6 Zepbound alternatives to try amidst a shortage

We hate to be the bearer of bad news but just because there’s no longer a shortage of Zepbound (tirzepatide) doesn’t necessarily mean filling your prescription will be a walk in the park. Because supply can (and often does) vary across pharmacies, you may experience delays in getting the weight loss medication. The good news? There are several Zepbound alternatives on the market that you can discuss with your healthcare provider. Read on the learn more about these other medications. 

Below, we dig deeper into these other medications and offer advice for finding Zepbound in stock—plus, what to do if you have to stop Zepbound, whether because of limited availability or another reason.

At the time of publication, tirzepatide (the active ingredient in Zepbound) is not in shortage, according to the Drug Shortages website managed by the US Food and Drug Administration (FDA). So, all dosage strengths of Zepbound—2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg—are considered available and, therefore, should be in stock at your pharmacy. Keyword being “should.” Because supply can vary across pharmacies, you may still have difficulty filling your prescription at your local pharmacy. 

Zepbound is not the only tirzepatide drug available: Mounjaro is also in stock. While the two medications contain tirzepatide as the active ingredient, come in the same dosage strengths, and are produced by Eli Lilly, they have different FDA-approved indications.  

• Zepbound is intended for people with obesity and overweight and helps with weight loss and weight management when taken in combination with a reduced-calorie diet and increased physical activity. 

• Mounjaro is intended for people with type 2 diabetes and helps lower blood sugar levels when used in combination with diet and exercise. 

Despite these differences, both Zepbound and Mounjaro have experienced shortages in the past due to an “unprecedented demand” that outpaced supply, per Eli Lilly. And while there’s been an increase in availability of the two drugs, during an early 2024 investor call, Eli Lilly acknowledged that it expects demand to outpace supply through the rest of this year. Meaning, those prescribed Zepbound  might face problems finding the medication in stock again in the next months. 

During the investor call, the company also said it plans to produce 1.5 times as many doses of Zepbound in the second half of 2024 compared to the amount they churned out during the same time last year. Seemingly with this goal in mind, Eli Lilly has been working to expand their global manufacturing and supply chain. In June 2024, for example, the drug maker opened a new plant in North Carolina. It also plans on building new facilities (such as one in Germany) in the coming years and expanding manufacturing capacity at some sites. 

Despite these strides forward, however, Eli Lilly still expects that demand for its highly popular weight loss drug will outpace supply throughout the rest of the year. With this in mind, it’s a good idea to learn what your options are during a Zepbound shortage (and in general), so you can be prepared should it ever affect your specific dosage.

As mentioned above, all dosage strengths of Zepbound are currently available at the time of publication. But to get a better idea of Zepbound’s availability, you can search for “tirzepatide” on the FDA Drug Shortages website. You can also sign up for supply update emails on the LillyDirect website (check “Lilly medicine/supply updates” when subscribing) as well as through the Ro GLP-1 Supply Tracker, a free and accessible tool that helps patients (and providers!) stay informed about the latest drug shortages. Through the tracker, you can report shortages to the FDA, track which drugs are currently in short supply (according to the FDA and community reports), as well as receive updates when supply becomes available nearby.

If you’re having trouble obtaining your medicine during a Zepbound shortage or in general, given local variability, Eli Lilly recommends calling different pharmacies in your area. The manufacturer also suggests contacting your pharmacy for a refill at least one week before it's needed. Many pharmacies offer home shipping, so you may be able to call ones that are even further away. 

You can also try ordering your Zepbound prescription through an online pharmacy. If you continue to experience difficulty getting your prescription (or just want to be safe), contacting your healthcare provider is a good idea; they should be able to assist you with a treatment in light of the Zepbound shortage.

If you typically get a one-month supply of Zepbound, consider asking if two- or three-month supplies are available to give you even more wiggle room.

There are a few medications you can take instead of Zepbound to help with weight loss. While some of these are FDA-approved for chronic weight management, others may be prescribed off-label for weight loss.

Below are several Zepbound alternatives along with their current availability. All of these drugs work best when combined with lifestyle changes, such as diet and exercise. The first five options include injectable medications that hail from the same drug class as Zepbound, which are called GLP-1 receptor agonists. Because they work in similar ways, these drugs typically share many side effects with Zepbound, including nausea, vomiting, diarrhea, and decreased appetite. Also listed below as potential Zepbound alternatives are oral medications that have been FDA-approved for weight loss. 

1. Mounjaro (tirzepatide)

One common Zepbound alternative is Mounjaro (tirzepatide). As noted earlier, Mounjaro contains the same active ingredient as Zepbound and comes in the same range of dosage strengths. It also has similar side effects and is injected on a weekly basis.

The key difference between these medications is that Mounjaro is FDA-approved to treat type 2 diabetes, while Zepbound is FDA-approved for chronic weight management. However, as both drugs contain the same active ingredient, healthcare providers may prescribe Mounjaro off-label for weight management. In clinical trials, Mounjaro produced an average weight loss of 6–8% within 10 months in people with type 2 diabetes.

Like Zepbound, Mounjaro is a dual GIP/GLP-1 receptor agonist. This name refers to the two gut hormones the drug mimics: glucose dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). Mounjaro was the first drug in its class to target both receptors. As a GIP/GLP-1 receptor agonist, Mounjaro (like Zepbound) works by increasing insulin and inhibiting glucagon after you eat, thereby keeping your blood sugar levels in check. GLP-1 drugs can also slow down digestion, so you tend to feel full sooner and may eat less as a result. 

Current availability: At the time of writing, all dosage strengths of Mounjaro are available, as reported by the FDA as well as Eli Lilly.

2. Wegovy (semaglutide)

Wegovy (semaglutide) is another FDA-approved medication for weight loss that’s injected on a weekly basis. It’s intended for people with obesity and overweight as a treatment for weight loss and weight management alongside diet and exercise. Wegovy is also FDA-approved to reduce the risk of major cardiovascular events (e.g. stroke, heart attack, and death) in people with heart disease and obesity or overweight. It shares a similar list of contraindications and side effects with Zepbound.

While Wegovy and Zepbound belong to the same class of injectable medications for weight loss, Wegovy is a GLP-1 receptor agonist, which means it only targets a single receptor. While no studies to date have compared Zepbound and Wegovy, indirect comparisons suggest that people lose more weight on the higher 10 mg and 15 mg dosage strengths of Zepbound than the highest 2.4 mg dosage of Wegovy. Even so, people still tend to lose a substantial amount of weight on Wegovy. In clinical trials, people taking Wegovy lost 15–16% of their body weight after just a year and half. 

Current availability: Like Zepbound, Wegovy is also a hugely popular medication and often experiences drug shortages due to the same issues, namely demand outpacing supply. At the time of writing, however, all five of the drug’s dosage strengths—0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg—are listed as “available,” according to the FDA Drug Shortages database.

3. Saxenda (liraglutide)

Saxenda (liraglutide) is another injectable medication for weight loss similar to Zepbound and Wegovy. However, it differs from Zepbound in that it must be injected on a daily (vs. weekly) basis. Many of Saxenda’s side effects are similar to those that may occur with Zepbound, but the Zepbound alternative can also cause headache, hypoglycemia (low blood sugar), dizziness, increased lipase levels, fever, and gastroenteritis.

Weight loss with Saxenda is less profound than with Wegovy or Zepbound, but it’s still significant. In clinical trials, many people lost around 5–7.5% of their body weight after a year of taking Saxenda.

Current availability: Saxenda is currently experiencing a shortage with an unknown end date, according to the FDA.

4. Ozempic (semaglutide)

Ozempic (semaglutide) shares the same active ingredient as Wegovy, and it is also injected on a weekly basis. However, unlike Zepbound, it is FDA-approved to control blood sugar levels in people with type 2 diabetes and, in those who also have heart disease, to lower their cardiovascular risk.

Ozempic and Wegovy share a similar backstory to Mounjaro and Zepbound, where their active ingredient was first developed to treat type 2 diabetes. Then, as researchers discovered the drug’s ability to produce weight loss as well, the manufacturers sought FDA approval for weight management and released a separate brand name version of the drug. However, while Zepbound and Mounjaro are available in similar dosage strengths and share similar side effects, Ozempic contains lower dosage strengths of semaglutide, the active ingredient it shares with Wegovy. 

