*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Zepbound is an injectable medication used for weight loss in obese or overweight patients. It aims to assist with weight loss by delaying the emptying of stomach contents. This results in a feeling of “fullness.” Zepbound should be used in combination with low-calorie diets and increased physical activity to achieve and maintain weight loss.1
Boxed Warning: Tirzepatide – Risk of Thyroid C-Cell Tumors
Tirzepatide, the active ingredient in Mounjaro, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Tirzepatide has a risk of thyroid c-cell tumors. Your healthcare provider will evaluate your health history and risk for thyroid tumors to decide if tirzepatide is safe for you.
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What Is Zepbound?
Zepbound, with the active ingredient tirzepatide, is an injectable medication that is used to help patients lose weight. Zepbound is a GIP/GLP-1 (glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1) agonist. GIP and GLP are regulators of appetite and caloric intake.1
Zepbound is FDA-approved for weight management in combination with a reduced-calorie diet and physical exercise in patients diagnosed with obesity or who are overweight and have certain health conditions. FDA approval means a medication has been found to be safe and effective for a specific use based on data from clinical trials.1
How Does Zepbound Work for Weight Loss?
Zepbound is a GIP receptor and GLP-1 receptor agonist. GIP and GLP increase insulin secretion and reduce glucagon secretion. These two substances also increase the body’s sensitivity to insulin. These are all important mechanisms for decreasing appetite.
It is thought that Zepbound delays or slows gastric emptying, which is the process of emptying the contents of the stomach into the small intestine. This gives the patient a feeling of being full and may reduce caloric intake. The use of this weight loss medication is recommended along with a reduced-calorie diet and physical exercise.1
Side Effects of Zepbound for Weight Loss
Zepbound may cause a variety of side effects. Some factors to consider when discussing side effects is the length of use for Zepbound. Some short term side effects while the body adjusts to the medication may include dizziness, headache, sweating and confusion. Some side effects may persist for as long as you are taking the medication in some patients.1
Common Side Effects of Zepbound
Common side effects of Zepbound include nausea, vomiting, and diarrhea. If these effects persist or worsen, please contact your prescriber or pharmacist.1
Common side effects of Zepbound include:1
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Indigestion
- Injection site pain
- Hair loss
- Heartburn
- Belching (burping)
*All medications, including Zepbound, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Zepbound
Zepbound may cause serious side effects. If you experience any of these, please seek medical attention. Severe stomach problems, serious allergic reactions and kidney failure have been reported in patients who take Zepbound.1
Serious side effects of Zepbound include:1
- Possible thyroid tumors, including cancer
- Severe stomach problems
- Kidney problems
- Gallbladder problems
- Inflammation of your pancreas
- Serious allergic reactions
- Low blood sugar
- Depression or thoughts of suicide
- Changes in vision (especially in patients with type 2 diabetes)
*All medications, including Zepbound, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.
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Zepbound for Weight Loss Warnings & Precautions
As with every medication, there are warnings and precautions to be aware of. It is important to discuss these safety issues with your primary care provider. Some of the risks and effects from taking Zepbound may require medical attention.1
Warnings and precautions for Zepbound:1
- Boxed warning- risk of thyroid cancer: It is not known if Zepbound will cause thyroid cancer in humans, but in animal studies it has been shown to occur in clinically relevant levels. Additionally, if you or your family have a history of thyroid cancer, this medication is not recommended.
- Allergic reactions: Anaphylaxis, a severe allergic reaction, has been shown to occur in patients treated with Zepbound. Symptoms of this include swelling of throat, difficulty breathing and wheezing. If this occurs, seek medical attention right away.
- Severe gastrointestinal disease: Gastrointestinal disease, sometimes severe, has been shown to occur in some patients using Zepbound. Symptoms include nausea, vomiting, and diarrhea.
- Acute kidney injury: Due to gastrointestinal reactions, dehydration can occur which can lead to kidney injuries.
- Acute gallbladder disease: Treatment with Zepbound has shown an increased occurrence with gallbladder disease. If gallbladder disease is suspected, a follow-up with a provider is recommended.
- Acute pancreatitis: Pancreatitis (at varying levels of severity) has been observed in patients taking Zepbound. If pancreatitis is suspected, stop taking Zepbound and consult your primary care provider.
- Hypoglycemia: Zepbound can lower blood sugar and thus can cause hypoglycemia. It is important to discuss the risks of Zepbound including hypoglycemia with your prescriber. Blood sugar may need to be monitored throughout your treatment course.
- Diabetic retinopathy complications in patients with type 2 diabetes: Vision change has been affected in patients with type 2 diabetes who are currently taking Zepbound. Discuss with your prescriber if going to the eye doctor to monitor may be a course of action necessary for you.
- Suicidal behavior and ideation: Suicidal ideation and behavior has been shown to occur in patients taking Zepbound. If you have a history of suicide attempts of suicide ideation, Zepbound may not be right for you. Discuss with your primary care provider if you develop any feelings of suicide.
There may be additional warnings or precautions with this medication. Talk with your healthcare provider about all risks before you start taking this medication.
Interactions With Zepbound
Zepbound may have harmful interactions with other substances such as prescription medications, supplements, herbs, and more. It is important to tell your prescriber everything you are currently taking, even over-the-counter medications, as these could have harmful interactions with Zepbound.1
2 substances you should avoid while taking Zepbound include:1
- Insulin secretagogues (e.g. glipizide, repaglinide): These medications promote the secretion of insulin. When starting Zepbound, insulin levels may increase to a higher level than is recommended or safe. Consider lowering the dose of these secretagogues.
- Oral medications: Zepbound delays gastric emptying. This may delay the effects of any oral medication. Discuss possible medication interactions with your pharmacist.
