Zepbound Cost, Dose and Side Effects (Tirzepatide)
Zepbound cost on 3 October 2026: $299 to $449 a month self-pay, $25 with covering insurance, $50 on Medicare's Bridge. Plus label dosing and side effects.
The short version
Zepbound is a once-weekly injection of tirzepatide, made by Eli Lilly. The FDA has approved it for long-term weight management in adults with obesity, or overweight plus a weight-related condition. It is also approved for moderate-to-severe obstructive sleep apnoea in adults with obesity. It is the same molecule as Mounjaro, which is approved for type 2 diabetes. As of 3 October 2026, Lilly sells Zepbound vials and KwikPens without insurance for $299 to $449 a month with on-time refills, depending on the dose. With a covering commercial plan, Lilly's savings card can bring a fill to $25. Medicare's GLP-1 Bridge charges $50 a month to people who qualify.
- Without insurance, Lilly charges $299 to $449 a month for Zepbound vials or KwikPens with on-time refills (3 October 2026). The list price is $499 to $1,086.37 per fill.
- A covering commercial plan plus Lilly's savings card can cut a single-dose pen fill to $25. Medicare's GLP-1 Bridge charges $50 a month for the KwikPen if you qualify.
- It starts at 2.5 mg once weekly. It rises in 2.5 mg steps, at least four weeks apart, to a maintenance dose of 5, 10 or 15 mg.
- Nausea, diarrhoea, vomiting and constipation are the most common side effects. A boxed warning rules it out with a personal or family history of MTC or MEN 2.
- Compounded or "research" tirzepatide is not Zepbound and has not been through FDA review.
Without insurance, Zepbound costs $299 to $449 a month from Eli Lilly as of 3 October 2026, for the vials or the multi-dose KwikPen. The price depends on the dose, the format, whether you refill on time and your insurance. A commercial plan that covers it can bring the cost to $25 with Lilly’s savings card. Medicare’s GLP-1 Bridge charges $50 a month to people who qualify.
Zepbound is Eli Lilly’s brand name for tirzepatide, a once-weekly injection. The FDA has approved it, alongside a reduced-calorie diet and more physical activity, for two uses:
- long-term weight management in adults with obesity, or with overweight and at least one weight-related condition;
- moderate-to-severe obstructive sleep apnoea in adults with obesity.
The molecule itself, its evidence and its full safety detail are on the tirzepatide page.
How much does Zepbound cost?
These prices come from the pages of Lilly, TrumpRx, Costco and Medicare, checked on 3 October 2026. Lilly counts a month as 28 days.
| How you pay | Price | Conditions |
|---|---|---|
| List price, before insurance | $499 to $1,086.37 per fill | Lilly’s wholesale price; what you pay depends mostly on your insurance |
| Self-pay, vial or KwikPen, 2.5 mg | $299 a month | Prescription required; not the single-dose pen |
| Self-pay, vial or KwikPen, 5 mg | $399 a month | As above |
| Self-pay, vial or KwikPen, 7.5 to 15 mg | $449 a month | Each refill within 45 days of the last delivery; otherwise $499 (7.5 mg) or $699 (10 to 15 mg) |
| Savings card, plan covers the single-dose pen | As little as $25 per 1-, 2- or 3-month fill | Savings capped at $100 a month and $1,300 a year; ends 31 December 2026 |
| Savings card, plan doesn’t cover it | As low as $499 a month | Single-dose pen, up to 4 pens per fill |
| Medicare GLP-1 Bridge | $50 a month | KwikPen only, if you meet the criteria; runs to 31 December 2027 |
| Costco member price, no insurance | $499.22 (2.5 to 7.5 mg) or $699.21 (10 to 15 mg) per KwikPen | Warehouse pick-up; 4 single-dose pens cost $1,086.56 at most strengths |
Zepbound cost without insurance
Lilly sells the vials and the KwikPen direct to self-paying patients through LillyDirect. TrumpRx.gov lists the same prices and sends orders to LillyDirect. Lilly says it may change or end the $449 refill offer at any time. Its pricing page gives the list price only as a $499 to $1,086.37 range, without saying which format sits at each end.
