Word count: 2800-3500

9 best alternatives to Zepbound for weight loss during the Zepbound shortage

Key highlights:

• Zepbound is a once-weekly injectable medication FDA-approved for weight loss. Due to its ongoing shortage, people may be looking for alternative weight loss medications.

• If Zepbound is hard to find, there are alternative injectable Zepbound alternatives including other GLP-1 medications such as Mounjaro (tirzepatide), Wegovy (semaglutide), Ozempic (semaglutide), and Saxenda (liraglutide).

• If you prefer not to inject, other oral weight loss medications are also available, including phentermine, Contrave (naltrexone/bupropion), Qsymia (phentermine/topiramate ER), and Xenical (orlistat).

• Lifestyle changes like diet, physical activity, sleep, and stress management can enhance the effectiveness of weight loss medications.

• Always consult with your healthcare provider to find the safest and most effective weight loss option for you.

Zepbound (tirzepatide) is an FDA-approved weight loss medication. The U.S. Food and Drug Administration approved Zepbound for obstructive sleep apnea in adults with obesity alongside diet and exercise in December 2024. This once-weekly injection works by mimicking two natural gut hormones, GIP and GLP-1. Many people have experienced significant weight loss with Zepbound.

Tirzepatide, when combined with diet and exercise, can lower blood sugar and help people with diabetes lose weight. It has also been shown to help those without diabetes lose weight.

Aside from limited access or shortages, people may seek alternatives to medications like Zepbound for several reasons. The cost can be a significant factor, as the medication might be too expensive for those without insurance coverage. Side effects may also make some look for other options. Some people may also not be comfortable injecting the medication.

Keep reading to discover the top 9 Zepbound alternatives, including GLP-1 , non-GLP-1 medications, and natural methods to consider.

GLP-1 Zepbound alternatives

There are several GLP-1 medications you can use instead of Zepbound to help with weight loss. Some of the medications are FDA-approved for chronic weight management, while others may be prescribed off-label for weight loss even though they aren’t officially approved for that purpose.

1. Ozempic (semaglutide)

Ozempic (semaglutide), manufactured by Novo Nordisk, was first approved by the FDA to help control blood sugar levels in adults with type 2 diabetes and can also lower the risk of heart problems in people with both diabetes and heart disease.

While it’s not officially approved for weight loss, many doctors prescribe it off-label for that purpose because it helps people lose weight.

In clinical trials, people using 2 mg of Ozempic once per week for diabetes lost at least 5% of their body weight over 40 weeks. Some lost more than 10%. Ozempic is typically prescribed in lower doses (0.25 to 2 mg per week) for diabetes, so the weight loss may be less compared to higher doses of Wegovy (up to 2.4 mg per week).

Ozempic also has fewer side effects than Wegovy, although it can still cause stomach issues like nausea, vomiting, diarrhea, stomach pain, and constipation.

If you have type 2 diabetes, your insurance may cover Ozempic. If your insurance doesn’t cover it, Ozempic costs around $1,029.35 per month with a discount card, which is about the same price as Zepbound. It might be difficult to find Ozempic in stock as it has been in short supply over the past year.

2. Wegovy (semaglutide)

Wegovy (semaglutide) is another medication like Zepbound, and it’s also a weekly injection for weight loss. It is FDA-approved for:

• Weight loss and long-term weight maintenance for adults and children 12 and older with obesity, and for adults who are overweight with a weight-related health condition, like type 2 diabetes or high blood pressure.

• Reducing the risk of heart problems, like heart attacks, in obese or overweight adults with heart disease.

While Zepbound is a combination drug that targets two receptors, Wegovy only targets one (GLP-1). This may mean you could lose less weight with Wegovy. An ongoing head-to-head clinical trial found that Zepbound is more effective for weight loss than Wegovy, with an average weight loss of 20.02% compared to 13.7% with Wegovy.

In clinical trials, people who made lifestyle changes while using Wegovy lost an average of 14.9% of their body weight over 68 weeks.

