Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
Overview
Zepbound is a brand name for tirzepatide, a once-weekly injection made by Eli Lilly Canada. Health Canada has authorized it for chronic weight management in adults, along with a reduced-calorie diet and more physical activity. It is also authorized for moderate to severe obstructive sleep apnea in adults with obesity.
Zepbound is the weight-management product. Mounjaro contains the same medicine and is the tirzepatide product authorized for type 2 diabetes. Zepbound is not authorized for anyone under 18.
Zepbound needs a prescription. BC residents can speak with a BC-licensed doctor by phone through Avee Health to ask whether it is appropriate for them. The doctor decides based on your health history. A prescription is not guaranteed.
In Canada, Zepbound is authorized for adults, along with a reduced-calorie diet and more physical activity:
- For chronic weight management if BMI is 30 kg/m2 or higher
- For chronic weight management if BMI is 27 to under 30 kg/m2 and there is at least one weight-related condition, such as high blood pressure, abnormal cholesterol, prediabetes, type 2 diabetes, obstructive sleep apnea or cardiovascular disease
- To treat moderate to severe obstructive sleep apnea in adults with obesity (BMI 30 kg/m2 or higher)
Zepbound is not recommended together with Mounjaro or any other tirzepatide product, or with a GLP-1 medicine such as semaglutide. Its safety and effectiveness with other weight-management products have not been established. It is not authorized for people under 18. For type 2 diabetes, Health Canada has authorized Mounjaro.
Tirzepatide
GIP and GLP-1 receptor agonist
weight management
Prescription required
Available
How Zepbound Works
Tirzepatide activates two hormone receptors, GIP and GLP-1. Your gut releases both hormones after you eat. They act on the brain and gut to lower appetite and slow how quickly the stomach empties, so you feel full sooner and eat less. It is injected once a week.
Dosage Instructions of Zepbound
Your doctor sets your dose. The usual schedule in the Canadian product monograph is:
- Start: 2.5 mg once weekly for 4 weeks. This is a starting dose to help the body adjust.
- Then: 5 mg once weekly. If needed, the dose goes up in 2.5 mg steps, with at least 4 weeks at each dose.
- Maintenance for weight management: 5 mg, 10 mg or 15 mg once weekly
- Maintenance for sleep apnea: 10 mg or 15 mg once weekly
- Maximum: 15 mg once weekly
Zepbound is injected under the skin of the abdomen, thigh or upper arm, on the same day each week. Use a different spot each week. You can change your injection day if there are at least 3 days (72 hours) between two doses. Each pen holds four weekly doses.
Missed dose: take it as soon as you can if it is within 4 days (96 hours) of the missed dose. If more than 4 days have passed, skip it and take the next dose on your usual day. Do not change your dose without talking to your doctor.
Storage Instructions
Store Zepbound in the refrigerator at 2°C to 8°C and protect it from light. Do not freeze it, and do not use it if it has been frozen. If needed, it can be kept unrefrigerated at no more than 30°C for up to 30 days. Throw out the pen after four weekly doses, in a puncture-resistant container. Keep out of reach of children.
Side Effects of Zepbound
The most common side effects affect the stomach and gut. In the 72-week weight-management trials, the percentages below were for the 5 mg to 15 mg doses, compared with placebo:
- Nausea: 25% to 29%, compared with 9% on placebo
- Diarrhea: 19% to 23%, compared with 8%
- Constipation: 11% to 17%, compared with 5%
- Vomiting: 8% to 13%, compared with 2%
- Abdominal pain: 9% to 10%, and indigestion: 9% to 10%
- Injection site reactions: 6% to 8%, compared with 2%
- Fatigue: 5% to 7%, compared with 3%. Hair loss: 4% to 5%, compared with 1%
These effects are most common when starting Zepbound or raising the dose. About 5% to 7% of people on Zepbound stopped it because of side effects, compared with 3% on placebo.
