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Instructions:
Zepbound (tirzepatide)

Storage

Keep unopened pens refrigerated at 36–46 °F (2–8 °C). Do not freeze. After first use, you may store it at room temperature (≤ 86 °F / 30 °C) for up to 21 days—then discard. Avoid excessive heat and light exposure. For more information, visit Eli Lilly’s Zepbound site.

Instructions

This information is intended for individuals who have been prescribed Zepbound by their Alan Health provider.

For instructions on how to administer this medication, please visit the manufacturer’s website: Zepbound website

Understanding your insuline syringe

Disclaimer: This information is for informational purposes only and not a substitute for medical advice. Your prescribed injection method and dosage are determined by your doctor and provided by your pharmacy. Always review the dosing instructions included with your medication and consult your doctor with any questions.

Measuring your dose

Insulin syringes are used for subcutaneous injections. They are marked in Units on the insulin syringe barrel (see illustration). Insulin syringes facilitate the precise measurement of tiny amounts of liquids which are ideal for medications such as insulin that require small and accurate dosing. Unit marks are also expressed in mL’s and can be interchangeably referenced. A prescriber may write a prescription in Units or in mL’s.

Within the amount of liquid is the prescribed mg dosage of your medication (see mg chart). Milligrams (mg) is not an amount of liquid, but rather the amount of drug that is within. The conversion between units and milligrams varies depending on the concentration of the product being used.


Example: 2.5 mg/ml = 2.5 mg of Zepbound (tirzepatide) in every 1.0 ml or 100 Insulin Units.
Important safety information
Always refer to the prescription dosing instructions included with your medication.
Please read our full guide before taking any compounded medication. Read more

What can I expect?

Safety information

The most common side effects of ZEPBOUND® (tirzepatide) include nausea, diarrhea, and vomiting.

Other common side effects may include constipation, abdominal pain, indigestion (dyspepsia), injection site reactions, fatigue, hypersensitivity reactions, belching (eructation), hair loss, and gastroesophageal reflux disease. If these symptoms persist or worsen, stop taking the medication and contact your healthcare provider.


A full list of side effects can be found here.

Indications

ZEPBOUND® is a prescription medication that acts as both a GIP and GLP-1 receptor agonist. It is indicated:

  • As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:
    • Adults with obesity (BMI ≥30), or
    • Adults with overweight (BMI ≥27) who also have at least one weight-related condition (e.g., hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, cardiovascular disease).
  • To treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity.

BLACK BOX WARNING: Risk of Thyroid C-Cell Tumors

In rodent studies, tirzepatide caused thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is unknown whether this risk applies to humans.


Do not use ZEPBOUND® if you:

  • Have a personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • Are pregnant or planning to become pregnant without guidance from your healthcare provider.

Contraindications

Do not take ZEPBOUND® if you:

  • Have a personal or family history of medullary thyroid carcinoma (MTC) or MEN 2.
  • Have type 1 diabetes.
  • Have a history of pancreatitis.
  • Have severe gastrointestinal problems such as gastroparesis or issues digesting food.
  • Have a known allergy to tirzepatide, GLP-1 drugs, or any of the inactive ingredients in ZEPBOUND® (including sodium chloride, sodium phosphate dibasic heptahydrate, and water for injection. pH may be adjusted with hydrochloric acid or sodium hydroxide).
  • Have a history of suicidal ideation or attempts.

Warnings and Precautions

  • Pancreatitis: Has been reported in trials. Discontinue ZEPBOUND® if suspected and do not restart if confirmed.
  • Gallbladder Disease: Acute gallbladder disease has occurred. Monitor if symptoms of cholelithiasis arise.
  • Severe Gastrointestinal Disease: ZEPBOUND® has not been studied in this population and is not recommended.
  • Hypoglycemia: May occur when combined with insulin or insulin secretagogues. Adjust doses as needed and educate patients on symptoms of low blood sugar.
  • Kidney Injury: Monitor renal function in patients with renal impairment, especially if reporting adverse GI effects.
  • Diabetic Retinopathy: Has not been studied in patients with certain forms of diabetic eye disease. Monitor those with a history of retinopathy for worsening.
  • Heart Rate Increase: Has been observed with GLP-1 receptor agonists. Monitor heart rate periodically.
  • Suicidal Behavior and Ideation: Monitor for new or worsening depression or suicidal thoughts. Discontinue if symptoms occur.
  • Hypersensitivity: Serious allergic reactions including anaphylaxis and angioedema have been reported. Discontinue immediately if suspected.
  • Pulmonary Aspiration Risk: Inform healthcare providers about planned surgeries or procedures requiring general anesthesia or deep sedation due to aspiration risk observed with GLP-1 receptor agonists.