With commercial insurance
Lilly’s savings card applies to the single-dose pen, for up to 13 fills a year. If your plan covers the pen, a fill can cost as little as $25. If it doesn’t, the card brings a month to $499. Lilly says coverage has been restored on select CVS Caremark formularies, starting at $25 a month. The card excludes Medicare, Medicaid and other government programs.
With Medicare
The Medicare GLP-1 Bridge runs from 1 July 2026 to 31 December 2027. It covers the Zepbound KwikPen for weight management at $50 a month, but not the vials or single-dose pens. You need Part D, must be 18 or older, and must meet one of these when you start:
- a BMI of 35 or more;
- a BMI of 30 or more with heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher;
- a BMI of 27 or more with prediabetes, a past heart attack or stroke, or peripheral artery disease with symptoms.
Your prescriber completes a prior authorisation when asked and certifies that you are in a diet and exercise programme. The $50 does not count toward the Part D deductible or the yearly out-of-pocket limit.
The Bridge excludes people with type 2 diabetes, moderate-to-severe sleep apnoea or fatty liver disease. It also excludes people whose Part D plan already covers their GLP-1. Medicare says the plan might cover a GLP-1 for those conditions instead.
At Costco
Costco’s member prices are its own cash prices and can’t be used with insurance. On 3 October 2026 they were higher than Lilly’s self-pay price at every KwikPen strength. Costco’s page does not say whether Lilly’s self-pay card applies there.
Compounded tirzepatide is priced separately and is not Zepbound: compounded GLP-1 pricing. The legal ways to get it online, with prices: tirzepatide online.
What is Zepbound?
Zepbound is a prescription medicine, not a supplement or a peptide sold for research. It comes as a clear solution in a prefilled single-dose pen, a single-dose vial, a four-dose multi-dose vial or a four-dose KwikPen. There are six strengths, from 2.5 mg to 15 mg.
It is injected under the skin of the abdomen or thigh once a week, at any time of day, with or without food. Someone else can inject the back of the upper arm. No pill form of Zepbound or any tirzepatide is approved. What is sold as one is covered in tirzepatide pills.
It is one of the GLP-1-type medicines on the list of FDA-approved peptide drugs.
Zepbound structure
- Molecular formula
- C225H348N48O68
- Molecular weight
- 4813 g/mol
- Length
- 39 amino acids
- Sequence
- YXEGTFTSDYSIXLDKIAQKAFVQWLIAGGPSSGAPPPS
- Modifications
- X = Aib (2-aminoisobutyric acid) at positions 2 and 13; Lys20 carries a C20 fatty diacid (eicosanedioic acid) attached through a gamma-Glu-2xOEG linker; C-terminal amide.
- PubChem CID
- 166567236
PubChem holds several tirzepatide records with the same formula; this is the one deposited with the Mounjaro/Zepbound drug names.
Identity checked against FDA prescribing information (Mounjaro), DailyMed.
Zepbound vs Mounjaro
Zepbound and Mounjaro are the same drug. Both contain tirzepatide, both are made by Eli Lilly, and both come in the same strengths and formats. What differs is the approval:
| Zepbound | Mounjaro | |
|---|---|---|
| Approved for | Weight management; obstructive sleep apnoea with obesity | Blood-sugar control in type 2 diabetes; lowering major cardiovascular risk in type 2 diabetes |
| Who | Adults | Adults, and children 10 and older for blood-sugar control |
| Maintenance dose | 5, 10 or 15 mg weekly (10 or 15 mg for sleep apnoea) | Up to 15 mg weekly in adults, 10 mg in children |
| Self-pay price, 3 October 2026 | $299 to $449 a month (vial or KwikPen) | $499 a month (pens, via LillyDirect) |
The Zepbound label states that it should not be used together with another tirzepatide product or with any GLP-1 receptor agonist. More on the diabetes brand: what is Mounjaro?
How Zepbound works
Tirzepatide activates two gut-hormone receptors, GIP and GLP-1, both of which sit in brain areas that regulate appetite. The label states it lowers calorie intake, most likely by reducing appetite, and slows stomach emptying, with that delay largest after the first dose. Its half-life of about five to six days is what makes a once-weekly injection possible. The mechanism in more depth: how tirzepatide works.
