealing that GLP-1 agonists have health benefits beyond weight loss, says Horn. “There are advantages not just for obesity, but also sleep apnea, osteoarthritis, and cardiovascular risk reduction,” she says. As more people and healthcare providers understand the benefits of these GLP-1s, more people are asking for them. 

As a result, the manufacturer of Zepbound, Eli Lilly, can’t make enough Zepbound to keep up. That’s partly due to the fact that Zepbound is administered via an injection from a single-use pen. The process to create these drugs and pens takes longer and requires more effort than manufacturing something more simple, like tablets, says Ponder. “It limits the ability to make these medications quickly.”

Consequences of the Zepbound shortage

The biggest impact of the national Zepbound shortage is that you may not be able to fill your prescription at the pharmacy. This can impact your weight-loss progress. “If you miss doses, it’s likely that the effects of the medication, such as appetite suppression, will wear off and you may regain weight,” says Dr. Michael Knight, M.D., a clinical professor of medicine at The George Washington University School of Medicine and Health Sciences in Washington, D.C. But this doesn’t happen immediately, he adds. “It usually occurs over many weeks or months.”

If you miss more than three weeks of Zepbound, you’ll likely need to adjust the dose you take when you start up again, Knight adds. To help your body adjust to the medicine, your provider will start with a smaller 2.5mg dose and gradually increase it. After three weeks without the medication, you need to restart the gradual increase in dosage so that you don’t experience side effects, such as stomach pain, vomiting, and nausea. (Find a full list of side effects here.) Your provider will be able to guide you, so talk to them if you missed any doses because of the national Zepbound shortage.

What to do if Zepbound is out of stock

Ask the pharmacist if they’re expecting any Zepbound shipments or if they know of any other pharmacy where your dose is in stock. “Each pharmacy chain has their own supply of these medications, so it is important to check with all available pharmacies, including mail-order pharmacies,” says Knight. Zepbound can be prescribed as an online weight-loss medication, where a pharmacy fills and mails the prescription to your doorstep. 

You may need to spend some time calling around to different pharmacies in your area. “Smaller pharmacies with fewer customers often have more availability,” says Knight. If you’re a member of WeightWatchers Clinic, your Care Team will be able to help, calling up to 10 pharmacies a week in your area to check if they have Zepbound. 

If you can’t find your Zepbound dose in stock, talk to your healthcare provider. Your doctor may recommend temporarily going on another dose that’s available, such as 5mg if you usually take 10mg. Or you may need to switch to another medication altogether, although that’s usually a last resort.

Zepbound alternatives

If there’s a backorder of your Zepbound dose, your doctor may suggest changing to another medication. Other GLP-1s approved by the FDA for weight loss – Wegovy and Saxenda – are options to discuss with your provider. Don’t try to switch between the medications on your own, warns Knight. Although they are all GLP-1 agonists, each one has its own set of doses and side effects.

People’s bodies also respond differently to medications, adds Horn. For example, you may feel great while taking Zepbound, but experience side effects with one of the other GLP-1s. Also keep in mind Wegovy and Saxenda may be experiencing their own shortages, so you’re not guaranteed a steady supply of medication by switching to another GLP-1 agonist.

You may also talk to your provider about other prescription weight-loss medications. They may not be as effective as GLP-1 agonists, says Knight, but they’re available as pills, and usually readily available. These include:

• Adipex-P (phentermine): One study showed that 80 percent of people with obesity taking phentermine lost 5 percent of their body weight. Keep in mind that it’s only approved for use up to 12 weeks, because there’s some concern about its long-term risks, including hypertension and valvular heart disease. 
  
  
• Qsymia (phentermine/topiramate): Qsymia helps you lose weight by targeting a neurotransmitter in the brain that suppresses appetite.
  
  
• Contrave (naltrexone/bupropion): Contrave contains buproprion, the active ingredient in certain antidepressants, which may reduce the brain’s reward centers, lowering appetite and food cravings.
  
  
• Xenical (orlistat): This medicine prevents your body from absorbing some of the fat in food. This can lead to weight loss, but may also cause unpleasant side effects, such as diarrhea.

The bottom line

Because of the Zepbound shortage, you may have a hard time finding Zepbound at your local pharmacy. If it’s out of stock, you may need to call around to other pharmacy locations. At WeightWatchers Clinic, your Care Team will call up to 10 pharmacies at a time to track supply on your behalf. Still can’t find your Zepbound dose? Talk to your healthcare provider about your options. You may need to take a different dose or medicine altogether until Zepbound is back in stock.