Drug Interactions and Limitations of Use

  • ZEPBOUND® delays gastric emptying, which may affect the absorption of oral medications. Use with caution, especially for drugs requiring rapid absorption.
    Do not use in combination with other tirzepatide-containing medications or GLP-1 receptor agonists.
  • The safety and efficacy of combining ZEPBOUND® with other weight-loss therapies have not been established.
  • ZEPBOUND® has not been studied in patients with a history of pancreatitis.

Reproductive Considerations

  • Pregnancy: Based on animal studies, ZEPBOUND® may cause fetal harm. Discontinue immediately if pregnancy is recognized.
  • Reproductive Planning: Stop ZEPBOUND® at least 2 months before a planned pregnancy due to its long half-life.
  • Oral Contraceptives: ZEPBOUND® may affect the efficacy of oral birth control. Women should switch to a non-oral contraceptive method, or add a barrier method for 4 weeks after starting treatment and after each dose escalation.

To Report Adverse Reactions, contact the FDA:

Disclaimer

These statements are intended for informational purposes and do not replace professional medical advice. Talk to your healthcare provider about any questions or concerns related to ZEPBOUND®.

Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Frequently Asked Questions

What are the side effects of Zepbound?

Potential side-effects can vary between individuals, based on medical history and lifestyle factors. The most common side effects are gastrointestinal: nausea, vomiting, diarrhea, and constipation. These often occur during dose titration and typically decrease over time. Rare but serious risks include pancreatitis and gallbladder issues. 

How do I store Zepbound pens?

Store in the refrigerator between 36–46°F. Once in use, the pen may be stored at room temperature (up to 86°F) for up to 56 days.

Additional support

For details about your medication and dosing, please log in to your patient portal. Your physician is here to help with any medical questions. If you are experiencing a medical emergency, call 911 right away.

