This guide will explore Zepbound, a weight loss and management medication. We will cover its active ingredient, dosage, applications, and potential side effects. Understanding the possible side effects and proper usage of Zepbound is crucial for successful treatment.

Key Facts

  • Zepbound helps with weight loss and is given as a weekly shot under the skin.

  • It uses tirzepatide to work and is meant for adults with weight issues and related health problems.
  • Zepbound is not a generic drug, needs a prescription, and was approved by the FDA in 2023.
  • Side effects range from mild to rare and severe, including things like stomach issues and potential thyroid cancer risks.
  • Before starting Zepbound, talk to your doctor about other medicines, alcohol, and birth control pills.

  • Your doctor will decide how much Zepbound you need, and they may change it over time.

  • Costs and savings programs for Zepbound can vary, so ask your doctor or pharmacist for advice.

  • Be careful about possible side effects, and contact your doctor if you have any concerns or unusual reactions.

Zepbound Unboxed

Zepbound is a brand-name subcutaneous injection medication designed for weight loss and long-term weight management. It contains the active ingredient tirzepatide and is FDA-approved for specific adult populations when used alongside exercise and a calorie-controlled diet.

Key Details about Zepbound

  • Drug Class: Zepbound belongs to the dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist class.
  • Form: It is a liquid solution for subcutaneous injection using prefilled pens.
  • Generic Availability: Zepbound does not have a generic version.
  • Prescription Requirement: A prescription is necessary to obtain Zepbound.
  • Controlled Substance: Zepbound is not classified as a controlled substance.
  • FDA Approval: Zepbound received FDA approval in 2023.

Understanding Zepbound Usage

Zepbound, containing tirzepatide, is a prescription drug to help adults lose weight and manage weight in the long term. It is administered through subcutaneous injection once weekly using prefilled pens; Zepbound reduces appetite and slows digestion, leading to fullness after meals and reduced calorie intake.

Zepbound is typically prescribed for adults with a body mass index (BMI) of 30 or higher (indicating obesity) or a BMI of 27 or higher (indicating overweight) with any weight-related health condition. It is recommended alongside a calorie-controlled diet and increased physical activity.

However, Zepbound may not be suitable if you are taking;

  • other medications with tirzepatide
  • similar glucagon-like peptide-1 medications
  • other weight loss drugs
  • history of pancreatitis.

Consult your healthcare provider for personalized advice on Zepbound use.

What are Zepbound's Side Effects?

Here's a list of some of the common and mild side effects of Zepbound. For more information about other common and mild side effects, it is best to talk with your doctor or pharmacist or refer to Zepbound's prescribing information .

Mild side effects of Zepbound may include:

  1. Injection site reactions: You might notice some redness, swelling, tenderness, or itchiness where you got the injection. It is usually not a big deal, and it goes away.
  2. Fatigue: Some people feel a bit more tired than usual, especially at the beginning of treatment. It often gets better with time.
  3. Nausea or vomiting: Occasional nausea and vomiting episodes may occur, especially at the start of treatment.
  4. Diarrhea or constipation: Changes in bowel movements, such as diarrhea or constipation, may occur but usually improve over time.
  5. Indigestion or gastroesophageal reflux disease (GERD): Mild indigestion, heartburn, or acid reflux may manifest occasionally.
  6. Abdominal pain: Common stomach pain, discomfort, or bloating may happen, especially after meals.
  7. Burping: You might find yourself burping more than usual, which is usually harmless.
  8. Hair loss: While rare, some people notice changes in their hair, like it getting thinner or feeling different.
  9. Low blood pressure: A slight decrease in blood pressure leading to occasional dizziness or lightheadedness. 
  10. Mildly increased heart rate: A transient increase in heart rate may occur, which is usually not a cause for concern
  11. Mild allergic reaction: In rare cases, you might have a mild reaction like a skin rash, itching, or minor swelling.

Most side effects mentioned above usually subside within a few days to a few weeks. However, if they persist, worsen, or don't improve, you should seek advice from your doctor or pharmacist.

Rare and Severe Side Effects

Severe side effects of Zepbound are not common, yet they may occur. It is essential to contact your doctor immediately. Call 911 or your local emergency number immediately for life-threatening symptoms or in case of any medical emergency.

Digestive System Complications:

  • Acute(sudden) gallbladder disease: Sudden onset of gallbladder problems like gallstones. Symptoms may include:
    • fever
    • abdominal pain
    • nausea and vomiting
  • Acute pancreatitis: Symptoms may include:
    • severe back or abdominal pain
    • fever
    • nausea and vomiting
    • elevated pancreatic enzymes
  • Severe digestive problems like severe nausea, vomiting, or diarrhea. This may cause dehydration and acute kidney injury. Symptoms may include:
    • urinating a lesser amount than is typical
    • fatigue
    • swelling of the legs or ankles

Metabolic and Endocrine Effects:

  • Low blood sugar (hypoglycemia): Particularly when combined with certain diabetes medications, Zepbound can cause low blood sugar symptoms like:
    • dizziness
    • shaking
    • sweating
  • Risk of thyroid cancer: Long-term use may slightly increase the chances of thyroid tumors, especially if you've had thyroid problems before.

Psychiatric and Behavioural Changes:

  • Suicidal thoughts or behaviors: Although rare, some individuals may experience symptoms like:
    • mood changes
    • depression
    • anxiety or panic attacks
    • agitation and restlessness
    • suicidal thoughts.

Allergic Reaction

Just like most medications, some people can have an allergic reaction to Zepbound. A common side effect observed during clinical trials was a mild allergic reaction at the injection site. Although severe allergic reactions were not reported during these trials, they have been rare since the drug was approved.

Symptoms of a mild allergic reaction may include:

  • Skin rash: widespread rash or hives on the skin
  • Itchiness: a severe itching sensation, especially on the skin or in the mouth.
  • Flushing

Although it is not common, a severe allergic reaction is possible. Signs of a severe allergic reaction may include:

  • Swelling: significant swelling of the face, tongue, throat, or extremities.
  • Difficulty breathing: breathing difficulties or wheezing due to airway constriction.

If you ever notice any of these side effects or suspect an allergic reaction, don't wait. Reach out to your doctor or seek medical help right away. They can guide you on what steps to take and ensure your safety throughout your treatment journey with Zepbound.

Precautions and Risk Management

It is vital to take precautions and manage risks when considering starting Zepbound. Talking to a healthcare professional before you begin is critical. They will check your personal or family history, medical history, current medications, and potential risks to ensure Zepbound is the right choice.

Watch for unusual reactions or side effects as you go through your treatment. Catching and dealing with them early is the best way to stay safe and healthy. It is also essential to know how to recognize and handle severe reactions if they happen.

For those with diabetes or a risk of hypoglycemia(low blood sugar), it's crucial to monitor your blood sugar levels regularly. Zepbound can sometimes lower blood sugar, especially when combined with certain diabetes medications. Knowing the signs of low blood sugar and what to do about it is essential for your well-being while on Zepbound treatment.

Strategies for Minimizing Side Effects

When it comes to managing medication side effects like those of Zepbound, making lifestyle adjustments can play a significant role in ensuring a smoother treatment journey and reducing the likelihood of experiencing adverse reactions. Here are essential lifestyle adjustments and strategies for minimizing Zepbound's side effects:

Lifestyle Adjustments

Consider these lifestyle tweaks to reduce side effects:

  • Skip alcohol while on Zepbound.
  • Always check with your doctor before adding new medications.
  • Talk to your healthcare professional about any changes in your exercise routine or diet that might affect your Zepbound treatment.
  • Keep a healthy, balanced diet, and drink plenty of water.

Emergency Preparedness

Stay prepared for unexpected situations by:

  • Wearing medical ID jewelry that notes your diabetes.
  • Carry a wallet card with essential health and medication information.

Immediate Action

Do not hesitate to reach out to your doctor if you notice any side effects coming up. They can guide you on how to manage them effectively.

What to Consider Before Starting Zepbound

If you are reading this, consider starting Zepbound to lose excess weight. Before you commence this medication, it is crucial to understand a few key things that can affect your treatment journey. From drug interactions to pregnancy implications, here's what you should consider before starting Zepbound treatment.

Interactions: How Zepbound Works with Other Substances

Drug interactions are about how they interact with your body and other medications and substances you may be taking. These interactions can influence the effectiveness and safety of your treatment. That's why it's vital to keep your healthcare professional informed about all your supplements, prescription drugs, and over-the-counter drugs.

Drug Interactions: Which Drugs Can Zepbound Interact With?

Zepbound can interact with various medications, potentially altering their effects or causing adverse reactions. Here are some drugs that may have interactions with Zepbound:

  1. Insulin and Other Diabetes Medications: Zepbound can affect blood sugar levels, so it's crucial to monitor closely if you're using insulin or other diabetes medications.
  2. Blood Thinners (Anticoagulants): Combining Zepbound (tirzepatide) with blood thinners like warfarin can increase the risk of blessing. Regular monitoring and dosage adjustments may be necessary.
  3. Medications for High Blood Pressure: Zepbound can lower blood pressure, so combining it with antihypertensive drugs may lead to excessively low blood pressure levels.
  4. Lipid-Lowering Medications (Statins): Zepbound may affect cholesterol levels, so discuss with your doctor if you're taking statins or other lipid-lowering medications.

Other drug interactions include:

  1. Certain Antibiotics: Zepbound may interact with antibiotics such as clarithromycin, erythromycin, and azithromycin, potentially affecting Zepbound's effectiveness or increasing the risk of side effects.
  2. Antifungal Medications: Some antifungal drugs like fluconazole and ketoconazole can also interact with Zepbound, altering its metabolism and leading to changes in drug levels in the body.
  3. Proton Pump Inhibitors (PPIs): Zepbound's effectiveness may be reduced, or its side effects may increase when taken with PPIs like omeprazole, esomeprazole, and pantoprazole.
  4. Certain Antidepressants: Zepbound's interactions with antidepressants such as fluoxetine, paroxetine, and sertraline can lead to changes in drug levels and effects, requiring careful monitoring and possible dosage adjustments.
  5. Corticosteroids: Using corticosteroids like prednisone or dexamethasone alongside Zepbound may increase the risk of high blood sugar (hyperglycemia) or worsen diabetes control in susceptible individuals.
  6. Herbal Supplements: Certain herbal supplements affecting blood sugar levels or liver function may interact with Zepbound and should be used cautiously or avoided.

It is essential to provide your health care professional with a comprehensive list of all medications, supplements, and herbal products you are taking to minimize the risk of interactions and serious allergic reactions and ensure safe treatment. Your healthcare provider can then make informed decisions about your treatment plan and adjust dosages and medications as needed.

Birth Control

When you take Zepbound along with birth control pills like Estarylla, Sprintec, Nextellis, and others that contain ethinyl estradiol/norgestimate or drospirenone/estetrol, it could make your birth control pills less effective. This is especially true during the first four weeks of starting Zepbound and four weeks after increasing your Zepbound dose.

To manage this, your doctor or pharmacist might suggest using extra protection like condoms during this time. They might also recommend switching to other types of birth control like the vaginal ring, patch, or condoms to make sure you're still protected while taking Zepbound.

Always follow your doctor's advice carefully and talk to them if you have any questions or worries about how Zepbound might affect your birth control.

Alcohol Interactions: Can You Drink Alcohol While Taking Zepbound?

Alcohol consumption while on Zepbound can have adverse effects on your health. It can increase the risk of low blood sugar (hypoglycemia) and may also exacerbate the medication's side effects. It is generally recommended to avoid alcohol or limit its intake significantly while undergoing Zepbound treatment to ensure optimal results and minimize potential risks.

Pregnancy and Breastfeeding Implications: What You Need to Know

If you're pregnant or planning to become pregnant, discussing Zepbound's implications with your healthcare professional is essential. While there is limited data on Zepbound's safety during pregnancy, it's generally not recommended unless the benefits outweigh the risks. Additionally, if you're breastfeeding, consult your doctor, as it's unclear whether Zepbound passes into breast milk.

Boxed Warning: Understanding Potential Risks

Zepbound carries a boxed warning, the most serious warning issued by the Food and Drug Administration (FDA), regarding a potential risk of thyroid cancer associated with the active ingredient, tirzepatide. Although this ingredient has been linked to thyroid tumors in animals, its impact on human thyroid cancer is still uncertain. Your doctor or pharmacist may avoid prescribing Zepbound if:

  • You or your family member have a family history of medullary thyroid cancer.
  • You have multiple endocrine neoplasia syndrome type 2, which increases the risk of thyroid cancer.

If you experience symptoms like persistent hoarseness, neck lumps, difficulty swallowing, or breathing issues while on Zepbound, contact your doctor promptly.

Other Warnings

Before starting Zepbound treatment, talk to your doctor about your health history. Zepbound may not be suitable for you if you have the following medical conditions:

  • severe digestive conditions like gastroparesis
  • kidney problems
  • diabetic retinopathy
  • history of pancreatitis
  • previous allergic reactions to Zepbound
  • pregnancy or breastfeeding
  • history of depression or suicidal thoughts

Zepbound Dosage

Your doctor will decide how much Zepbound you should take based on how you're doing and how your body responds. Zepbound comes in pens with liquid medicine that you inject under your skin. There are six strengths available:

  • 2.5milligrams in 0.5 milliliters (2.5mg/0.5mL)
  • 5mg/0.5mL
  • 7.5mg/0.5mL
  • 10mg/0.5mL
  • 12.5mg/0.5mL
  • 15mg/0.5mL

Starting with a lower dose, like 2.5mg once a week for four weeks, helps your body adjust and reduces the chance of stomach pain. Your doctor may increase the dose to 5 mg weekly after the initial period. If needed, they may adjust the dose in increments of 2.5mg until finding the right amount for you, with each dose being used for at least four weeks.