The label’s 72-week trial enrolled 2,539 adults with obesity or overweight and no diabetes. Average body weight fell 15.0%, 19.5% and 20.9% on the 5, 10 and 15 mg doses, and 3.1% on placebo. In adults with type 2 diabetes it fell 12.8% on 10 mg and 14.7% on 15 mg, against 3.2%.
When people who had lost weight over 36 weeks were switched to placebo, they regained 14.0% over the following year. Those who stayed on Zepbound lost a further 5.5% Aronne 2024 - Aronne LJ, Sattar N, Horn DB et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024;331(1):38-48., in the references below. What stopping looks like in practice: coming off a GLP-1.
Zepbound dosage
| Step | Dose |
|---|---|
| Start | 2.5 mg once weekly for 4 weeks (a starting dose only, not a maintenance dose) |
| Week 5 | 5 mg once weekly |
| After that | Up in 2.5 mg steps, with at least 4 weeks on each dose, as needed |
| Maintenance, weight | 5, 10 or 15 mg once weekly |
| Maintenance, sleep apnoea | 10 or 15 mg once weekly |
| Maximum | 15 mg once weekly |
The label says the slow escalation is there to reduce gastrointestinal side effects, and that the maintenance dose is chosen on response and tolerability. A missed dose can be taken within 4 days (96 hours); after that, skip it and take the next one on the usual day. The full schedule, week by week: tirzepatide dosage.
Side effects and who should not take it
The most common adverse reactions in the label’s two pooled weight-loss trials, against placebo:
| Reaction | Placebo | 5 mg | 10 mg | 15 mg |
|---|---|---|---|---|
| Nausea | 8% | 25% | 29% | 28% |
| Diarrhoea | 8% | 19% | 21% | 23% |
| Vomiting | 2% | 8% | 11% | 13% |
| Constipation | 5% | 17% | 14% | 11% |
| Abdominal pain | 5% | 9% | 9% | 10% |
| Dyspepsia | 4% | 9% | 9% | 10% |
| Injection-site reactions | 2% | 6% | 8% | 8% |
| Fatigue | 3% | 5% | 6% | 7% |
Most nausea, vomiting and diarrhoea happened during dose escalation and eased over time. Across the two trials, 4.8% to 6.7% of people on Zepbound stopped because of side effects, against 3.4% on placebo.
Do not take Zepbound with a personal or family history of MTC or MEN 2, or a known serious allergy to tirzepatide or any of its ingredients.
The label also warns about:
- acute pancreatitis
- gallbladder disease
- kidney injury from dehydration
- serious allergic reactions
- low blood sugar when combined with insulin or a sulfonylurea
- inhaling stomach contents during anaesthesia
It is not recommended with severe gastroparesis. It should be stopped once a pregnancy is recognised, and its safety in children has not been established. Because it slows stomach emptying, the label advises anyone on oral contraceptive pills to switch method. Adding a barrier method for 4 weeks after starting and after each dose increase is the other option.
Zepbound vs compounded tirzepatide
Compounded or “research use only” tirzepatide is not Zepbound. The FDA states that unapproved versions of GLP-1 drugs, including tirzepatide, are not reviewed for safety, effectiveness or quality before they are sold. It lists a seller claiming a compounded drug is the same as an approved one as a red flag. What legally separates the two: compounded vs branded. If you are already using a compounded vial, the units for each label dose are on the compounded tirzepatide dosage chart.
Is Zepbound the same as tirzepatide?
Yes and no. Zepbound’s active ingredient is tirzepatide, so “Zepbound” and “tirzepatide” name the same molecule, and tirzepatide is also what is in Mounjaro. But the approval belongs to the product, not the molecule. A vial labelled “tirzepatide” from a compounding pharmacy or a research supplier has not been through the review behind the Zepbound label. For how tirzepatide compares with semaglutide, including a head-to-head trial in which weight fell 20.2% against 13.7% Aronne 2025 - Aronne LJ, Horn DB, le Roux CW et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025;393(1):26-36., in the references below, see semaglutide vs tirzepatide.