In addition to weight loss, Wegovy is approved to lower the risk of serious heart problems for adults who are overweight or obese and have heart disease. Zepbound's heart benefits are still being studied. If you have heart disease, your doctor might switch you to Wegovy for its extra heart benefits.

Wegovy is more expensive than Zepbound, costing about $1,430 per month without insurance. You might save money with insurance or savings programs, but some insurance plans may require prior authorization. Wegovy is also hard to find in stock at many pharmacies due to shortages and high demand.

3. Mounjaro (tirzepatide)

Mounjaro (tirzepatide) is another alternative to Zepbound and is made by the same company, Eli Lilly. It’s also a once-weekly injection with the same active ingredient, tirzepatide, and comes in the same dosages.

Zepbound is approved for weight loss in certain people with obesity or being overweight, while Mounjaro is approved for controlling blood sugar in people with type 2 diabetes. Healthcare professionals can prescribe Mounjaro off-label for weight loss off-label, but it’s more likely to be covered by insurance if you have type 2 diabetes.

As for weight loss, clinical trials of Mounjaro showed people with type 2 diabetes lost up to 13.9% of their body weight over 104 weeks. However, these trials mainly focused on diabetes, not weight loss.

Like Zepbound, Mounjaro is a dual GIP/GLP-1 agonist, which means it mimics two gut hormones: GIP and GLP-1. Mounjaro was the first drug to target both of these hormones. It works by boosting insulin and reducing glucagon after eating, helping control blood sugar. It can also slow digestion, making you feel full sooner and eat less.

Mounjaro has the same side effects and supply issues as Zepbound. It’s easier to get Mounjaro covered by insurance if your type 2 diabetes isn’t well-controlled with other medications, like metformin.

4. Compounded tirzepatide

Compounded tirzepatide is a custom-made version of the same drug used in Mounjaro and Zepbound (tirzepatide).

Pharmacies can create compounded versions of tirzepatide based on a healthcare provider’s prescription. This might be an option if the regular brand name of the drug is unavailable or if you are allergic to any of the ingredients in the brand name drug.

However, compounded drugs are not FDA-approved, which means they aren’t subject to the same strict quality controls and regulations as FDA-approved medications. This can raise concerns about the consistency, safety, and effectiveness of the drug.

People considering compounded tirzepatide should discuss the risks and benefits with their healthcare provider for medical advice to ensure it's a safe and suitable option for them.

5. Compounded semaglutide

Compounded semaglutide is another GLP-1 medication that is similar to Zepbound. It’s a custom-made version of the same active ingredient found in Wegovy and Ozempic.

Compounded semaglutide is prepared by a pharmacy based on a doctor’s prescription, and it may be used if the standard versions are not available or affordable.

If you and your provider decide that compounded tirzepatide is the best option for you, be sure to choose a reputable, licensed compounding pharmacy that requires a prescription.

6. Saxenda (liraglutide)

Approved in 2010, Saxenda (liraglutide) was the first GLP-1 medication approved for weight loss in adults with obesity or overweight with at least one weight-related health issue. It is also approved for certain children 12 and older with obesity.

Saxenda, being an older GLP-1 medication, has some downsides compared to newer options like Zepbound. For example, it’s taken daily instead of weekly, and you might lose less weight with it.

In clinical trials, people taking Zepbound for 72 weeks (about 16.5 months) lost an average of 15% to 20% of their starting body weight. In comparison, people taking Saxenda for 56 weeks lost an average of 8% of their body weight.

In another 56-week clinical trial, people taking Saxenda 3 mg once a day lost an average of 18 lbs, while those using a placebo injection only lost 8 lbs.

Saxenda is a potential alternative for people who can't get Zepbound or Wegovy. It has also shown heart health benefits for people with diabetes or those at high risk of heart disease.

Saxenda is more expensive, costing about $1,430 per month without insurance. Like Zepbound and Wegovy, insurance plans usually won’t cover Saxenda without prior authorization. However, Saxenda’s active ingredient, liraglutide, might be covered if your healthcare provider prescribes Victoza (the brand name of liraglutide), if you have type 2 diabetes.

