BADDIE
Health
powered by FELLA HEALTH
Zepbound (tirzepatide) is an FDA-approved injectable medication for chronic weight management in adults with obesity or overweight with weight-related health conditions. As the first dual GIP and GLP-1 receptor agonist specifically indicated for weight loss, Zepbound works by regulating appetite, slowing digestion, and promoting fullness. Administered once weekly, it requires careful medical supervision, gradual dose escalation, and lifestyle modifications including diet and exercise. Understanding proper use, eligibility criteria, potential side effects, and safety considerations is essential for anyone considering or currently using this medication.
Summary: Zepbound is an FDA-approved dual GIP/GLP-1 receptor agonist for chronic weight management in adults with obesity or overweight with comorbidities, administered as a once-weekly injection alongside diet and exercise.
We offer compounded medications and Zepbound®. Compounded medications are prepared by licensed pharmacies and are not FDA-approved. References to Wegovy®, Ozempic®, Rybelsus®, Mounjaro®, or Saxenda®, or other GLP-1 brands, are informational only. Compounded and FDA-approved medications are not interchangeable.
Zepbound (tirzepatide) is an injectable prescription medication approved by the FDA in November 2023 for chronic weight management in adults with obesity or overweight with at least one weight-related comorbid condition. It is the first FDA-approved dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist indicated specifically for weight loss as of its approval date.
The medication works through a dual-receptor mechanism. Tirzepatide activates both GIP and GLP-1 receptors, which are naturally occurring incretin hormones involved in glucose and appetite regulation. By stimulating GLP-1 receptors, Zepbound slows gastric emptying, reduces appetite, and promotes feelings of fullness after eating. The additional GIP receptor activation may contribute to these effects, though the precise mechanisms and specific contributions of GIP to weight loss remain under investigation.
In the SURMOUNT-1 clinical trial, participants lost an average of 15-21% of their body weight over 72 weeks, depending on the dose used, compared to approximately 3% with placebo. These results represent significant weight reductions compared to other available obesity medications.
Zepbound is manufactured by Eli Lilly and Company and is administered as a once-weekly subcutaneous injection. It is important to note that Zepbound contains the same active ingredient as Mounjaro, which is FDA-approved for type 2 diabetes management, but the two medications are indicated for different conditions and should not be used interchangeably without physician guidance. Zepbound has not been studied for concomitant use with other GLP-1 receptor agonists or other weight-loss products, and such combined use is not recommended.
Zepbound is indicated for adults with a body mass index (BMI) of 30 kg/m² or greater (obesity), or a BMI of 27 kg/m² or greater (overweight) with at least one weight-related comorbid condition such as hypertension, type 2 diabetes, dyslipidemia, or obstructive sleep apnea. The medication is intended as an adjunct to a reduced-calorie diet and increased physical activity, not as a standalone treatment.
Zepbound should not be used by individuals with:
A personal or family history of medullary thyroid carcinoma (MTC)
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
A known serious hypersensitivity to tirzepatide or any excipients
Zepbound is not recommended during pregnancy. If pregnancy occurs while using Zepbound, the medication should be discontinued. Weight loss offers no benefit during pregnancy and may cause fetal harm.
Additional populations requiring careful consideration include patients with a history of pancreatitis or severe gastrointestinal disease (including severe gastroparesis). The safety and efficacy of Zepbound have not been established in pediatric patients under 18 years of age.
Patients with type 1 diabetes should not use Zepbound, as it is not a substitute for insulin. Those with a history of severe hypersensitivity reactions to GLP-1 receptor agonists should discuss alternative options with their healthcare provider. Women who are breastfeeding should consult their physician, as it is unknown whether tirzepatide passes into breast milk.
Importantly, Zepbound reduces the exposure to oral contraceptives. Women using oral contraceptives should switch to a non-oral method or add a barrier method for 4 weeks after initiating Zepbound and for 4 weeks after each dose escalation.
Patients should be monitored for suicidal thoughts or behaviors, which have been reported with weight management medications. Those with type 2 diabetes and pre-existing diabetic retinopathy should be monitored for worsening retinopathy.
Before starting Zepbound, patients should undergo a comprehensive medical evaluation including assessment of renal function and a thorough medication review to identify potential drug interactions, particularly with insulin or insulin secretagogues, which may require dose adjustments to prevent hypoglycemia.
Zepbound is administered as a subcutaneous injection once weekly, on the same day each week, at any time of day, with or without meals. The medication comes in single-dose prefilled pens available in six dosage strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. The pen is designed for ease of use, requiring minimal preparation and featuring an automatic injection mechanism.
The recommended dosing schedule follows a gradual escalation approach:
Starting dose: 2.5 mg once weekly for 4 weeks (this is a dose escalation step, not a therapeutic dose)
Maintenance escalation: Increase to 5 mg once weekly; after at least 4 weeks, may increase in 2.5 mg increments based on tolerability and efficacy
Maximum dose: 15 mg once weekly
This gradual titration strategy helps minimize gastrointestinal side effects, which are most common during dose initiation and escalation. Patients should not increase their dose more frequently than every 4 weeks unless directed by their healthcare provider.
