tirzepatide (Zepbound)

Adjunctive therapy

Brands: ZEPBOUND

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Quick answers

What is tirzepatide (Zepbound)?
Zepbound is a once-weekly injectable form of tirzepatide, a dual GIP/GLP-1 receptor agonist indicated for chronic weight management with diet and exercise (label).
What is ZEPBOUND?
ZEPBOUND is a brand name for tirzepatide (Zepbound).
What is ZEPBOUND (tirzepatide (Zepbound)) used for?
Label indications include: Chronic weight management (with diet and exercise) in adults with obesity or overweight with weight-related comorbidities (label). No FDA-approved psychiatric indications.
What drug class is ZEPBOUND (tirzepatide (Zepbound))?
Weekly injectable dual GIP/GLP-1 receptor agonist (tirzepatide) indicated for chronic weight management (with diet and exercise). It has no FDA-approved psychiatric indications but may be considered in psychiatric populations for cardiometabolic risk reduction with careful monitoring for mood changes (label/clinical).
What strengths does ZEPBOUND (tirzepatide (Zepbound)) come in?
Single-dose pens for subcutaneous injection once weekly (label).

Snapshot

Primary label indications include: Chronic weight management (with diet and exercise) in adults with obesity or overweight with weight-related comorbidities (label).
Class: Adjunctive therapy
Common US brands: ZEPBOUND
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

Chronic weight management (with diet and exercise) in adults with obesity or overweight with weight-related comorbidities (label). No FDA-approved psychiatric indications.

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Clinical Highlights

Zepbound is a once-weekly injectable form of tirzepatide, a dual GIP/GLP-1 receptor agonist indicated for chronic weight management with diet and exercise (label). Zepbound is not a psychiatric medication and has no FDA-approved psychiatric indications. In psychiatric populations it may be discussed as a metabolic risk-reduction tool (obesity and cardiometabolic risk), including in people taking weight-gain–promoting psychotropics (clinical).

Zepbound includes a warning to monitor for suicidal behavior and ideation. This is particularly relevant to psychiatric populations and should be addressed explicitly in risk assessment and follow-up (label).
A key practical warning is reduced efficacy of oral hormonal contraceptives during initiation and dose escalation due to delayed gastric emptying; patients using oral contraceptives should switch to a non-oral method or add a barrier method for 4 weeks after initiation and for 4 weeks after each dose escalation (label).
The compare view, evidence feed, and print page help compare titration schedules and safety monitoring themes.

Dosing & Formulations

Zepbound is supplied in single-dose pens for subcutaneous injection once weekly (label). Typical titration starts at 2.5 mg once weekly for 4 weeks (initiation; not a maintenance dose), then increases by 2.5 mg steps after at least 4 weeks at each dose until a maintenance dose is reached (label).

Recommended maintenance dosing for weight reduction/maintenance is 5 mg, 10 mg, or 15 mg injected subcutaneously once weekly, with selection based on response and tolerability (label).
If a dose is missed, administer as soon as possible within 4 days (96 hours); if more than 4 days have passed, skip and resume the regular schedule. Do not take two doses within 3 days of each other (label).
GI tolerability often improves with slower escalation and attention to hydration and meal size (clinical).

Monitoring & Risks

Boxed warning: risk of thyroid C-cell tumors; contraindicated with personal/family history of MTC or MEN2 (label). Suicidal behavior and ideation: monitor for new or worsening depression, suicidal thoughts/behaviors, and unusual mood changes; discontinue if symptoms develop and avoid in patients with active suicidal ideation (label).

Pancreatitis and gallbladder disease have been reported; evaluate severe or persistent abdominal pain and discontinue if pancreatitis is suspected (label).
Dehydration from vomiting/diarrhea can worsen renal function; monitor volume status and renal function when clinically indicated (label/clinical).
Females of reproductive potential using oral hormonal contraceptives need contraception counseling during initiation and dose escalation (label).

Drug Interactions

Oral hormonal contraceptives: delayed gastric emptying can reduce oral contraceptive exposure during initiation and dose escalation. Switch to non-oral contraception or add a barrier method for 4 weeks after initiation and after each dose escalation (label). Delayed gastric emptying can also affect absorption of other oral drugs during titration; review narrow-therapeutic-index agents and time-sensitive regimens (clinical).

When used in patients taking other glucose-lowering therapies (e.g., in diabetes populations), the main interaction risk is hypoglycemia with insulin or sulfonylureas (label/clinical).
Major CYP-mediated interactions are not expected (peptide metabolism), but polypharmacy review is still essential (clinical).

Practice Notes

Because Zepbound carries a warning about suicidal behavior and ideation, psychiatric history and current risk should be reviewed before starting and monitored over time (label/clinical). In serious mental illness care, weight-loss pharmacotherapy should not compromise psychiatric stability; align goals with realistic, safe targets and ensure follow-up is feasible (clinical).

Proactive nausea management and hydration planning can reduce missed psychotropic doses and adherence disruptions during early titration (clinical).
Screen for disordered eating and ensure weight-loss goals are safe and appropriate; monitor for excessive appetite suppression and dehydration (clinical).
Discuss reproductive planning and oral contraceptive limitations early, particularly in populations where follow-up can be inconsistent (label/clinical).

References

ZEPBOUND (tirzepatide) injection prescribing information — DailyMed (2026)
Tirzepatide once weekly for the treatment of obesity — New England Journal of Medicine (2022)
Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes — New England Journal of Medicine (2021)
Therapeutic Management OF Atypical Antipsychotic Related Metabolic Dysfunctions Using GLP 1 Receptor Agonists: A Systematic Review — Experimental and Therapeutic Medicine (2023)