This is not a comprehensive list of the possible interactions with Zepbound. You should talk with your healthcare provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Zepbound.
Zepbound Dosages for Weight Loss
While Zepbound only comes in injection form, it can come in varying dosage forms. Dosage is dependent on the condition being treated, your age, and other related factors.1
Zepbound is manufactured in the following dosages: 2.5 mg (milligram), 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg. All of these are in a volume of 0.5 mL (liquid injection). Zepbound is approved for ages 18 years and older.1
How Do I Take Zepbound for Weight Loss?
The recommended starting dose is a 2.5 mg injection once weekly. After one month, the dose may be increased to a 5 mg once weekly injection. After a subsequent month, the dose may be increased in 2.5 mg increments. The common maintenance dosages are 5 mg, 10 mg and 15 mg.
It is important to educate yourself and/or a caregiver on the proper injection technique. Following the instruction pamphlet that is included and having your pharmacist help you find an injection technique video for Zepbound is a great way to make sure you are doing everything correctly. Ensure that you are visually inspecting the injection liquid to make sure it does not look contaminated. Inject Zepbound into the abdomen, thigh or upper arm.1
What Happens If I Miss a Dose of Zepbound?
If you miss a dose of Zepbound, immediately administer the dose within 4 days. If more than 4 days have gone by, skip the missed dose and continue the regular dosing pattern. It is important to not stop taking Zepbound abruptly, as you may regain any weight that was lost. Always consult your prescriber or pharmacist.1
How to Get Zepbound for Weight Loss
A licensed prescriber may prescribe Zepbound for weight loss. The indication for Zepbound is for patients whose BMI is at least 27. Additionally, you may be considered for Zepbound if you have another weight-related condition, such as diabetes or high blood pressure. Due to its many possible health risks, a prescriber may not recommend Zepbound at first. It is important to discuss your case with your prescriber.1
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Zepbound Vs. Other Weight Loss Methods
There are additional medications that are used for weight loss, such as Wegovy. Wegovy is similar to Zepbound and acts in a similar way. Wegovy is FDA-approved for weight loss. Another weight loss medication is Mounjaro. Mounjaro contains the same active ingredient as Zepbound.
However, Mounjaro is FDA-approved for blood sugar control in patients with type 2 diabetes, not weight management. It is important to note while they have the same active ingredient, they are approved for different purposes.2, 3
Zepbound in Combination With Lifestyle Changes
Zepbound is approved specifically for use in weight management in combination with a reduced-calorie diet and increased physical activity. It is shown that combining these two lifestyle changes while taking Zepbound can prove better management in weight.1
FAQs About Zepbound for Weight Loss
You may have some questions about Zepbound. It is important to discuss any and all questions with your healthcare provider so that they may give you the best care.
How Quickly Can You Lose Weight on Zepbound?
Weight loss may be seen after 2-3 weeks on Zepbound. However, it is important to note that each individual is different and that a variety of factors may affect weight loss.4
How Much Weight Can I Lose on Zepbound?
Some patients reported weight loss of up to 48 pounds while on 15 mg doses of Zepbound for 72 weeks (16+ months). The average percentage of weight loss also varies depending on the dose given.
For patients on a lower dose, the average percentage of weight loss will be lower. However, it is important to note that each individual is different, and a variety of factors contribute to how the body will respond to Zepbound.5
How Effective Is Zepbound for Weight Loss?
Zepbound is effective at maintaining weight loss. In one research study, 300 participants were shown to maintain 80% of their weight loss after 88 weeks (20+ months) of taking Zepbound. It is important to keep taking Zepbound as directed and not abruptly stop taking the medication.6
How Does Zepbound Compare With Mounjaro?
Zepbound and Mounjaro contain the same active ingredient, tirzepatide. They both work to help patients lose weight in similar fashions. However, some patients may feel harsher side effects with Mounjaro compared to Zepbound. Additionally, Mounjaro is only FDA-approved for weight management in those with type 2 diabetes.5
Questions to Ask Your Healthcare Provider About Zepbound for Weight Loss
It is important to have an open discussion with your prescriber and pharmacist to ensure all your questions are answered. Work with your healthcare providers to see if Zepbound is right for you.
Questions to ask your care team about Zepbound for weight loss include:
- How safe is Zepbound for weight loss?
- How long will it take for me to adjust to taking Zepbound for weight loss?
- Am I at risk for more serious symptoms with Zepbound if I am already taking other medications?
- Will Zepbound allow me to lose weight and keep it off long-term?
- Can I continue my altered diet (paleo, keto) while taking Zepbound?
- Can I inject Zepbound on my own or does a provider need to perform the injection?
- How soon can I tell if Zepbound is working for me?
- How long will I need to take Zepbound for?
- Will I need regular lab tests while taking Zepbound?
How to Know if Zepbound for Weight Loss Is Right for You
It is important to consider all the factors to determine if Zepbound is right for you. If you have not felt other weight management methods have been helpful enough, Zepbound may be an option for you. If you have a history of thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN 2), then Zepbound may not be right for you.
Additionally, if you have a history of suicidal behavior or ideation, other alternatives may need to be considered. Please consult with your healthcare team about your health history and how Zepbound could be a solution for you.1
In My Experience
Additional Resources
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Semaglutide: Uses, Side Effects, Interactions, & More
Understanding the complexities of medications like semaglutide is crucial for anyone seeking effective treatment. It’s important to acknowledge that semaglutide is extensively used in managing type 2 diabetes and obesity, with potential benefits in weight loss and cardiovascular risk reduction.
Mounjaro Weight Loss: Safety, Side Effects, & More
Mounjaro is a relatively new medication that is within a class of medications known for their control of blood sugar and potential for managing weight. It’s unique in that it has two different ways of working in the body. It is generally recommended that patients make lifestyle choices alongside any medications used for weight management.