Like Zepbound and Wegovy, Saxenda is also in short supply, so it may be hard to find a pharmacy that has it in stock.

Non-GLP-1 Zepbound alternatives

FDA has approved other oral medications for weight loss that are not GLP-1s such as Qsymia, Contrave, and Xenical. All three of these weight loss pills have been shown to help people lose at least 5% of their weight in clinical trials. In one year, people taking Qsymia lost an average of 19 pound, people taking Contrave lost 11 pounds, and people taking Xenical lost almost 6 pounds.

1. Contrave (naltrexone/bupropion)

Contrave (bupropion-naltrexone) is another weight loss pill that combines two ingredients: bupropion (an antidepressant) and naltrexone (used to block opioid effects). It’s FDA-approved for chronic weight management along with diet and exercise for adults with obesity or overweight with at least one weight-related health condition.

With diet and exercise, Contrave can help people lose 5 to 10% of their body weight over 56 weeks. Some side effects of Contrave are similar to Zepbound, like nausea, but it can also cause insomnia, trouble sleeping, and high blood pressure.

After the first few weeks of taking Contrave, the usual dosage is 2 pills taken twice a day. Unlike injectable GLP-1 medications, there have been no shortages of Contrave reported so far.

In comparison to GLP-1 drugs, Contrave was found to have a lower incidence of side effects like, bowel obstruction, pancreatitis and gastroparesis. 

Without insurance, it costs about $667.84 per month with a discount card. It’s easier to find in stock, and if your insurance covers it, you’ll likely pay less. If not, coupons and savings programs can help lower the cost.

2. Qsymia (phentermine/topiramate ER)

Qsymia (phentermine/topiramate) is another oral alternative to Zepbound. It’s a combination pill that works by reducing your appetite and can be used as an alternative to Zepbound in individuals without certain health conditions like cardiovascular disease, high cholesterol, or uncontrolled hypertension.

Qsymia may be more convenient for some people than Contrave because you only need to take one pill once a day in the morning.

In clinical trials, most people lost about 8% to 10% of their starting body weight. Qsymia has shown long-term results, with an average weight loss of 21 lbs with the low dose and 24 lbs with the high dose after 108 weeks of use.

Before switching to Qsymia, you and your healthcare provider should discuss its neuropsychiatric side effects, risks, and interactions. Common side effects include numbness or tingling, constipation, and dry mouth.

Qsymia can cause severe birth defects, so there is a mandatory risk management program. If you can get pregnant, you’ll need to take a pregnancy test before starting and once a month while taking Qsymia. You must also use reliable birth control while on this medication.

There is no shortage of Qsymia right now, so it should be easier to find than Zepbound. However, pharmacies must be FDA-certified to dispense it because of the risk management program.

3. Xenical, Alli(orlistat)

Orlistat is another option to consider instead of Zepbound. It’s the active ingredient in two weight loss medications: Xenical, a 120 mg prescription pill, and Alli, a 60 mg pill you can buy over the counter. Neither brand nor generic orlistat is affected by drug shortages right now.

Orlistat works differently from Zepbound by blocking your body from absorbing some of the fat you eat, which then leaves your body as waste. However, it can cause uncomfortable side effects like fatty stools, flatus with discharge, oily spotting, and more frequent or urgent bowel movements. It’s best to use Orlistat with a low-fat diet to help reduce these side effects.

You’re likely to lose less weight with Orlistat compared to Zepbound. In clinical trials, people taking Xenical lost 5% or more of their body weight after 1 year. To make Xenical effective, you need to take it three times a day with meals that contain fat.

Xenical has demonstrated efficacy in weight loss for up to four years and can be used chronically by patients. Studies found that it also has potential benefits on cardiovascular risk factors like diabetes, high cholesterol. and high blood pressure.

