Zepbound® Medication Guide

How Zepbound® Works

Zepbound® (tirzepatide) is a GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide) medication which can assist with weight-loss by doing the following:

  • Increasing insulin production from the pancreas. Insulin is a hormone that helps your body process glucose (blood sugar) into energy.
  • Removing excess glucose from your blood. Decreasing glucagon release after a meal.
  • Glucagon triggers your liver to store fat.
  • Slowing gastric emptying during digestion, which will make you feel less hungry.

Dosing and Storage Instructions

See instructions

Dosage and Administration Instructions

  • The recommended starting dosage is 2.5 mg injected subcutaneously once weekly.
  • After 4 weeks, increase to 5 mg injected subcutaneously once weekly.
  • Increase the dosage in 2.5 mg increments after at least 4 weeks on the current dose.
  • The recommended maintenance dosages are 5 mg, 10 mg, or 15 mg injected subcutaneously once weekly. 
  • Consider treatment response and tolerability when selecting the maintenance dosage.
  • The maximum dosage is 15 mg subcutaneously once weekly.
  • Administer once weekly at any time of day, with or without meals.
  • Inject subcutaneously in the abdomen, thigh, or upper arm.
  • Rotate injection sites with each dose.

How To Store Your Zepbound® Pen

  • Store Zepbound® in the refrigerator between 36°F to 46°F (2°C to 8°C). Store Zepbound® in the original carton until use to protect it from light.
  • If needed, each single-dose pen can be stored at room temperature up to 86°F (30°C) for up to 21 days. If Zepbound® is stored at room temperature, it should not be returned to the refrigerator.
  • Discard if not used within 21 days after removing from the refrigerator.
  • Do not freeze Zepbound®. Do not use Zepbound® if frozen.
  • Dispose of your pens in a heavy-duty plastic storage container or an FDA-approved sharps container. The pen is not recyclable.

What If I Miss a Dose of Zepbound®

  • If a dose is missed, instruct patients to administer Zepbound® as soon as possible within 4 days (96 hours) after the missed dose. 
  • If more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing schedule.
  • The day of weekly administration can be changed, if necessary, as long as the time between the two doses is at least 3 days (72 hours).

When Should I Stop Taking Zepbound®?

  • At the beginning of the Pine Medical program, you communicate your goal weight to your Pine Medical physician. If you achieve your goal weight or achieve a body mass index (BMI) less than 27, you should stop taking Zepbound®. 
  • ~If you believe you may have a BMI less than 30, please proactively communicate with your doctor every month regarding your current weight because it may inform the dosage for future prescriptions.
  • You should stop taking Zepbound® if any of these apply:
  • ~Pregnancy is recognized
  • ~New or worsening suicidal thoughts or ideation
  • ~Hypersensitivity or allergic reaction after administration
  • ~Suspected or confirmed pancreatitis diagnosis, Do not restart if pancreatitis is confirmed.
  • ~Suspected or confirmed severe gastrointestinal disease.

Refilling Your Prescription &
Communicating with Your Pine Medical Physician

How To Refill Your Zepbound® Prescription

  • For the initial four to six months of the Pine Medical program, refilling your Zepbound® prescription requires a monthly check-in with your Pine Medical physician. During this check-in, your physician will evaluate your weight-loss progress and determine whether it is safe to prescribe a higher dose of Zepbound®.
  • ‍The goal of the monthly check-in with your physician is to determine the proper dose of Zepbound® which will optimize your weight-loss progress while minimizing side effects.
  • Every month, we will reach out via email during Week 3 to initiate your check-in with your physician. You can also initiate a check-in by emailing support@pinemedical.com.

When You Should Message Your Pine Medical Physician

You are able to message your physician at any time through the Pine Medical messaging portal. In addition, below are specific times you should reach out to your Pine Medical physician:

  • When you are ready to refill your medication.
  • Any time you experience severe side effects.
  • Any time you have been hospitalized with other medical conditions, or started new medications.
  • Any time your BMI is less than 27.

Additional Zepbound® FAQs

What Are Common Side Effects of Zepbound®?

Please message your Pine Medical physician if you are experiencing any adverse symptoms. Call 911 or go to an emergency room if you feel like you are experiencing a medical emergency.

  • Click here for the full list Zepbound® of side effects.
  • Common side effects of Zepbound® include nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and heartburn.
  • Nausea is most common in patients beginning treatment with Zepbound®. You will be prescribed generic Zofran (ondansetron) to help alleviate nausea, which will be available at your local pharmacy with your Zepbound® prescription. This medication should be taken only if you have significant nausea.
  • Visit the Zepbound® Full Prescribing Information to learn more about the possible side effects of Zepbound®.

Who Should Not Take Zepbound®?

Your Pine Medical physician evaluated your health history prior to writing your initial prescription based on the medical intake form you filled out when signing up for Pine Medical. As a result, some patients may not be eligible to take Zepbound®. If you develop any of these conditions after starting your prescription, please stop using Zepbound® and reach out to your Pine Medical physician right away.

  • Family or personal history of medullary thyroid cancer
  • Family of personal history of multiple endocrine neoplasia Type 2 (MEN-2) syndrome
  • Currently pregnant or planning to become pregnant in the next two months
  • Currently breastfeeding
  • Retinopathies (diseases of the retina)
  • Type 1 Diabetes
  • Serious gastrointestinal disorders (Severe GERD/hiatal hernia/Crohn's diagnosis/ulcerative colitis)
  • Recent bariatric surgery (within past 6 months)
  • Pancreatitis using GLP-1s in the past or patients with chronic pancreatitis
  • Drug use disorder
  • Alcohol use disorder
  • Disordered eating
  • Gallbladder disease (does not include gallbladder removal)

Warning: Zepbound® may cause worsening depression or suicidal thoughts, intestinal blockage, or thyroid cancer. Watch for possible symptoms, such as mood changes, abdominal pain, swelling in the neck, trouble swallowing, hoarseness, and shortness of breath. If you have any of these symptoms, tell your healthcare provider.

Additional Online Resources

Last Updated: 12/04/2023

Table of contents