6 Zepbound alternatives to try amidst a shortage

The latest medication to make headlines due to its dwindling supply? Zepbound (tirzepatide), an FDA-approved weight loss medication produced by Eli Lilly. While the Zepbound shortage originally only applied to a few of the drug’s doses, it’s now plaguing five of the six dosage strengths, making it increasingly more challenging for patients to fill their prescription. As for what’s to blame for the limited supply? A growing demand for the drug, according to the FDA’s Drug Shortages database. 

So, what’s the manufacturer doing to replenish its supply? And how, if at all, can a patient go about getting their prescribed dose despite the low supply? Read on for those answers and more, including which doses are particularly hard to come by and Zepbound alternatives you can discuss with your healthcare provider if you find yourself in a tough spot.

As of April 17, 2024, nearly all dosage strengths of the injectable medication—5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg—are in short supply. The only version not part of the nation-wide Zepbound shortage is the 2.5 mg injection, which is the typical starting dose of the drug that patients tend to use just for the first month of treatment before moving up to a higher maintenance shot. As mentioned above, the limited availability of the meds is occurring for a simple reason: an “unprecedented demand” that’s currently outpacing supply, per Eli Lilly.

The current Zepbound shortage is expected to last through the end of the second quarter of the year, meaning the five aforementioned doses could be in short supply through June 2024. 

While Eli Lilly hasn’t publicly responded to the FDA’s most recent update—that five of the six doses of Zepbound now have limited availability—in February, the manufacturer said it achieved its goal of doubling production capacity by the end of 2023, and it will continue to expand production with “equal urgency” this year, according to CNBC. 

The drugmaker has also said that it expects to produce one and a half times as many doses in the second half of 2024 compared to the amount they churned out during the same time last year, Reuters reports. Despite increasing production, however, Eli Lilly still expects that demand for its highly popular weight loss drug will outpace supply throughout the rest of the year. 

With this in mind, it’s a good idea to learn what your options are during the Zepbound shortage, so you can be prepared should it ever affect your specific dosage.

If you’re having trouble obtaining your medicine during a Zepbound shortage, Eli Lilly recommends calling different pharmacies in your area. The manufacturer also suggests contacting your pharmacy for a refill at least one week before it's needed. Many pharmacies offer home shipping, so you may be able to call ones that are even further away. 

You can also try ordering your Zepbound prescription through an online pharmacy. If you continue to experience difficulty getting your prescription (or just want to be safe), contacting your healthcare provider is a good idea; they should be able to assist you with a treatment in light of the Zepbound shortage.

If you typically get a one-month supply of Zepbound, consider asking if two- or three-month supplies are available to give you even more wiggle room.

There are a few medications you can take instead of Zepbound to help with weight loss. While some of these are FDA-approved for chronic weight management, others may be prescribed off-label for weight loss.

Below are several Zepbound alternatives along with their current availability. All of these drugs work best when combined with lifestyle changes, such as diet and exercise. The first five options include injectable medications that hail from the same drug class as Zepbound, which are called GLP-1 receptor agonists. Because they work in similar ways, these drugs typically share many side effects with Zepbound, including nausea, vomiting, diarrhea, and decreased appetite. Also listed below as potential Zepbound alternatives are oral medications that have been FDA-approved for weight loss. 

1. Mounjaro (tirzepatide)

One common Zepbound alternative is Mounjaro (tirzepatide), which is also experiencing a shortage at the time of publication. Mounjaro contains the same active ingredient as Zepbound, has similar side effects, is injected on a weekly basis, and comes in the same range of dosage strengths.

The key difference between these medications is that Mounjaro is FDA-approved to treat type 2 diabetes, while Zepbound is FDA-approved for chronic weight management. However, as both drugs contain the same active ingredient, healthcare providers may prescribe Mounjaro off-label for weight management. In clinical trials, Mounjaro produced an average weight loss of 6%–8% within 10 months in people with type 2 diabetes.

Like Zepbound, Mounjaro is a dual GIP/GLP-1 receptor agonist. This name refers to the two gut hormones the drug mimics: glucose dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). Mounjaro was the first drug in its class to target both receptors. As a GIP/GLP-1 receptor agonist, Mounjaro (like Zepbound) works by increasing insulin and inhibiting glucagon after you eat, thereby keeping your blood sugar levels in check. GLP-1 drugs can also slow down digestion, so you tend to feel full sooner and may eat less as a result. 

Current availability: At the time of writing, Mounjaro is experiencing a drug shortage expected to last through the end of June 2024, as reported by both the FDA and Eli Lilly.

2. Wegovy (semaglutide)

Wegovy (semaglutide) is another FDA-approved medication for weight loss. Similar to Zepbound, it is injected on a weekly basis and may be prescribed to people with a body mass index (BMI) of 30 or higher (defined as “obesity”) or to people with a BMI of 27 or higher (defined as “overweight”) who also have a weight-related health condition, such as high blood pressure, high cholesterol, or type 2 diabetes. Wegovy shares a similar list of contraindications and side effects with Zepbound.

While Wegovy and Zepbound belong to the same class of injectable medications for weight loss, Wegovy is a GLP-1 receptor agonist, which means it only targets a single receptor. While no studies to date have compared Zepbound and Wegovy, indirect comparisons suggest that people lose more weight on the higher 10 mg and 15 mg dosage strengths of Zepbound than the highest 2.4 mg dosage of Wegovy. Even so, people still tend to lose a substantial amount of weight on Wegovy. In clinical trials, people taking Wegovy lost 15%–16% of their body weight after just a year and half. 