There is no shortage of Xenical. This means you might have an easier time getting your prescription filled. Orlistat is much cheaper than Zepbound. Prices range from $55.82 per month for Alli to $803.15 for a 1-month supply of Xenical.

Comparing Zepbound alternatives

Here’s a table comparing the effectiveness, cost, side effects, and accessibility of different Zepbound alternatives:

https://docs.google.com/spreadsheets/d/1BDy67n2PHkuxY9TAImmai_YUxfiOEYwa2wEtRjWAKXc/edit?gid=0#gid=0

Each medication has its benefits depending on your personal needs, so it is important to consult with your healthcare provider to determine the best fit for you.

• Affordability: Orlistat (Alli/Xenical) and Contrave are the most affordable options.

• Rapid weight loss: Zepbound, Wegovy, and Mounjaro offer the fastest and most significant weight loss results.

• Diabetes and weight loss: Ozempic and Mounjaro are great choices for people with type 2 diabetes.

• Long-term use: Saxenda and Qsymia are good for ongoing weight management.

When to consider Zepbound alternatives

Here’s when you might consider Zepbound alternatives:

• Cost concerns: If Zepbound is not included in your insurance coverage or is too expensive without insurance, more affordable alternatives could be a better option. Some alternatives might be cheaper or offer discounts, making them easier to fit into your budget.

• Side effects: If you experience side effects like nausea, headaches, or digestive issues with Zepbound or any other prescription drug, or if you can’t tolerate the medication, it might be a good idea to explore other options that have a different side effect profile or work better for your body.

• Accessibility: If you’re struggling to find Zepbound at your pharmacy due to supply shortages or delays in prescription fulfillment, you may want to look into alternatives that are easier to find or have better availability at your local pharmacies.

Zepbound vs. Mounjaro

Zepbound and Mounjaro are both weekly injectables with the same active ingredient, tirzepatide, but they are approved for different indications. Zepbound is approved for chronic weight management and obstructive sleep apnea, and Mounjaro is approved for type 2 diabetes.

Zepbound and Mounjaro are both dual GIP (glucose-dependent insulinotropic peptide) and GLP-1 (glucagon-like peptide-1) receptor agonist, meaning they target 2 hormones to control blood sugar and appetite.

Both can help you lose weight, but Zepbound may have slightly better weight loss because it has higher dosages.

Both are used with a healthy diet and exercise plan to get the best results, and both are taken once a week. The choice between Zepbound and Mounjaro is based on your health goals, preferences, insurance coverage, your health condition, and your healthcare provider’s recommendation.

Is there a Zepbound shortage?

As of now, tirzepatide, the active ingredient in Zepbound, is not listed as being in shortage on the FDA Drug Shortages website and all dosages; 2.5 mg to 15 mg are in stock at most pharmacies. However, availability can vary between pharmacies, and you may not be able to fill your prescription depending on your location.

Both Zepbound and Mounjaro contain tirzepatide, the active ingredient, and are made by Eli Lilly. They have the same active ingredients and dosages, but Zepbound is for chronic weight management in people with obesity or overweight and obstructive sleep apnea, and Mounjaro is for people with type 2 diabetes.

In the past, Zepbound and Mounjaro have been in shortage due to higher-than-expected demand. Eli Lilly has said demand will continue to outpace supply through 2024.

To address the shortage, the company is increasing production by 1.5 times in the second half of 2024 vs 2023 and adding manufacturing sites including international sites.

When will the Zepbound shortage be over?

The Zepbound shortage is ongoing, and it’s unclear when it will be resolved. Lilly, the pharmaceutical company that makes the drug, is increasing production but certain doses, like 10 mg and 15 mg, are still in limited supply.

However, the 2.5 mg, 5 mg, 7.5 mg, and 12.5 mg doses are currently available. Lilly recommends calling nearby pharmacies if your pharmacy is out of stock and asking for refills a week in advance to give pharmacies time to order more.

To check Zepbound’s availability, you can search for “tirzepatide” on the FDA Drug Shortages website. You can also sign up for supply updates on the LillyDirect website.