If you have a missed dose, take it as soon as you remember. But if it's almost time for your next dose, wait and take that one. Don't take extra to make up for the one you missed.

Keep Zepbound in the fridge between 36°F to 46°F (2°C to 8°C) in its original packaging to keep it safe from light. Don't freeze it, and don't use it if it's been frozen. Also, don't store Zepbound in the freezer part of the fridge.

For more details on how much to take and how to store it, check the medication guide that comes with Zepbound or consult your doctor.

Zepbound Cost

When considering Zepbound, knowing the costs and available assistance options is essential. Specifics about coverage, discounts, and programs may vary based on factors like insurance and location. Here are a few things to keep in mind:

  1. Generic Version: Zepbound does not yet have a generic form, which usually costs less than the brand-name drug.
  2. Coverage and Savings: Visit the Zepbound website to explore discounts, savings programs, and copay assistance offered by Lilly, the manufacturer.
  3. Optum Perks Coupons: You can check Optum Perks for estimated prices of Zepbound using their coupons. Note that these coupons cannot be used with insurance copays or benefits.
  4. Insurance Coverage: Help is available if you need financial support to pay for Zepbound.

Remember, the actual costs and available discounts may vary based on your insurance plan, location, and eligibility. Consult your healthcare provider or pharmacist for personalized assistance and to learn more about cost-saving options.

By utilizing available resources and understanding cost-saving options, you can better manage the expenses associated with Zepbound treatment.

Frequently Asked Questions

Should I inject Zepbound without food?

You can inject Zepbpund whether you've eaten, as it doesn't make a big difference. But always listen to what your doctor says about when to take it. If you need more clarity, ask your doctor or pharmacist for advice.

Is there a best time of day to inject Zepbound?

There's no specific "best" time of day to inject Zepbound. You can take it whenever convenient, following your healthcare provider's instructions. If you are not sure, ask your doctor or pharmacist for advice.

What if I miss a dose of Zepbound?

If you forget to take your Zepbound dose, take it as soon as you remember. But if it's almost time for your next dose, skip the missed dose. Don't take extra doses. If you need more clarification, ask your doctor for advice.

Will I need Zepbound treatment long-term?

How long you will need to take Zepbound depends on your health and what your doctor recommends. Some take it for a short while, while others need it longer. Follow your doctor's advice and check in regularly. If you have more questions, speak with your doctor or pharmacist.

How long does Zepbound take to work?

Zepbound usually starts working within a few weeks to months after starting treatment. This information is supported by FDA research, which approved Zepbound as a new medication for chronic weight management. It's important to keep taking Zepbound as your doctor directs, even if you don't see immediate weight loss results. Your doctor will monitor your progress and make adjustments as needed. If you have concerns about how long Zepbound takes to work, talk to your doctor for personalized advice.

How does Zepbound compare with Wegovy?

Zepbound and Wegovy are classified as weight loss drugs, but they're a bit different. Zepbound contains tirzepatide, while Wegovy contains semaglutide. Both drugs affect the hormones that control hunger and blood sugar levels.

Zepbound is taken once a week, while Wegovy is taken once a week for the first month and then every four weeks. Both medications can lead to weight loss, but the extent of weight loss may differ from person to person.

You must talk to your doctor to determine which is right for you based on your needs and health.


We have delved into Zepbound, a medication for weight loss. It works by reducing appetite and slowing down digestion. Taking Zepbound involves injecting it under your skin once a week, along with a healthy diet and exercise. 

While it can be beneficial, it is essential to know possible side effects like tiredness or digestive issues. Always talk with your doctor before starting, and if you notice any side effects, don't hesitate to reach out for guidance. Your healthcare team supports you in achieving your weight management goals.


At Diabetic Me, we are committed to delivering information that is precise, accurate, and pertinent. Our articles are supported by verified data from research papers, prestigious organizations, academic institutions, and medical associations to guarantee the integrity and relevance of the information we provide. You can learn more about our process and team on the about us page.

  1. AccessData ZEPBOUND™ (tirzepatide) Injection, for subcutaneous use Initial U.S. Approval: 2022
  2. What is Zepbound?
  3. FDA FDA Approves New Medication for Chronic Weight Management
  4. DailyMed Medication Guide ZEPBOUND® (ZEHP-bownd) (tirzepatide) injection, for subcutaneous use

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About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

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