Is Zepbound safe?

If you're considering taking Zepbound (tirzepatide) for weight loss, you might be asking yourself, is Zepbound safe? Whether you’ve learned about it from your healthcare provider, a friend, or an ad, trusting a medication you decide to take is essential for making informed choices about your health.

The good news is that Zepbound has been studied extensively, with solid scientific evidence supporting its safety and effectiveness. In this article, we’ll dive into everything you need to know about Zepbound—including how it works, its potential benefits, and any risks or precautions to keep in mind as you consider it for weight loss or chronic weight management.

Zepbound (tirzepatide) is a prescription medication approved by the US Food and Drug Administration (FDA) for weight loss in people with obesity or overweight who also have a weight-related condition, such as high blood pressure, high cholesterol, or type 2 diabetes. It is also approved for the treatment of sleep apnea in people with obesity. For both uses, Zepbound is meant to be used in combination with a reduced-calorie diet and increased physical activity.

It belongs to a class of medications called  GLP-1/GIP receptor agonists, which mimic the actions of two naturally occurring hormones in the body: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones regulate appetite, metabolism, and blood sugar levels, making them vital targets for addressing body weight and weight-related health challenges.

Zepbound's ability to act on two natural hormones sets it apart from other weight management medications. By reducing appetite, enhancing feelings of fullness, and regulating blood sugar levels, Zepbound helps people achieve sustainable weight loss. Its active ingredient, tirzepatide, is the same as in Mounjaro—an FDA-approved treatment for type 2 diabetes—but Zepbound is specifically approved for weight management.

Zepbound is available in two forms: single-dose vials and pre-filled pens, providing flexibility based on your preferences and needs. Both options are administered as once-weekly subcutaneous (under the skin) injections. While the medication is the same in both formats, there are differences in how they are prepared and used.

• Single-dose vials require you to draw the medication into a syringe before injecting it. This option may be suitable for those comfortable handling syringes and needles.

• Pre-filled pens come preloaded with a single dose and a built-in needle. The pens are ideal for those who may be new to injectable medications or prefer to avoid seeing or handling needles.

The form you choose—vials or pre-filled pens—can affect the cost of your treatment. Vials tend to be more cost-effective compared to pre-filled pens. Ro offers access to Zepbound vials and pens, providing options for those who want flexibility, especially when it comes to cost. Choosing between vials and pre-filled pens depends on individual comfort, budget, and preferences.

Zepbound doses start at 2.5 mg weekly and may gradually increase to a maximum dose of 15 mg based on how your body responds to treatment and tolerates the medication. Your healthcare provider will evaluate factors such as your weight loss progress, tolerance to the medication, and any side effects you experience to determine whether a dose adjustment is necessary. Whether or not you reach the maximum dose of 15 mg depends on your health goals and how well your body responds to lower doses. Some people experience weight loss and metabolic benefits at lower Zepbound doses, while others may require the highest dose to achieve optimal results. 

When combined with healthy lifestyle changes, such as a reduced-calorie diet and regular physical activity, Zepbound can be a valuable asset in a comprehensive weight management plan. It represents a modern advancement in obesity care, giving hope to people who struggle to lose weight through conventional methods alone. 

Zepbound (tirzepatide) promotes weight loss by influencing hormones that control appetite, metabolism, and blood sugar regulation. It is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, meaning it mimics the action of these two naturally occurring incretin hormones—hormones that regulate metabolism (how the body processes and stores energy), blood sugar control, and appetite. 

When you eat, these hormones typically signal your brain to feel full and satisfied. 

Zepbound’s innovative dual-action mechanism can help people achieve sustainable weight loss. Here’s how: 

• Reduces appetite: Zepbound slows gastric emptying, the rate at which food moves from your stomach to your small intestine. This keeps food in your stomach longer and sends signals to your brain that you’re full. When you feel satisfied for longer periods after meals, it’s easier to maintain a calorie deficit for weight loss. 

• Regulates blood sugar (glucose): Zepbound improves insulin sensitivity (how effectively the body uses insulin). Insulin, produced by the pancreas, is responsible for moving glucose (sugar) from the bloodstream into cells for energy. The GLP-1 component of Zepbound triggers your body to release more insulin after you eat. The GIP component of Zepbound enhances how sensitive your body is to insulin and improves how your cells use energy. This regulation of blood sugar levels not only supports weight loss but may also promote a beneficial shift in metabolism and lower the risk of weight-related health complications. 

