Zepbound vials: what they are, how to use them, and more

Zepbound (tirzepatide) is one of the most effective weight loss injections available today, with people losing up to 20.9% of their body weight in clinical trials. But Zepbound is also expensive. Out-of-pocket, the drug costs over $1,000 per month. Zepbound vials, a more affordable alternative, are now available directly from Eli Lilly and Ro (yes, Ro!).  

How do Zepbound vials differ from the pens? How many doses come in a Zepbound vial? In this guide to Zepbound vials, we answer those questions and more.

Zepbound vials contain the same medicine approved by the US Food and Drug Administration (FDA) as the Zepbound pre-filled pens—the liquid, if you will, is just housed in a different package. Like the pens, Zepbound vials are made by Eli Lilly and intended for weekly use.  They’re currently available in two dosage strengths (2.5 mg and 5 mg), and each vial holds a single dose of the drug. You must use a separate syringe to draw the medication from Zepbound vials before administering your dose with a needle.

Zepbound vials were introduced in late August 2024 in an effort to increase supply of and accessibility to the medication. They’re available for “less than half the list price” of the Zepbound pens, according to an Eli Lilly press release. 

Zepbound vials and pens contain the same active ingredient (tirzepatide), which is a dual-action GLP-1 and GIP agonist that helps regulate your metabolism. This means you can expect the same efficacy and side effects when taken at the same dose. However, there are some key differences between Zepbound vials and pens.

• Dosage strengths. Zepbound vials are only available in two dosage strengths: the starting dose of 2.5 mg and the lowest maintenance dose of 5 mg. The pens are available in all six dosage strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. 

• Administration. With Zepbound vials, you use a separate needle and syringe to draw out the medication yourself. Zepbound injector pens come prefilled with a needle attached.

• Cost. Zepbound vials cost $399 for a four-week supply of the 2.5 mg dose and $549 for a four-week supply of the 5 mg dose. These are cash-only prices, as the Zepbound vials are not eligible for insurance coverage. The Zepbound pens cost more than double, with a list price of $1,086.37 for a four-week supply and a retail price that averages $1,249.99–$1,404.69, according to SingleCare. 

• Insurance coverage. Zepbound vials are not eligible for insurance coverage. They can only be purchased when paying cash. Zepbound pens, on the other hand, are eligible for insurance coverage, but insurance coverage may vary.

• Coupon eligibility. Zepbound vials have a set price of $399–$549 and cannot be purchased with any coupons. Meanwhile, you can use Zepbound coupons to pay for your refill, such as the official Zepbound Savings Card from Eli Lilly (if you’re eligible) or pharmacy discount cards like those offered by certain sites (e.g. SingleCare, GoodRx).

• Availability. Zepbound vials can only be purchased directly from Eli Lilly through their LillyDirect program or through Ro. Zepbound pens can be purchased from any pharmacy that has them in stock, as well as through weight loss programs such as Ro’s Body membership. Both forms of the drug require a prescription from a licensed healthcare provider.

To use Zepbound vials, you’ll need to use a separate needle and syringe to draw the medication out from the vial and give yourself a shot. These needles and syringes are not included with the vials and must be purchased separately. You’ll use a new needle and syringe each time you inject Zepbound. 

You should always follow your healthcare provider’s advice and the instructions that come with the medication. But here’s a general idea of how to use Zepbound vials:

1. Gather your supplies and wash your hands with soap and water.

2. Pull off the plastic cap from the vial, but keep the rubber stopper intact.

3. Wipe the rubber stopper with an alcohol swab.

4. Remove the outer wrapping from the syringe and the needle. Attach the needle to the syringe if needed.

5. Remove the needle shield by pulling it straight off.

6. Hold the syringe in one hand with the needle pointing up. Use your other hand to pull down on the plunger until the tip reaches the line on the syringe indicating the 0.5 mL of air has been drawn into it.

7. Push the needle through the rubber stopper of the vial, then push the plunger all the way in.

8. With the syringe still in the vial, turn the vial and syringe upside down. Make sure that the needle tip is in the liquid and slowly pull the plunger until the plunger tip is past the 0.5 mL line. (If you see any air bubbles, tap the syringe gently a few times.)

9. Slowly push the plunger up until the tip reaches the 0.5 mL line. 

10. Pull the syringe out of the vial’s rubber stopper.

11. Choose your injection site (i.e. abdomen, thigh, or, if someone else is giving your injection, back of your upper arm).