Get medical help right away if you have:
- Severe stomach pain that does not go away, with or without vomiting (possible pancreatitis)
- A lump or swelling in the neck, hoarseness, or trouble swallowing or breathing
- Signs of a serious allergic reaction, such as swelling of the face or throat
- Vomiting or diarrhea that leaves you unable to keep fluids down
- New or worsening depression, or thoughts of suicide
- Sudden vision changes
Important Safety Information About Zepbound
Thyroid tumours: the Canadian monograph carries a boxed warning. Tirzepatide caused thyroid C-cell tumours in rats. It is not known whether this happens in humans. Do not use Zepbound if you or a family member have had medullary thyroid cancer, or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2).
Allergy: do not use Zepbound if you are allergic to tirzepatide or any ingredient in it. The pen contains benzyl alcohol.
Pregnancy: do not use Zepbound while pregnant. Stop it at least 1 month before a planned pregnancy.
Breastfeeding: in a study, tirzepatide was undetectable or at very low levels in breast milk. Talk to your doctor before breastfeeding while on Zepbound.
Pancreatitis: stop the medicine and seek care if you develop severe, persistent abdominal pain.
Gallbladder problems: in trials, gallstones were reported in 1.1% of people on Zepbound and 1.0% on placebo. Gallbladder inflammation was reported in 0.6% and 0.2%.
Kidneys: vomiting and diarrhea can cause dehydration, which can worsen kidney function. Drink fluids and tell your doctor if these effects persist.
Low blood sugar: the risk is higher in people with type 2 diabetes who also take a sulfonylurea or insulin. The doses of those medicines may need to be lowered.
Mood: tell your doctor about any new or worsening depression, thoughts of suicide, or unusual changes in mood or behaviour.
Eyes: a fast improvement in blood sugar can temporarily worsen diabetic retinopathy. A sudden vision problem called NAION has been reported with GLP-1 medicines. Get care quickly for any sudden change in vision.
Surgery and procedures: Zepbound slows stomach emptying. Tell your care team you take it before general anesthesia or deep sedation.
Stomach and heart: Zepbound is not recommended for people with severe stomach or gut disease, such as severe gastroparesis. It has not been studied in the most severe (class IV) heart failure. In trials it raised heart rate by about 3 beats per minute on average.
Drug Interactions
Tell your doctor and pharmacist about everything you take, including non-prescription products. Points from the Canadian monograph:
- Birth control pills: Zepbound can lower the amount of the pill your body absorbs. Switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after starting Zepbound and for 4 weeks after each dose increase.
- Insulin and sulfonylureas: the risk of low blood sugar is higher. Your doctor may lower the dose of these medicines.
- Mounjaro, other tirzepatide products and GLP-1 medicines: using them together with Zepbound is not recommended.
- Other medicines taken by mouth: Zepbound slows stomach emptying, which could affect how they are absorbed.
- Medicines that raise heart rate: use with caution.
Brands & DIN Number of Zepbound
Brand Names
Zepbound
DIN (Drug Identification Numbers)
- 02557509
- 02557517
- 02557525
- 02557533
- 02557541
- 02557568
Key Takeaways
- 1Zepbound is tirzepatide, a once-weekly injection authorized in Canada for chronic weight management and for moderate to severe sleep apnea in adults with obesity.
- 2Mounjaro is the tirzepatide product for type 2 diabetes. Using the two together is not recommended.
- 3Dosing starts at 2.5 mg weekly for 4 weeks. Weight-management maintenance doses are 5 mg, 10 mg or 15 mg weekly.
- 4Nausea, diarrhea, constipation and vomiting are the most common side effects.
- 5Do not use it with a personal or family history of medullary thyroid cancer or MEN 2, or during pregnancy.
- 6It can make birth control pills less effective for 4 weeks after starting and after each dose increase.
- 7Zepbound needs a prescription. BC residents can ask a BC-licensed doctor by phone whether it is right for them.
Frequently Asked Questions
Avee Editorial
Avee Editorial Team