In one large-scale study, participants taking Zepbound achieved an average weight loss of 15 to 20.9% of their body weight over 72 weeks when combined with lifestyle interventions, such as diet and exercise. In contrast, participants taking a placebo (a “fake” treatment) lost only around 3% of their body weight, on average.  This outcome surpasses the results typically seen with other weight loss medications that target only GLP-1 receptors, such as Ozempic (semaglutide) and Wegovy (semaglutide).

Zepbound can also lower the risk of weight-related health conditions. Research shows that Zepbound may reduce blood pressure and cholesterol levels, improving cardiovascular health and reducing the risk of major cardiovascular events like heart attack and stroke. 

Overall, Zepbound’s unique mechanism of action and strong clinical evidence highlight its potential as an important treatment for weight management. As part of a comprehensive weight management strategy, Zepbound can promote weight loss and lead to better long-term health outcomes. 

Yes, Zepbound is considered safe when used as prescribed. It is approved by the US Food and Drug Administration (FDA), meaning it has undergone rigorous clinical trials to evaluate its safety and efficacy. The FDA approval ensures that it meets strict safety standards and provides clear guidelines for its proper use.

Like any medication, Zepbound has risks, and its use may not be safe for everyone. It also comes with the potential for side effects. If you’re considering Zepbound, talk to a healthcare provider to determine if it’s the right option for your health needs and goals.

As with any medication, Zepbound comes with the potential for side effects. Most side effects are mild to moderate and tend to improve as the body adjusts to the medication. The most common Zepbound side effects include: 

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Abdominal pain 

• Indigestion

• Discomfort at the injection site

• Fatigue 

• Hair loss 

These side effects are often more noticeable during the early weeks of treatment. Your provider will likely start you at a low dose to help your body adjust to the medication and minimize side effects. 

Sometimes, side effects can become more intense or noticeable at higher doses as the medication’s effects on appetite and digestion are amplified. Even with gradual dose increases, some people may not be able to tolerate Zepbound. In studies for weight loss, around 5-7% of participants had to stop taking the medication during the first few months of treatment, mainly due to gastrointestinal side effects. But don’t quit taking it on your own—tell your healthcare provider if you’re having persistent nausea, vomiting, or other side effects. They may lower your dose or recommend switching to a different weight loss medication, such as semaglutide.

Adverse events can occur with Zepbound (tirzepatide), though serious ones are generally rare. Stop using Zepbound and contact your healthcare provider immediately if you experience any of the following serious side effects:

• Allergic reactions. Symptoms of an allergic reaction to any ingredients in Zepbound may include swelling of the face or throat, difficulty breathing or swallowing, itching or rash, dizziness, fainting, or rapid heartbeat. Injection site reactions can also develop, causing itching, swelling, and a skin rash. 

• Pancreatitis. If Zepbound causes inflammation of your pancreas (pancreatitis), symptoms may include severe abdominal pain that persists and may radiate to your back, accompanied by nausea or vomiting.

• Gallbladder problems.  Symptoms may include pain in the upper right abdomen, fever, yellowing of the skin or eyes, or pale, clay-colored stools.

• Kidney problems. Dehydration due to Zepbound side effects like vomiting and diarrhea can worsen symptoms like infrequent urination, swelling, and fatigue in people with existing kidney disease.  In rare cases, kidney injury may occur even in those without prior kidney disease.

• Low blood sugar (hypoglycemia).Symptoms may include dizziness, blurred vision, rapid heartbeat, confusion, shakiness, or excessive hunger. This is more common if Zepbound is used alongside other blood sugar-lowering medications like insulin.

• Vision changes. Symptoms may include blurred vision, floaters, or spots in your visual field. People with a history of diabetic retinopathy (a condition causing damage to the retina) should be closely monitored, as Zepbound may worsen symptoms.

• Gastroparesis or bowel obstruction. Zepbound can slow stomach emptying, and in rare cases, this can lead to issues like severe nausea, vomiting, or bowel obstruction.

