Zepbound (Tirzepatide Injection)

Zepbound (tirzepatide) is a GIP and GLP-1 receptor agonist used for chronic weight management in adults with obesity or those who are overweight with at least one weight-related medical condition (such as high blood pressure, type 2 diabetes, or high cholesterol). It works by mimicking two natural gut hormones (GIP and GLP-1) to suppress appetite, slow gastric emptying, and increase the feeling of fullness.

Manufacturer Information

We currently offer the brand Zepbound, manufactured in Canada by Eli Lilly, in the strengths of 2.5 mg/0.6 ml, 5 mg/0.6 ml, 7.5 mg/0.6 ml, 10 mg/0.6 ml, and 12.5 mg/0.6 ml, pre-filled pens. The generic tirzepatide injection is currently unavailable (at this pharmacy).

Commonly reported side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion, and injection site reactions (such as redness or bruising). Fatigue, burping, and flatulence are also common.

Contact your doctor if you have any of the serious side effects of Zepbound:
• Gallbladder problems: Symptoms such as upper right stomach pain, fever, or yellowing of the skin or eyes (jaundice).
• Kidney issues: Changes in urination frequency, dark urine, or swelling in the legs and ankles.
• Lump or swelling in the neck: Along with hoarseness or trouble swallowing, these may be signs of a thyroid tumor (this is a Boxed Warning based on animal studies).
• Mental health changes: New or worsening depression or suicidal thoughts. Patients should be monitored for mood changes.
• Severe abdominal pain: May indicate pancreatitis (inflammation of the pancreas). Discontinue the medication immediately if this occurs.
• Severe digestive issues: Persistent vomiting or diarrhea that may lead to severe dehydration and subsequent kidney injury.
• Vision changes: New or worsening blurred vision.

Seek medical attention immediately if you experience signs of a severe allergic reaction, such as trouble breathing, hives, or swelling of the face, tongue, or throat.

Precautions:

Do not use Zepbound if:
o You have a known serious hypersensitivity to tirzepatide or any of the ingredients in the injection.
o You have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). (This is an absolute contraindication; you must not use Zepbound).

Tell your doctor about your medical history, especially if you have:
o A history of pancreatitis
o Diabetic retinopathy (worsening has been reported in patients with type 2 diabetes)
o Kidney disease (dehydration from side effects can worsen kidney function)
o Severe stomach problems (like severe gastroparesis/delayed stomach emptying)

Drug Interactions:

Zepbound slows stomach emptying, which can affect the absorption of oral medications. It may specifically make oral birth control pills less effective. Your doctor may recommend switching to a non-oral contraceptive or adding a barrier method for 4 weeks after starting the medication and for 4 weeks after each dose increase.

Pregnancy/Breastfeeding:

Zepbound is not recommended during pregnancy, as weight loss during pregnancy can harm the fetus. Discontinue Zepbound if you become pregnant. It is unknown if the drug passes into breast milk. Consult your doctor before breastfeeding.

Concomitant use:

Tell your doctor if you are taking other GLP-1 receptor agonists, as Zepbound should not be combined with them. Tell your doctor if you take insulin or a sulfonylurea, as using them together significantly increases the risk of hypoglycemia (low blood sugar). Your doctor may need to lower your insulin or sulfonylurea dose.

Storage:

Store unused pens in the original carton in the refrigerator between 2°C and 8°C (36°F to 46°F). Do not freeze. If needed, single-dose pens can be stored at room temperature (up to 30°C or 86°F) for up to 21 days, provided they are protected from light. Do not use if the pen has frozen.

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