Current availability: Like Zepbound, Wegovy is also a hugely popular medication and often experiences drug shortages due to the same issues, namely demand outpacing supply. At the time of writing, certain dosages of Wegovy (.25 mg, .5 mg, 1 mg, and 1.7 mg) are currently experiencing limited availability with only the highest maintenance dose (2.4 mg) currently available, according to the FDA’s Drug Shortages database.

3. Saxenda (liraglutide)

Saxenda (liraglutide) is another injectable medication for weight loss similar to Zepbound and Wegovy. However, it differs from Zepbound in that it must be injected on a daily (vs. weekly) basis. Many of Saxenda’s side effects are similar to those that may occur with Zepbound, but the Zepbound alternative can also cause headache, hypoglycemia (low blood sugar), dizziness, increased lipase levels, fever, and gastroenteritis.

Weight loss with Saxenda is less profound than with Wegovy or Zepbound, but it’s still significant. In clinical trials, many people lost around 5%–7.5% of their body weight after a year of taking Saxenda.

Current availability: Saxenda is currently experiencing a shortage with an unknown end date, according to the FDA.

4. Ozempic (semaglutide)

Ozempic (semaglutide) shares the same active ingredient as Wegovy, and it is also injected on a weekly basis. However, unlike Zepbound, it is FDA-approved to control blood sugar levels in people with type 2 diabetes and, in those who also have heart disease, to lower their cardiovascular risk.

Ozempic and Wegovy share a similar backstory to Mounjaro and Zepbound, where their active ingredient was first developed to treat type 2 diabetes. Then, as researchers discovered the drug’s ability to produce weight loss as well, the manufacturers sought FDA approval for weight management and released a separate brand name version of the drug. However, while Zepbound and Mounjaro are available in similar dosage strengths and share similar side effects, Ozempic contains lower dosage strengths of semaglutide, the active ingredient it shares with Wegovy. 

Ozempic also has a shorter list of side effects than Wegovy, although it’s still common to experience gastrointestinal symptoms like the other drugs on this list of Zepbound alternatives, such as nausea, vomiting, diarrhea, abdominal pain, and constipation. In clinical trials, people with type 2 diabetes lost an average of 13–15 pounds after 10 months of taking Ozempic.

Current availability: At the time of writing, Ozempic is listed as available on the FDA Drug Shortages website, although that may change as there have been ongoing Ozempic shortages in the past.

5. Trulicity (dulaglutide)

Trulicity (dulaglutide) is another medication for type 2 diabetes that may be prescribed off-label for weight loss. Similar to Ozempic, it helps lower blood sugar levels in people with type 2 diabetes who have not found success with other treatments, such as metformin. It can also lower the risk of heart attack, stroke, or death in people who have type 2 diabetes and heart disease. 

Trulicity is available in four dosage strengths, with people taking higher dosage strengths typically losing more weight. In one study, people with type 2 diabetes lost between 7–10 pounds after nine months of taking Trulicity. Trulicity’s side effects are similar to those of other Zepbound alternatives (e.g. nausea, diarrhea, vomiting, and abdominal pain).

Current availability: At the time of publication, some dosage strengths of Trulicity are experiencing limited availability through May and June 2024, but the starting dosage of 0.75 mg is currently available. 

6. Non GLP-1s

Given that many of the above GLP-1 medications are currently in shortage, you may wonder if there are any Zepbound alternatives not in short supply. Good news: There are. In addition to Zepbound, Wegovy, and Saxenda, the FDA has approved other medications for weight loss. These include Qsymia (phentermine/topiramate), Contrave (naltrexone/bupropion) and Xenical or Alli (orlistat). 

Besides being available at the time of writing, these medications also differ from the GLP-1s on this list in that they are taken orally on a daily basis. (In the case of Orlistat, the recommended dosage schedule is three times daily.) Similar to GLP-1 drugs, though, these medications may cause gastrointestinal upset and other digestive side effects. Depending on the medication, other side effects may include headache, insomnia, dizziness, tingling sensations, anxiety, and irritability. 

All three of these weight loss pills have been shown to produce an average weight loss of at least 5% in clinical trials. In one year, people taking Qsymia (phentermine/topiramate) lost an average of 19 pounds, Contrave (naltrexone/bupropion) lost an average of 11 pounds, and Xenical or Alli (orlistat) lost an average of almost 6 pounds.

Current availability: Neither Qsymia, Contrave, Xenical, nor Alli are reported to be experiencing a drug shortage at the time of writing, according to the FDA, though availability may change depending on your local pharmacy. 

You shouldn’t stop taking Zepbound without first talking to a healthcare professional. If a Zepbound shortage disrupts your treatment, talk to your healthcare provider about your options. They may be able to help you find a refill or direct you towards an alternative treatment. If you have to stop Zepbound, keep up with the lifestyle changes you started during treatment, such as diet and exercise. 

Zepbound has a half-life of about five days, but it will take some time for the drug to fully flush out of your system. Once you stop taking Zepbound, you may notice a few changes as the effects of the medication wear off:

• Side effects should subside

• Your appetite may return

• You may regain weight

If the Zepbound shortage forces you to stop taking the medication, we understand that it can be disheartening. But you can still make lifestyle changes including dietary changes and exercise to keep weight off and potentially lose even more.

Try as pharmaceutical companies might to keep up with demand, it seems like the skyrocketing popularity of many weight loss medications will continue to outpace production at least for a couple of months. Unfortunately for current Zepbound users, that means it might be increasingly more difficult to obtain their doses. If you're worried about the Zepbound shortage and how it might impact you, it's always a good idea to talk to your healthcare provider; they’re best equipped to help you navigate the limited availability and determine whether any Zepbound alternatives might work for you. You can also stay up to date on the Zepbound shortage—and any others, such as the Wegovy shortage—by looking up the drug’s active ingredient on the FDA Drug Shortage database as well as checking the manufacturer’s web site. 

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Current version

April 23, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD