Zepbound dosage, forms, and strengths

Zepbound is a brand-name prescription weight loss medication for people with chronic weight problems. It is classified as a dual GIP and GLP-1 receptor agonist. The active ingredient, tirzepatide, is the same drug found in Mounjaro, a Type 2 diabetes drug. Despite their different brand names, Zepbound and Mounjaro are available in the same dosage strengths and are administered similarly. Treatment starts with weekly 2.5 mg injections, increasing to 5 mg after four weeks with the option to increase the dosage every 4 weeks.

Zepbound forms and strengths

Zepbound is a medication injected under the skin (subcutaneously). The shots can be self-administered using a prefilled single-dose pen or single-dose vial with a syringe.

• Single-dose injection pens: 2.5 mg/0.5 milliliters (mL), 5 mg/0.5 mL, 7.5 mg/0.5 mL, 10 mg/0.5 mL, 12.5 mg/0.5 mL, and 15 mg/0.5 mL

• Single-dose vials: 2.5 mg/0.5 mL, 5 mg/0.5 mL, 7.5 mg/0.5 mL, 10 mg/0.5 mL, 12.5 mg/0.5 mL, and 15 mg/0.5 mL

Zepbound dosage for adults

Zepbound is a weight management drug approved by the U.S. Food and Drug Administration (FDA) for adults with obesity, defined as having a body mass index (BMI) of 30 kg/m2 or higher. People who are overweight with a BMI of 27 kg/m2 may be prescribed Zepbound for weight loss if they have at least one weight-related medical condition, such as high blood pressure or high cholesterol. Zepbound is also approved to manage moderate to severe obstructive sleep apnea (OSA) in adults with obesity. 

The dosage for Zepbound treatment ranges from a starting dosage of 2.5 mg once weekly to a maximum dosage of 15 mg once weekly. A gradual increase in dosage may help reduce the risk and severity of potential side effects. 

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Zepbound dosage for chronic weight management

For weight management, Zepbound treatment starts with a low dose of 2.5 mg injected weekly for at least four weeks. After that, the dose is slowly increased by 2.5 mg every four weeks until the standard or maintenance dosage is reached, which can be 5 mg, 10 mg, or 15 mg each week. The maximum dosage for weight management is 15 mg per week.

Zepbound dosage for OSA

For OSA, treatment begins with a low dose of 2.5 mg injected once a week for at least four weeks. Unlike the weight management plan, the standard maintenance dosage for OSA is either 10 mg or 15 mg per week. The dosage is gradually increased by 2.5 mg every four weeks until the target dose is reached, with 15 mg being the highest allowed dose.

Zepbound dosing schedule for older adults

The dosing schedule for Zepbound remains the same for older adults and younger patients. Studies have shown that there are no significant differences in safety or effectiveness between those aged 65 and older and younger adults. This means that older individuals can take Zepbound just as prescribed without needing any special adjustments to their dosage.

Zepbound dosing schedule for children

The FDA has not approved Zepbound for children younger than 18 years of age.

Zepbound dosing restrictions

Zepbound should not be used by individuals who have a personal or family history of a type of thyroid cancer called medullary thyroid carcinoma (MTC) or a condition known as multiple endocrine neoplasia syndrome type 2 (MEN 2). It is also not recommended for those who have had serious allergic reactions to tirzepatide or any of the other ingredients in the medication.

People taking Zepbound do not need to change their dose if they have kidney problems, even severe ones. The medicine works the same for people with kidney problems as it does for people with healthy kidneys. The same applies to people with liver problems; no dosage changes are needed since the drug behaves the same regardless of liver health.

Zepbound side effects

Like other drugs, Zepbound may cause unwanted side effects. The most common side effects of Zepbound are:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Upset stomach

• Abdominal pain

• Fatigue

• Injection site reactions

These side effects may increase or worsen when transitioning from lower to higher doses. Zepbound’s most severe adverse reactions include inflammation of the pancreas (pancreatitis), acute kidney injury, gallbladder disease, suicidal thoughts or behaviors, diabetic retinopathy, and low blood sugar (hypoglycemia). 

Although rare, Zepbound may also cause severe allergic reactions, with symptoms such as swelling of the face, lips, tongue, or throat, difficulty breathing, and chest tightness. Seek immediate medical help if serious side effects develop.

How to take Zepbound

Zepbound should only be used with a valid prescription and medical advice from a healthcare provider. A healthcare provider will give directions on how to properly take Zepbound. You can also keep in mind the following guidelines:

• Take this medicine as instructed. Do not take more medicine than prescribed.

• A doctor, nurse, or other healthcare provider will demonstrate how to give injections properly. Make sure to clarify any confusion or questions you might have during the demonstration.

• This medicine comes with both a Medication Guide and Instructions for Use. 

  • If these inserts are missing, ask the pharmacist for copies. 

  • Read both before administering the first injection. 

  • Reread the Instructions for Use before each injection.

  • Alternatively, you could also review the process using the video instructions on the Zepbound website. 

• Injections are made under the skin once per week on the same day of the week.

• Zepbound can be injected at any time of day, with or without food.

• Check Zepbound before using it. It should look clear and colorless to slightly yellow. Do not use it if you see any particles or the color is off.

• Give Zepbound as an injection just under the skin in the belly, thigh, or upper arm. 

• Change the injection spot each time you use Zepbound.

• Use Zepbound along with a lower-calorie diet and more physical activity. 

• How to store Zepbound:

  • Store Zepbound in the refrigerator (between 36°F to 46°F) in its original carton protected from light. Do not freeze.

  • It’s okay to store Zepbound syringes or vials at room temperature for up to 21 days provided they’re kept in the original carton, protected from heat and sunlight, and disposed of after 21 days.