How to find Zepbound during a shortage

If you're having trouble getting your Zepbound,  Eli Lilly recommends that you try calling different pharmacies in your area and contact your pharmacy at least a week before your refill is needed.

Some pharmacies offer home delivery, so you can also try contacting ones that aren’t nearby you. You can also order from an online pharmacy.

If you're still having trouble finding the medication, talk to your healthcare provider for help, and consider asking for a two- or three-month supply to avoid running out.

How to switch to a Zepbound alternative

If you’re switching to a Zepbound alternative you can start the new medication 7 days after stopping Zepbound.

Most weight loss medications require you to gradually increase the dose and it’s important to follow the prescribed schedule.

Stay in touch with your healthcare provider during the transition to monitor side effects, dose adjustments, and any potential drug interactions.

Natural alternatives to Zepbound

There’s no quick fix to weight loss; it takes time and effort. Don’t fall for diet supplements with little to no proof of effectiveness or safety and always consult with your healthcare provider before trying new weight loss drugs even if they’re available over the counter.

Eat healthy and 150 minutes a week and behavior therapy will help you change for good.

Dietary supplements

• Berberine: Found in plants like barberry, Phellodendron, Oregon grape, and tree turmeric, works similarly to GLP-1 medications by boosting metabolism and may support weight loss and reduce waist size. Studies suggest it improves insulin resistance and blood sugar control, with a recommended dose of about 1.5 grams per day.

• Chromium: Chromium can help improve blood sugar control and insulin response, supporting better diabetes management and weight loss. However, it is important to use it carefully if you're taking other medications or have health conditions. Chromium is also found in foods like broccoli, green beans, whole grains, turkey, grapes, and tomato juice.

• Garcinia Cambogia: A fruit extract often used in weight loss supplements. It may help control appetite by blocking an enzyme that turns carbohydrates into fat and increasing serotonin levels, which could reduce hunger.

Herbal remedies

• Bitter melon: A fruit that can help lower blood sugar. It has compounds that act like insulin to regulate blood sugar in diabetics. Consult with a healthcare provider before using it as treatment.

• Fenugreek: A plant that can help with digestion and insulin sensitivity. It has fiber that can help digestion and some studies say it can lower blood sugar by improving the body’s response to insulin.

Dietary changes

• The Mediterranean diet: Eat whole foods like fruits, vegetables, whole grains, nuts, and healthy fats (olive oil). Good for heart and overall health.

• Plant-based eating: Eating more plants, veg, beans, and whole grains can help with metabolic health and reduce the risk of chronic diseases like diabetes and heart disease.

• Low-carb and ketogenic diets: These diets restrict carbs and focus on fat and protein. Good for weight loss and blood sugar control especially for diabetics or those looking to lose weight.

Exercise approaches

• Strength training: Lifting weights or bodyweight exercises build muscle which helps boost your metabolism and burn more calories at rest.

• Cardio workouts: Running, walking, cycling, or swimming improves heart health and makes your body more insulin sensitive which is good for blood sugar control.

• Yoga and mindfulness: Yoga or mindfulness like deep breathing helps with stress management, lowers cortisol, and overall mental well-being.

How to maximize weight loss with weight loss drugs

To get the best results from weight loss drugs, it is important to live a healthy lifestyle. This can be different for everyone. Follow your healthcare provider’s instructions and take the medication as prescribed, combined with a healthy diet, cutting calories, regular exercise, lifestyle changes, sleeping well, and managing stress for the best results.

 FAQs about Zepbound alternatives

What’s the closest prescription alternative to Zepbound?

The closest prescription alternative to Zepbound is Mounjaro, which works similarly and is also a weekly injection. It contains the same active ingredient, tirzepatide, a dual GIP/GLP-1 receptor agonist, like Zepbound.

Are over-the-counter options effective for weight loss or diabetes management?

Over-the-counter options for weight loss, like Alli (orlistat), can help some people lose weight, but they may not be as effective as prescription medications. They are not approved for managing diabetes, so they should not be used for that purpose.

