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Zepbound ® (tirzepatide) injection
2.5 mg/ 5 mg/ 7.5 mg/ 10 mg/ 12.5 mg/ 15 mg
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
What should a patient do if they miss a dose of Zepbound® (tirzepatide)?
If a dose is missed, it should be administered as soon as possible within 4 days. If more than 4 days have passed, skip the missed dose and take the next dose on the regularly scheduled day. In each case, resume regular dosing schedule thereafter.
See important safety information, including boxed warning, in the attached prescribing information.
When Should Tirzepatide Be Injected if a Dose Was Missed?
If a dose is missed, when the next dose is administered depends on the following schedule (Instructions for a Missed Dose of Tirzepatide and Example for a Missed Dose of Tirzepatide).1
If a dose of tirzepatide is missed and it is… | Then… | And... |
4 days (96 hours) or less after the missed dose | it should be administered as soon as possible | patients can resume their regular once-weekly dosing schedule. |
more than 4 days (96 hours) after the missed dose | the missed dose should be skipped |
Figure Description: If a dose of tirzepatide is missed and it is 4 days or less after the missed dose, then it should be administered as soon as possible, and patients can resume their regular once-weekly dosing schedule. If a dose of tirzepatide is missed and it is more than 4 days after the missed dose, then the missed dose should be skipped, and patients can resume their regular once-weekly dosing schedule.
How Can the Weekly Tirzepatide Dose Day Be Adjusted?
The day of weekly administration can be changed, if necessary, as long as the time between the two doses is at least 3 days (72 hours).1
How Should a Missed Tirzepatide Dose Be Managed During Escalation?
In the SURMOUNT study protocols, if participants temporarily interrupted tirzepatide therapy and the number of consecutive missed doses was
- 1 to 2 doses, the treatment was restarted at the same dose if the drug was well tolerated prior to discontinuation, or
- 3 doses or more, the treatment was restarted at 5 mg regardless of the dose received before the interruption and subsequently escalated as required by protocol.3-7
How Does Tirzepatide Dose Timing Affect Pharmacokinetics Exposure?
Steady-state plasma tirzepatide concentrations were achieved following 4 weeks of once-weekly injections.1
In Simulation of the Impact of a Missed Dose on Tirzepatide Concentration Over Time, it can be seen that when the next dose is taken on the regularly planned day, there is a transient, approximately 15% increase in concentration due to the subsequent dose. When the missed dose is administered 5 days or more after planned dosing day, the subsequent dose can lead to approximately 20% or greater increases in exposure.2
Figure 2 description: Simulation of steady-state tirzepatide pharmacokinetics was performed with the tirzepatide population pharmacokinetic model. Solid black lines denote the simulation median, gray triangles denote once-weekly tirzepatide dosing interval, red triangles denote tirzepatide dosing time beyond 1 week after a dose. The y-axis is tirzepatide concentration relative to the maximum concentration of the pharmacokinetic profile. The shaded area denotes the interval between minimum and maximum concentration of the steady state pharmacokinetic profile. There is more variance in relative concentration when tirzepatide doses are delayed beyond the recommended dosing of every week.
Enclosed Prescribing Information
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1Zepbound [package insert]. Indianapolis, IN: Eli Lilly and Company; 2026.
2Data on file, Eli Lilly and Company and/or one of its subsidiaries.
3Jastreboff AM, Aronne LJ, Ahmad NN, et al; SURMOUNT-1 Investigators. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038
4Garvey WT, Frias JP, Jastreboff AM, et al; SURMOUNT-2 investigators. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402(10402):613-626. https://doi.org/10.1016/S0140-6736(23)01200-X
5Wadden TA, Chao AM, Machineni S, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023;29(11):2909-2918. https://doi.org/10.1038/s41591-023-02597-w
6Aronne LJ, Sattar N, Horn DB, et al; SURMOUNT-4 Investigators. 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. https://doi.org/10.1001/jama.2023.24945
7Aronne LJ, Horn DB, le Roux CW, et al; SURMOUNT-5 Trial Investigators. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025;393:26-36. https://www.doi.org/10.1056/NEJMoa2416394
Date of Last Review: January 29, 2026