Zepbound should be injected subcutaneously in the abdomen, thigh, or upper arm. Injection sites should be rotated with each dose to reduce the risk of local reactions. The medication should appear clear and colorless to slightly yellow; it should not be used if it appears cloudy, discolored, or contains particles.
If a dose is missed, it should be administered as soon as possible within 4 days (96 hours) of the missed dose. If more than 4 days have passed, the missed dose should be skipped, and the next dose should be administered on the regularly scheduled day. Patients should never take two doses within 3 days (72 hours) of each other. If several doses are missed, contact your healthcare provider, as re-titration at a lower dose may be needed to minimize side effects.
Important administration notes:
Each pen is for single use only and should never be shared between patients
Used pens should be disposed of in an FDA-cleared sharps container
Women using oral contraceptives should use non-oral contraception or add a barrier method for 4 weeks after initiating Zepbound and for 4 weeks after each dose escalation
Storage requirements include:
Refrigerate at 36°F to 46°F (2°C to 8°C)
May be kept at room temperature (up to 86°F/30°C) for up to 21 days
Protect from light; store in original carton
Do not freeze; discard if frozen
The most frequently reported adverse effects of Zepbound are gastrointestinal in nature, consistent with the GLP-1 receptor agonist class. In clinical trials, the most common side effects (occurring in ≥5% of patients) included nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, and injection site reactions. These effects are typically mild to moderate in severity and tend to decrease over time as the body adjusts to the medication.
Nausea is the most prevalent side effect, affecting approximately 25-30% of patients during dose escalation. To minimize gastrointestinal symptoms, patients should eat smaller, more frequent meals, avoid high-fat foods, and stay well-hydrated. Most gastrointestinal side effects resolve within several weeks, but persistent or severe symptoms warrant medical evaluation.
Serious adverse effects requiring immediate medical attention include:
Pancreatitis: Severe abdominal pain radiating to the back, with or without vomiting, requires immediate evaluation. Zepbound should be discontinued if pancreatitis is confirmed.
Gallbladder disease: Rapid weight loss increases the risk of cholelithiasis. Symptoms include right upper quadrant pain, fever, and jaundice.
Hypoglycemia: While uncommon with Zepbound alone, risk increases when used with insulin or sulfonylureas. Patients should recognize symptoms such as shakiness, sweating, confusion, and rapid heartbeat.
Acute kidney injury: Dehydration from gastrointestinal side effects may impair renal function, particularly in patients with pre-existing kidney disease.
Hypersensitivity reactions: Anaphylaxis and angioedema have been reported rarely with GLP-1 receptor agonists.
Thyroid C-cell tumor warning: Zepbound carries a boxed warning regarding the risk of thyroid C-cell tumors observed in rodent studies. While there is no established link in humans, patients should be counseled about symptoms of thyroid tumors, including a neck mass, dysphagia, dyspnea, or persistent hoarseness, and should report these immediately. Routine calcitonin or thyroid ultrasound monitoring is not recommended unless clinically indicated.
Additional safety considerations:
Suicidal ideation and behavior: Monitor for new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior. Discontinue Zepbound if these symptoms occur.
Diabetic retinopathy: Patients with type 2 diabetes and pre-existing retinopathy should be monitored for worsening of retinopathy.
Oral contraceptives: Zepbound reduces the exposure to oral contraceptives. Women should use non-oral contraception or add a barrier method for 4 weeks after initiating Zepbound and for 4 weeks after each dose escalation.
Pregnancy planning: Women should discontinue Zepbound at least 1 month before a planned pregnancy and discuss individualized timing with their healthcare provider.
Regular monitoring by a healthcare provider is essential to assess treatment response, manage side effects, and screen for potential complications throughout the course of therapy.
Yes, Zepbound is indicated for weight management in adults with type 2 diabetes as a weight-related comorbidity. However, it should not be used with other GLP-1 receptor agonists, and insulin or sulfonylurea doses may need adjustment to prevent hypoglycemia.
Weight loss typically begins within the first few weeks of treatment, with gradual progression as doses are increased. Clinical trials demonstrated significant results over 72 weeks when combined with reduced-calorie diet and increased physical activity.
Eat smaller, more frequent meals, avoid high-fat foods, and stay well-hydrated. If nausea is severe or persistent, contact your healthcare provider, as dose adjustment or temporary discontinuation may be necessary.
All medical content on this blog is created using reputable, evidence-based sources and is regularly reviewed for accuracy and relevance. While we strive to keep our content current with the latest research and clinical guidelines, it is intended for general informational purposes only.
This content is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare provider with any medical questions or concerns. Use of this information is at your own risk, and we are not liable for any outcomes resulting from its use.