How long does it take to see results with natural methods?

With natural methods like diet and exercise, it can take a few weeks to start seeing noticeable results, but it varies for each person. Consistency is key, and significant changes may take a few months.

Is it safe to combine natural alternatives with existing medications?

It can be safe to combine natural alternatives with existing medications, but it's important to talk to your healthcare provider first. Some natural remedies may interact with medications, so your healthcare professional can help ensure it's safe for you.

Bottom line

Zepbound (tirzepatide) is a popular weight-loss injection given its significant weight loss benefits, but some people may consider alternatives due to side effects, not wanting to inject the medication, insurance coverage, or cost concerns.

Alternatives like Wegovy and Saxenda are similar options, although they may also be in short supply. Oral alternatives such as Contrave, Qsymia, and Xenical are more readily available but may not lead to as much weight loss.

Each alternative has different risks, side effects, and effectiveness. Before making any changes to your medication, it's crucial to consult with your healthcare provider to ensure the best and safest option for your health.

Sources:

• https://pubmed.ncbi.nlm.nih.gov/35658024/

• https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/217806s000lbl.pdf

• https://pubmed.ncbi.nlm.nih.gov/36356111/

• https://pubmed.ncbi.nlm.nih.gov/37796527/

• https://pubmed.ncbi.nlm.nih.gov/36579723/

• https://pubmed.ncbi.nlm.nih.gov/35015037/

• https://pubmed.ncbi.nlm.nih.gov/27633186/

• https://pubmed.ncbi.nlm.nih.gov/38796653/

• https://pubmed.ncbi.nlm.nih.gov/26132939/

• https://pubmed.ncbi.nlm.nih.gov/27295427/

• https://pubmed.ncbi.nlm.nih.gov/21481449/

• https://pubmed.ncbi.nlm.nih.gov/22158731/

• https://pubmed.ncbi.nlm.nih.gov/21969342/

• https://pubmed.ncbi.nlm.nih.gov/14693982/

• https://pubmed.ncbi.nlm.nih.gov/12087008/

• https://pubmed.ncbi.nlm.nih.gov/26934640/

• https://pubmed.ncbi.nlm.nih.gov/7957533/

• https://diabetesjournals.org/clinical/article/38/4/390/35426

• https://clinicaltrials.gov/study/NCT05822830

• https://clinicaltrials.gov/study/NCT06075667?cond=obesity&term=Children&intr=tirzepatide&rank=1

• https://clinicaltrials.gov/study/NCT05556512

• https://www.accessdata.fda.gov/spl/data/1761b768-7da0-44a9-bded-54c3bc63414a/1761b768-7da0-44a9-bded-54c3bc63414a.xml

• https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Liraglutide%20Injection&st=c

• https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Tirzepatide%20Injection&st=c

• https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Semaglutide%20Injection&st=c

• https://www.nature.com/articles/0801128

• https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a2d3bd73-f3af-4ea5-a57c-66b0004cfe4f

• https://www.accessdata.fda.gov/spl/data/db470b78-cc2c-455f-a430-078a78a625df/db470b78-cc2c-455f-a430-078a78a625df.xml

• https://supply.lilly.com/zepbound

• https://www.accessdata.fda.gov/spl/data/bd00a70b-9fe2-4614-97a6-09d80b9505a0/bd00a70b-9fe2-4614-97a6-09d80b9505a0.xml

• https://nejm.org/doi/full/10.1056/NEJMoa1411892

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771085/

• https://qsymia.com/patient/include/media/pdf/patient-brochure.pdf?v=2306

Competitors

• https://www.singlecare.com/blog/zepbound-alternatives/

• https://www.goodrx.com/zepbound/zepbound-alternatives

• https://ro.co/weight-loss/zepbound-alternatives/

• https://www.helloklarity.com/post/zepbound-alternatives/

Other reports:

• wegovy shortage

• wegovy alternative

• wegovy substitute

• alternative to wegovy