Who it's for
Adults with BMI ≥30, or BMI ≥27 with at least one weight-related comorbidity. Also approved for obstructive sleep apnea in adults with obesity (2024).
What the trials show
Zepbound's registration trial was SURMOUNT-1 (NEJM, 2022). At 72 weeks at the maximum dose, mean weight loss was 20.9% (17.8 percentage points greater than placebo). 91.0% of patients lost at least 5% of body weight; 56.7% lost at least 15%. Real-world results vary; trial patients are typically more adherent and more closely managed than typical telehealth patients.
Dose schedule
Dose levels: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg. Standard practice is to titrate up monthly, holding at any tolerated dose. Maximum dose is 15mg weekly; many patients reach goal weight at sub-maximum doses and stay there.
What it costs in 2026
| Retail cash (no insurance, no DTC) | $1,099/mo |
| Manufacturer DTC (cash-pay direct) | $349-$549/mo via LillyDirect (vials cheaper than pens) |
| With insurance + prior authorization | $25-$50/mo with prior authorization |
| Compounded version (503A pharmacy) | $199-$349/mo via 503A pharmacies (regulatory exposure) |
Telehealth programs add a membership fee on top of the medication cost (typically $40-$200/mo). For all-in monthly costs by program, see the chart.
Common side effects
The most commonly reported side effects in the registration trial:
- nausea (29%)
- diarrhea (23%)
- constipation (17%)
- vomiting (13%)
- abdominal pain (10%)
Boxed warning: Risk of thyroid C-cell tumors (rodent data); contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN2 syndrome.
How Zepbound differs from related drugs
Same molecule as Mounjaro, branded specifically for weight loss. The dual-agonist mechanism produces greater mean weight loss in trials than semaglutide-only drugs.
Compounded tirzepatide
Compounded tirzepatide is the same active molecule prepared by a 503A pharmacy under prescription rather than manufactured under FDA new-drug approval as Zepbound. Cash-pay savings versus branded Zepbound are typically 50-80%, but the regulatory environment has tightened. Briefly on FDA shortage list early 2024, off the list since late 2024. Lilly has filed coordinated lawsuits against compounded tirzepatide pharmacies through 2025-2026. For the comparison, see compounded vs FDA-approved semaglutide.
Programs that prescribe Zepbound
These programs in our chart prescribe Zepbound (with insurance coverage where applicable, or as a cash-pay option). Ranked by overall score.
Zepbound vs other GLP-1s
Editorial disclosure
GLP Chart is an editorial comparison site. We do not dispense, prescribe, or fulfill medications. Talk to a licensed clinician about whether Zepbound is appropriate for you. Pricing reflects publicly verified rates as of 12 May 2026; verify with the manufacturer or your prescriber before committing.