12. Insert the needle into the skin of your injection site.

13. Push down on the plunger to inject your dose and keep it there for at least 5 seconds.

14. Pull the needle out and throw it and the syringe in a FDA-cleared sharps disposal container.

15. If you see any blood on the skin of your injection site, dab it with gauze or an alcohol swab. Do not rub.

Each Zepbound vial contains a single dose of the medication, which makes it easy to ensure you’re getting a full dose when you take the medication. Each order of Zepbound vials comes in a four-week supply. It contains four vials, each of which contains one dose of the medication. The 2.5 mg vials cost $399 ($99.75 per vial), and the 5 mg vials cost $549 ($137.25 per vial). 

The eligibility criteria for Zepbound vials are generally the same as for Zepbound pens since both forms of the medication are prescribed based on the drug’s FDA-approved uses. 

Need a quick refresher? You got it. Zepbound is indicated in combination with diet and exercise to:

• Reduce excess body weight and maintain weight reduction long term in adults with obesity or with overweight and at least one weight-related health condition (e.g. high blood pressure, high cholesterol, type 2 diabetes, heart disease)

• Treat moderate-to-severe obstructive sleep apnea in adults with obesity

The choice between vials and pens is often influenced by patient preference, dosing flexibility, or specific medical needs—all of which should be discussed with a healthcare provider to best determine which form of the drug might be the best fit for you. 

You can get Zepbound vials through Eli Lilly and directly through Ro. 

As of mid-December, Ro and Eli Lilly partnered to offer a complete end-to-end experience, providing access to the Zepbound vials on a single platform. You can meet with a provider and get a prescription for Zepbound vials (if appropriate) at the same time through Ro. After you complete an online health questionnaire, you’ll be connected with a healthcare provider who can prescribe Zepbound vials (or another GLP-1 medication, if appropriate). Then, your Zepbound vials will be shipped directly to you.

If you already have a prescription and want to purchase through Eli Lilly, visit the LillyDirect website. After you select “Zepbound” from the dropdown menu, you’ll see the NPI and NCPDP numbers you’ll need to share with your healthcare provider so they can send your prescription to LillyDirect pharmacy providers. 

Hear from Ro patients

Ro members taking branded GLP-1 medications were paid for their testimonials.

Sonia

Ro member

James

Ro member

Chaleeta

Ro member

Zepbound vials cost between $399–$549, depending on your prescribed dose. Impressed by these numbers? Makes sense, since they’re the lowest prices of tirzepatide currently available. The 2.5mg vials, which are typically prescribed to people starting Zepbound, cost $399 for a four-week supply ($99.75 per vial, per week). After you spend at least four weeks on the 2.5 mg dosage, your healthcare provider may recommend titrating up your dosage to 5 mg weekly. The 5 mg vials cost $549 for a four-week supply ($137.25 per vial, per week). 

The Zepbound vials cost less than half the list price of Zepbound pens, which is $1,086.37 for a four-week supply. The list price is the price at which Eli Lilly sells the products to wholesalers, so the retail price of Zepbound tends to be even higher. According to SingleCare, the average 12-month price of Zepbound ranges from $1,249.99 to $1,404.69, depending on the pharmacy.

Zepbound vials offer an accessible, cost-effective alternative to Zepbound pens, making this breakthrough weight loss medication more affordable for people who don’t have insurance coverage for Zepbound. Here’s a recap: 

• Zepbound vials are available in fewer dosage strengths than the pens. Zepbound vials are limited to the 2.5 mg and 5 mg doses, while the pens offer a wider range up to maximum dose of 15 mg.

• Zepbound vials cost less than half the cash price of Zepbound pens. Zepbound vials cost $399–$549 for a four-week supply, while a four-pack of Zepbound pens ranges from $1,250–$1,405. However, the vials are not eligible for insurance or coupons and can only be purchased when paying cash.

• Zepbound vials and pens each contain a single dose of the medication. Vials require the use of a separate needle and syringe, while pens come with a needle already attached.

For those prescribed 2.5 mg or 5 mg doses, the vials can be a more affordable option than the pens. While Zepbound vials require a few more steps to administer the medication, the savings can be well worth it. Talk to your healthcare provider to determine whether Zepbound vials or pens are the best fit for you.

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Current version

January 10, 2025

Written by

Amelia Willson

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.