There is a boxed warning for Zepbound regarding the potential risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). People with a personal or family history of thyroid tumors may not be suitable candidates for Zepbound or similar medications. Although the warning about thyroid tumors is based on animal studies and has not been seen in humans, it's best to err on the side of caution and avoid Zepbound if you or a family member have a history of thyroid cancer.

Tell your healthcare provider immediately if you experience symptoms such as difficulty swallowing, a lump or swelling in your neck, hoarseness, or shortness of breath, as these could be signs of a thyroid tumor. 

With proper monitoring and guidance, Zepbound can be a safe and helpful part of a weight management plan. Still, it’s important to discuss your medical history and any concerns with your healthcare provider before starting this medication.

Zepbound may interact with other medications, so it’s important to inform your healthcare provider about all prescription and over-the-counter medications you currently take, as well as dietary supplements and herbal remedies. Being transparent about your medication use can help reduce the risk of potential interactions and side effects. Talk to your healthcare provider or pharmacist for guidance if you’re unsure about a specific medication or supplement. 

Drugs that can potentially interact with Zepbound include: 

• Oral medications. Zepbound can delay gastric emptying and slow digestion, affecting how well your body absorbs oral medications, including birth control pills and other medicines taken by mouth. While clinical trials suggest that these effects are generally minimal, it’s important to discuss concerns with your healthcare provider if you rely on oral medications for managing chronic conditions. 

• Insulin and sulfonylureas. The risk of hypoglycemia (dangerously low blood sugar levels) is higher if you’re taking Zepbound alongside certain diabetes medications. These include insulin and sulfonylureas, which are medications that stimulate insulin production (e.g., glyburide, glipizide, or glimepiride). Close monitoring of blood sugar levels is important with these combinations, and your provider may adjust the dosage of your diabetes medications when you start Zepbound.

• GLP-1 receptor agonists. Since Zepbound already has GLP-1 activity, it should not be taken with other GLP-1 receptor agonist medications. Doing so could increase the risk of severe side effects or complications.

Always consult your healthcare provider or pharmacist before starting or stopping any medications while taking Zepbound to ensure your treatment plan is safe and addresses your health needs. 

Zepbound (tirzepatide) may not be suitable for everyone. It is not recommended for people who are pregnant, breastfeeding, or planning to become pregnant in the near future. Experts recommend you discontinue Zepbound at least two months before trying to conceive. 

It’s also important to avoid Zepbound use if you have a personal or family history of medullary thyroid carcinoma (a rare type of thyroid cancer) or multiple endocrine neoplasia syndrome type 2 (MEN 2), a genetic condition affecting hormone-producing glands. These conditions are associated with a higher risk of thyroid tumors.

If you have a history of pancreatitis, kidney disease, or other health conditions, speak with your healthcare provider to determine if Zepbound is the right option for you. Some conditions may require closer monitoring or an alternative treatment plan. Before prescribing Zepbound, your healthcare provider will carefully review your medical history, considering factors like medical conditions and current medications, to ensure Zepbound is safe. 

Zepbound is a promising tool for weight management, but it’s not for everyone. If you’re considering Zepbound, talk to your healthcare provider to determine if it fits your health and weight-loss goals.

• Zepbound is FDA-approved for weight management. It is a safe and effective weight loss medication for adults with obesity or overweight who have weight-related health conditions. 

• Zepbound works by regulating blood sugar and appetite. Zepbound’s dual-action mechanism mimics natural hormones to reduce appetite, slow digestion, and improve how the body processes blood sugar, making it easier to lose weight sustainably.

• Mild side effects are common but often temporary. Most users experience nausea, diarrhea, or constipation during the early weeks of treatment, but these symptoms typically improve as the body adjusts to the medication or dose increase. 

• Some people should not use Zepbound. People with a history of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, or severe allergic reactions to its ingredients should avoid Zepbound.

• Long-term use depends on individual needs. While Zepbound is designed for long-term use, your healthcare provider will assess your progress and goals to determine how long you should stay on the medication.

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Current version

February 28, 2025

Written by

Lindsay Curtis

Fact checked by

Patricia Weiser, PharmD

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About the medical reviewer

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.