• How to use the single-dose pen:

  • Check the pen first. Check the drug name and expiration date, and make sure there is no damage to the pen.

  • Wash your hands before injecting the medicine.

  • Wipe the skin area with an alcohol swab.

  • When ready to inject, pull straight down on the gray base cap to remove it. Don’t try to replace the cap. Don’t touch the needle.

  • Place the clear base flat on the skin where the injection will be made.

  • Turn the lock ring right below the injection button to unlock the injector.

  • Press and hold the purple injection button for up to 10 seconds. The pen will click to signal the injection has started and will click a second time when the injection is complete. The gray plunger should be visible in the pen.

  • Dispose of the pen in a closed sharps container that is out of reach of children and pets.

• How to give an injection using the Zepbound vial:

  • Read the instructions that come with this medicine. They will show you how to prepare the vial, prepare the syringe, measure out the dose, and administer the injection.

• How to change the Zepbound dosing schedule:

  • Take Zepbound once per week on the same day each week. If necessary, the injection day can be changed later. 

  • You can change to any other day of the week provided that the new dose is administered at least three days after the current dose.

Zepbound dosage FAQs

How long does it take Zepbound to work?

Zepbound starts to work as soon as it is given, but the time it takes for someone to notice its effects can differ from person to person. It usually takes about four weeks for Zepbound to build up in your body, which is when many people might begin to see some modest weight loss. However, it might take longer for some to achieve the desired effect. A study showed that after 20 weeks of treatment, people taking tirzepatide lost significantly more weight than those who received a placebo. Talk to your doctor if you have questions about what results to expect and when.

How long does Zepbound stay in your system?

The half-life of Zepbound is around five days. That means it takes the body about five days to remove half a dose of Zepbound from the system. Drugs are typically cleared from the body after four to five half-lives. Therefore, after about 20 to 25 days, Zepbound should be cleared from the body. 

What happens if I miss a dose of Zepbound?

If you miss a dose of Zepbound, inject it as soon as you remember, as long as it's within four days (96 hours) of your missed dose. If more than four days have passed since your missed dose, skip the missed dose and take your next dose at the regularly scheduled time. Do not take two doses of Zepbound within three days of each other. You may need to restart at a lower dosage if you miss two consecutive doses (14 days without medication) to reduce the risk of potential adverse side effects, such as an upset stomach.

How long can you take Zepbound?

Zepbound is FDA-approved for chronic weight management, meaning it is intended for long-term use. The timeline for taking Zepbound can vary based on your specific needs and goals, as well as your response to the medication. Like other anti-obesity medications, Zepbound is not a quick, short-term fix, and patients may need to continue taking it to maintain their body weight and other health benefits.

How do I stop taking Zepbound?

If you’re considering stopping Zepbound, it's important to consult your healthcare provider to create a plan that reduces the risk of weight regain. If you stop using Zepbound for weight loss, you will most likely regain much of the weight you have lost. To minimize this risk, your healthcare provider may recommend gradually weaning off the medication by extending the time between doses or lowering the doses when you hit your goal weight.

Zepbound may need to be stopped in the event of an allergic reaction, thyroid tumors, or severe gastrointestinal distress. In those cases, Zepbound alternatives may include:

• Wegovy (semaglutide)

• Rybelsus (semaglutide)

• Saxenda (liraglutide)

• Qsymia (phentermine/topiramate extended-release)

• Contrave (naltrexone/bupropion)

Consult a healthcare provider when stopping Zepbound due to adverse effects. They can recommend the best treatment option based on your overall health condition. 

Can you overdose on Zepbound?

A Zepbound overdose is possible if too much is taken at once or if doses are taken within three days of one another. If too much Zepbound is administered, contact a poison control center. 

What interacts with Zepbound?

Drug interactions are a potential risk with Zepbound. Because Zepbound lowers blood sugar levels, taking it with insulin or sulfonylureas can increase the risk of low blood sugar (hypoglycemia). Your doctor might need to adjust the doses of these medications when you start Zepbound. It can also slow down how quickly your stomach empties, which may affect how well some oral medications work, such as warfarin. 

Zepbound may negatively affect how birth control pills are absorbed. Therefore, women using oral hormonal contraceptives should switch to a non-oral method or add barrier methods (like condoms) for four weeks after starting Zepbound and for four weeks after any dose increase.

What happens when you mix Zepbound and alcohol?

While there are no known direct interactions between Zepbound and alcohol, it's best to limit or avoid alcohol while on this medication. Alcohol can cause both low and high blood sugar levels, depending on how much you consume. It may also make side effects like nausea and vomiting worse.

Is it safe to take Zepbound during pregnancy?

Zepbound is not recommended during pregnancy. Zepbound was found to cause fetal harm in animal studies, and it is not known whether it is safe to take during pregnancy in humans. If you are pregnant or planning to become pregnant, consult a medical provider to discuss the potential risks and benefits of taking Zepbound.

Is it safe to take Zepbound when breastfeeding?

There is limited information about the safety of taking Zepbound while breastfeeding. While it’s not expected to get into breast milk in large amounts, it should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. If you are breastfeeding or planning to breastfeed, discuss the potential risks and benefits of taking Zepbound with your healthcare provider.

Sources

• Zepbound highlights of prescribing information, U.S. Food and Drug Administration (2025)

• Zepbound drug label information, DailyMed (2025)

• Zepbound, Eli Lilly and Company (2025)

• Zepbound for healthcare professionals, Eli Lilly and Company (2025)

• Tirzepatide once weekly for the treatment of obesity, New England Journal of Medicine (2022)

• Population pharmacokinetics of the GIP/GLP receptor agonist tirzepatide, CPT: Pharmacometrics & Systems Pharmacology (2024)

• Tirzepatide (Mounjaro, Zepbound), MotherToBaby (2024)