Standard Titration Schedule
Week 1-2
0.6 mg
15 mg/mL
Once Daily
Week 3-4
1.2 mg
15 mg/mL
Once Daily
Week 5-6
1.8 mg
15 mg/mL
Once Daily
Week 7-8
2.4 mg
15 mg/mL
Once Daily
Week 9+
3 mg
15 mg/mL
Once Daily
Standard Titration Schedule
Week 1-2
0.1 mg
100 mg/mL
2 times per week
Week 3-4
0.3 mg
100 mg/mL
2 times per week
Week 5+
0.5 mg
100 mg/mL
2 times per week
Metformin
Week 1-2
Getting Started
Mild nausea or digestive changes are common. Take with food to ease symptoms.
Week 3-6
Blood Sugar Begins to Stabilize
Side effects usually fade. You may notice steadier energy and reduced appetite.
Week 7-12
Ongoing Metabolic Support
Blood sugar levels improve, and many users see benefits in A1C and weight over time.
Anti-Aging Complex
Week 1-2
Initial Sensitivity & Purging
You may experience mild redness, dryness, or flaking. This is common as your skin acclimates to increased cell turnover.
Week 3-6
Smoother Skin, Less Pigmentation
Skin starts to feel smoother, breakouts may reduce, and early hyperpigmentation begins to fade. Hydration improves as hyaluronic acid builds the barrier.
Week 7-12
Firmer, Brighter, Even-Toned Skin
Fine lines soften, texture improves, and skin tone looks more even and youthful. Most users see continued improvement over 8–12 weeks.
Anti-Aging Serum
Week 1-4
Scalp Adjustment & Shedding
Some users experience temporary shedding as older hairs make way for new ones. The scalp may feel drier or mildly irritated—this typically resolves.
Week 5-8
Less Shedding, Healthier Scalp
Inflammation and dandruff may improve thanks to ketoconazole, while minoxidil starts stimulating follicle activity.
Week 9-16
Thicker, Fuller Hair
Hair density begins to visibly improve. Clinical use shows noticeable regrowth and stronger strands with consistent application over 2–4 months.
NAD+ Face Cream
Week 1-2
Instant Glow, Gentle Start
Some users report a visible glow or smoother texture within the first few applications. You may feel a light tingle—this is normal.
Week 3-6
Hydration, Tone, and Texture Improve
Skin often becomes more even-toned and hydrated, with reduced dullness and fine lines as cellular energy and barrier strength are restored.
Week 7-12
Firmer, Healthier-Looking Skin
Elasticity improves and wrinkles soften. Continued use supports deeper repair, giving skin a firmer, more resilient appearance with lasting radiance.
Generic Latisse
Week 1-4
Subtle Beginnings
You may not notice much change at first. This phase is about setting the foundation—bimatoprost is extending your lashes’ growth cycle behind the scenes.
Week 5-8
Early Lash Gains
Many users start seeing longer lashes and less lash shedding. Look for subtle darkening and early thickening along the lash line.
Week 9-16
Fuller, Longer, Darker Lashes
Expect dramatically enhanced lash length, volume, and color. Clinical studies show up to 106% improvement in fullness, 25% longer lashes, and 18% darker pigmentation by week 16. Continue using generic latisse to maintain results.
Rosacea Treatment
Week 1-2
Gentle Start, Possible Tingling
Skin may tingle or feel slightly dry as the formula gets to work. This is normal and usually fades quickly.
Week 3-4
Redness and Bumps Decrease
You may notice a reduction in inflammation, fewer breakouts, and a calmer appearance—especially around the cheeks and nose.
Week 5-8
Skin Tone Looks More Even
Most users see fewer flare-ups and smoother texture by week 6. Ongoing use helps maintain long-term skin balance.
Oral Acne Treatment
Week 1-2
Hormonal Reset Begins
Your oil production begins to regulate, but breakouts may temporarily persist. Some users experience a short purging phase.
Week 3-6
Fewer, Milder Breakouts
Acne lesions often appear less inflamed and less frequent, especially along the chin and jawline. Oiliness typically decreases.
Week 7-12
Clearer, More Balanced Skin
Many users see significant improvements by month 3—fewer cystic breakouts, smoother skin, and more even tone.
Oral Minoxidil
Week 1-4
Early Shedding is Normal
Some users experience an increase in shedding during the first month—this means older hairs are making way for new growth.
Week 5-12
Subtle Signs of Progress
You may notice reduced shedding or fine baby hairs emerging along the hairline or crown. Results are still building—stick with daily use.
Week 12+
Noticeable Regrowth and Density
Hair appears fuller and thicker in areas of previous thinning. Most users see visible improvements in density and coverage by month 6 with consistent use.
Acne Cream
Week 1-2
Skin Adjustment Phase
Mild dryness, peeling, or a temporary purge may occur as your skin adjusts to increased cell turnover. Use moisturizer and SPF daily.
Week 3-6
Breakouts Diminish, Texture Improves
Blemishes begin to clear, and skin feels smoother as clogged pores are cleared and inflammation subsides.
Week 7-12
Brighter, Healthier-Looking Skin
Expect fewer breakouts and a visible reduction in post-acne marks and roughness. Continued use supports long-term clarity.
The Spot Corrector
Week 1-2
Early Adjustment
Mild tingling or dryness is normal as your skin adjusts. Continue with once-daily use unless otherwise advised.
Week 3-8
Visible Improvement
Dark spots begin to fade and skin tone appears more even and calm.
Week 9-16
Full Results
Brighter, clearer skin with reduced discoloration and improved tone. Continued use is key to maintaining results.
Hair Regrowth Spray
Week 1-4
Adjustment Phase
Your scalp may feel dry or irritated as it adjusts. Initial shedding can occur as dormant follicles transition to active growth.
Week 5-12
Less Shedding, Early Hints of Growth
You may see less hair in your brush and some fine regrowth beginning. Tretinoin and melatonin support absorption and scalp health.
Week 12+
Fuller Hair, Visible Improvements
With daily use, most users notice increased hair density and coverage in thinning areas. Continued use beyond month 3 is essential to maintain and build on results.