What Zepbound is
Zepbound is tirzepatide, a once-weekly injection from Eli Lilly. Unlike semaglutide, it acts on two hormone receptors, GLP-1 and GIP, which is thought to explain its larger average weight loss. It's approved for chronic weight management in adults with obesity, or overweight plus a weight-related condition, and for moderate to severe obstructive sleep apnea in adults with obesity. The same molecule is sold as Mounjaro for type 2 diabetes.
Doses and schedule
Zepbound starts at 2.5 mg once a week for four weeks. The dose then rises by 2.5 mg every four weeks or more as needed, up to a maximum of 15 mg. Maintenance doses are 5 mg, 10 mg or 15 mg; 2.5 mg is only a starting dose.
It comes as a single-dose pen, a multi-dose KwikPen or single-dose vials that you draw up with a syringe. Self-pay patients buying through LillyDirect get vials or the KwikPen.
Tirzepatide can make birth control pills less effective. The label advises switching to, or adding, a non-oral method for four weeks after starting and after each dose increase.
How much weight people lose
In SURMOUNT-1, adults without diabetes lost an average of 15.0% of body weight on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg over 72 weeks, versus 3.1% on placebo.
In SURMOUNT-5, the first head-to-head trial against semaglutide, people on tirzepatide lost about 20% of body weight over 72 weeks compared with about 14% on semaglutide.
Side effects
Side effects are similar to other GLP-1 medicines: nausea, diarrhea, vomiting, constipation, indigestion and stomach pain are most common, mainly while the dose is increasing. Serious risks on the label include pancreatitis, gallbladder disease, kidney problems from dehydration and serious allergic reactions. Zepbound carries the same boxed warning about thyroid C-cell tumors as semaglutide. See side effects.
Cost and how to get it
Through LillyDirect, self-pay Zepbound costs $299 for 2.5 mg, $399 for 5 mg and $449 for 7.5 mg to 15 mg when you refill within 45 days. Miss that window and higher doses cost $499 to $699. Full table in the cost guide.
Cheapest way to get Zepbound without insurance
If you already have a clinician who can prescribe it, ask whether LillyDirect's self-pay vial or KwikPen program fits your situation. That avoids an added clinic membership. If you need a new clinician, compare pay-per-visit care with the online clinic plans; add the visit or membership charge to the medicine price. The $449 price for 7.5 mg and higher depends on an on-time refill, and 2.5 mg is a starting dose rather than a maintenance dose.
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