Related
- Tirzepatide: the full label, evidence and risks
- Tirzepatide dosage chart
- How to get tirzepatide online legally, with prices
- Mounjaro price, dose and side effects
- Foundayo price: the orforglipron pill
- Tirzepatide pills: why there is no approved one
- Cheapest tirzepatide and semaglutide: compounded vs branded cost
- Semaglutide (Ozempic, Wegovy)
- Best GLP-1 for weight loss: the approved options compared
Common questions
How much does Zepbound cost without insurance?
As of 3 October 2026, Lilly's self-pay price for Zepbound vials or the KwikPen is $299 a month at 2.5 mg and $399 at 5 mg. It is $449 at 7.5 to 15 mg. The $449 price holds when each refill comes within 45 days of the last delivery. Otherwise it is $499 at 7.5 mg and $699 at 10 to 15 mg. A prescription is required, and the single-dose pen is not part of this offer.
What is the cheapest way to get Zepbound?
It depends on your coverage. With a commercial plan that covers the single-dose pen, Lilly's savings card can bring a fill to $25. On Medicare, the GLP-1 Bridge charges $50 a month for the KwikPen if you meet its criteria. With no coverage, Lilly's self-pay vials or KwikPen cost $299 to $449 a month as of 3 October 2026. That is less than Costco's member price for the same pens.
How much does Zepbound cost at Costco without insurance?
On 3 October 2026, Costco's member price for one Zepbound KwikPen (a month's supply) was $499.22 at 2.5, 5 or 7.5 mg. It was $699.21 at 10, 12.5 or 15 mg. Both prices are for warehouse pick-up. A box of four single-dose pens was $1,086.56 at most strengths. These are Costco Member Value Prices, which cannot be used with insurance. Lilly's own self-pay price was lower at every KwikPen strength.
Will Zepbound get cheaper in 2026?
As of 3 October 2026, I found no announcement of a further price cut on Lilly's savings pages or in its recent press releases. Its savings card terms run to 31 December 2026, and Lilly says it may change or end the $449 refill offer at any time. The Medicare GLP-1 Bridge, which charges $50 a month for the KwikPen to people who qualify, runs to 31 December 2027.
Is Zepbound cheaper than Ozempic or Wegovy?
Not at every dose. At the makers' self-pay prices on 3 October 2026, Zepbound vials and KwikPens cost $299 a month at 2.5 mg and $399 at 5 mg. They cost $449 at 7.5 to 15 mg with on-time refills. Wegovy pens cost $349 a month up to 2.4 mg and $399 at 7.2 mg, and the Wegovy pill $149 to $299. Ozempic, approved for type 2 diabetes, costs $349 a month up to 1 mg and $499 at 2 mg. New patients pay $199 a month for their first two months of either Novo pen at the starting doses. Wegovy costs less than Zepbound at maintenance doses.
Does Medicare cover Zepbound?
For weight management, through the Medicare GLP-1 Bridge. From 1 July 2026 to 31 December 2027, people with Part D who meet its BMI and health criteria pay $50 a month for the Zepbound KwikPen. It does not cover vials or single-dose pens. The Bridge excludes people with type 2 diabetes, moderate-to-severe sleep apnoea or fatty liver disease. Medicare says their Part D plan might cover a GLP-1 instead. Lilly's savings card excludes Medicare.
What is the generic name for Zepbound?
Tirzepatide. Zepbound is the brand name Eli Lilly uses for tirzepatide when it is prescribed for weight management or obstructive sleep apnoea. The same molecule is sold as Mounjaro for type 2 diabetes.
How is Zepbound different from Mounjaro?
They are the same drug, tirzepatide, from the same maker, in the same strengths and pen and vial formats. The difference is what each label approves. Zepbound is for weight management and obstructive sleep apnoea in adults. Mounjaro is for blood-sugar control in type 2 diabetes (adults and children 10 and older). It is also for lowering the risk of major cardiovascular events in adults with type 2 diabetes at high risk. The Zepbound label says not to use it alongside another tirzepatide product.
Is Zepbound the same as Ozempic?
No. Ozempic is semaglutide, made by Novo Nordisk and approved for type 2 diabetes. Zepbound is tirzepatide, made by Eli Lilly, and it activates two gut-hormone receptors (GIP and GLP-1) where semaglutide activates only GLP-1. In a 72-week open-label trial in adults with obesity and no diabetes, weight fell 20.2% on tirzepatide against 13.7% on semaglutide, each at its maximum tolerated dose.
How much weight will I lose with Zepbound?
The label reports averages, not individual outcomes. In its 72-week trial of adults with obesity or overweight and no diabetes, average body weight fell 15.0% on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg. It fell 3.1% on placebo. In adults with type 2 diabetes the averages were 12.8% on 10 mg and 14.7% on 15 mg, against 3.2%. Individual results vary with dose, starting weight and response.
What happens when you stop taking Zepbound?
In the label's withdrawal trial, adults had lost an average 20.9% over 36 weeks on Zepbound. They were then randomised to keep taking it or switch to placebo. Over the next 52 weeks, those who switched to placebo regained 14.0% of their body weight, while those who continued lost a further 5.5%.
Who should not take Zepbound?
The label contraindicates it for anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. It also rules it out for anyone with a known serious hypersensitivity to tirzepatide or its ingredients. It is not recommended with severe gastroparesis. It should be stopped once a pregnancy is recognised. It has not been established as safe or effective in children.
References (15 sources)
Bibliographic detail is fetched from PubMed, not written by me - so a citation here cannot drift from the paper it names. Study design comes from PubMed's own tags rather than my judgement.
- 1.Aronne LJ, Sattar N, Horn DB et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024;331(1):38-48.Randomised trialPMID 38078870full text
- 2.Aronne LJ, Horn DB, le Roux CW et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025;393(1):26-36.Clinical trialPMID 40353578
- 3.ZEPBOUND (tirzepatide) injection - prescribing information: indications, dose escalation, boxed warning, contraindications, adverse reaction rates and clinical studies.- DailyMed, National Library of Medicinelabel
- 4.MOUNJARO (tirzepatide) injection - prescribing information, used here for the Mounjaro indications compared against Zepbound.- DailyMed, National Library of Medicinelabel
- 5.FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss - compounded and unapproved semaglutide and tirzepatide are not reviewed by FDA for safety, effectiveness or quality.- US Food and Drug Administrationregulatory
- 6.Lilly: Zepbound cost information - list price (WAC) range per 28-day fill and direct-to-patient self-pay prices by dose for vials and KwikPen, checked 3 October 2026.- Eli Lilly and Companyother
- 7.Lilly: Zepbound savings and coverage - $299 self-pay starting price, the $449 refill offer, savings card terms, CVS Caremark coverage and the Medicare GLP-1 Bridge, checked 3 October 2026.- Eli Lilly and Companyother
- 8.TrumpRx: Zepbound vial listing - self-pay prices by strength, the 45-day refill condition and ordering through LillyDirect, checked 3 October 2026.- TrumpRx.gov (US government)other
- 9.TrumpRx: Mounjaro listing - $499 out-of-pocket price for every strength, ordered through LillyDirect, checked 3 October 2026, used for the Zepbound vs Mounjaro table.- TrumpRx.gov (US government)other
- 10.Costco Pharmacy: Zepbound KwikPen member prices by strength, warehouse pick-up and home delivery, checked 3 October 2026.- Costco Pharmacyother
- 11.Costco Pharmacy: Zepbound single-dose pen (box of 4) member prices by strength, checked 3 October 2026.- Costco Pharmacyother
- 12.Medicare.gov: weight-loss drugs - the GLP-1 Bridge drug list (Zepbound KwikPen only), $50 monthly copay, eligibility criteria and exclusions.- Medicare.gov (Centers for Medicare & Medicaid Services)regulatory
- 13.CMS: Medicare GLP-1 Bridge - program dates (1 July 2026 to 31 December 2027) and how the $50 copay sits outside the Part D benefit.- Centers for Medicare & Medicaid Servicesregulatory
- 14.Novo Nordisk: what to pay for Wegovy - self-pay pen and pill prices and the new-patient offer, checked 3 October 2026, used for the Zepbound price comparison.- Novo Nordiskother
- 15.Novo Nordisk: save on Ozempic - self-pay pen prices and the new-patient offer, checked 3 October 2026, used for the Zepbound price comparison.- Novo Nordiskother