Ozempic also has a shorter list of side effects than Wegovy, although it’s still common to experience gastrointestinal symptoms like the other drugs on this list of Zepbound alternatives, such as nausea, vomiting, diarrhea, abdominal pain, and constipation. In clinical trials, people with type 2 diabetes lost an average of 13–15 pounds after 10 months of taking Ozempic.

Current availability: At the time of writing, all dosage strengths of Ozempic are available despite the drug’s active ingredient, semaglutide, being categorized as “currently in shortage,” on the FDA Drug Shortages website.

5. Trulicity (dulaglutide)

Trulicity (dulaglutide) is another medication for type 2 diabetes that may be prescribed off-label for weight loss. Similar to Ozempic, it helps lower blood sugar levels in people with type 2 diabetes who have not found success with other treatments, such as metformin. It can also lower the risk of heart attack, stroke, or death in people who have type 2 diabetes and heart disease. 

Trulicity is available in four dosage strengths, with people taking higher dosage strengths typically losing more weight. In one study, people with type 2 diabetes lost between 7–10 pounds after nine months of taking Trulicity. Trulicity’s side effects are similar to those of other Zepbound alternatives (e.g. nausea, diarrhea, vomiting, and abdominal pain).

Current availability: While dulaglutide (the active ingredient in Trulicity) is categorized as “currently in shortage,” all dosage strengths of the brand-name drug are available,  per the FDA. 

6. Non GLP-1s

In addition to Zepbound, Wegovy, and Saxenda, the FDA has approved other medications for weight loss that are not GLP-1s. These include Qsymia (phentermine/topiramate), Contrave (naltrexone/bupropion) and Xenical or Alli (orlistat). 

These medications also differ from the GLP-1s on this list in that they are taken orally on a daily basis. (In the case of Orlistat, the recommended dosage schedule is three times daily.) Similar to GLP-1 drugs, though, these medications may cause gastrointestinal upset and other digestive side effects. Depending on the medication, other side effects may include headache, insomnia, dizziness, tingling sensations, anxiety, and irritability. 

All three of these weight loss pills have been shown to produce an average weight loss of at least 5% in clinical trials. In one year, people taking Qsymia (phentermine/topiramate) lost an average of 19 pounds, Contrave (naltrexone/bupropion) lost an average of 11 pounds, and Xenical or Alli (orlistat) lost an average of almost 6 pounds.

Current availability: Neither Qsymia, Contrave, Xenical, nor Alli are reported to be experiencing a drug shortage at the time of writing, according to the FDA, though availability may change depending on your local pharmacy.

You shouldn’t stop taking Zepbound without first talking to a healthcare professional. If a Zepbound shortage disrupts your treatment, talk to your healthcare provider about your options. They may be able to help you find a refill or direct you towards an alternative treatment. If you have to stop Zepbound, keep up with the lifestyle changes you started during treatment, such as diet and exercise. 

Zepbound has a half-life of about five days, but it will take some time for the drug to fully flush out of your system. Once you stop taking Zepbound, you may notice a few changes as the effects of the medication wear off:

• Side effects should subside

• Your appetite may return

• You may regain weight

If the Zepbound shortage forces you to stop taking the medication, we understand that it can be disheartening. But you can still make lifestyle changes including dietary changes and exercise to keep weight off and potentially lose even more.

Try as pharmaceutical companies might to keep up with demand, it seems like the skyrocketing popularity of many weight loss medications will continue to outpace production at least for a couple of months. So, although there isn’t a Zepbound shortage at the moment, it still might be increasingly difficult to obtain doses. If you're worried about a Zepbound shortage and how it might impact you, it's always a good idea to talk to your healthcare provider; they’re best equipped to help you navigate challenges, such as local variability, and determine whether any Zepbound alternatives might work for you. You can also stay up to date on the Zepbound shortage—and any others—by looking up the drug’s active ingredient on the FDA Drug Shortage database as well as checking the manufacturer’s web site or using the Ro GLP-1 Tracker. 

---

How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

November 01, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD

---

About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.