Can’t Fill Your Zepbound Prescription? Here Are 5 Zepbound Alternatives to Consider

HRAUN/E+ via Getty Images

Zepbound (tirzepatide) is one of several FDA-approved weight-loss medications. This once-weekly injection mimics the effects of two natural gut hormones: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). Taking Zepbound has led to significant weight loss for many people.

Zepbound has been growing in popularity since its FDA approval. But because of this increase in demand, there's a shortage of the medication. This has many people looking at other options. But what's available for chronic weight management? Below, we'll review five Zepbound alternatives your prescriber may discuss with you.

1. Wegovy

Wegovy (semaglutide) is very similar to Zepbound. It's also a once-weekly injection that can provide significant weight loss. But Wegovy only acts like one gut hormone: GLP-1. Zepbound is currently the only FDA-approved weight-loss medication that acts like both GLP-1 and GIP.

This difference in how each works means that Zepbound may provide greater weight loss than Wegovy for some people. An ongoing head-to-head clinical trial is looking to confirm whether this is true.

Wegovy has a few notable differences from Zepbound. Beyond weight loss, it's also approved to lower the risk of serious cardiovascular problems for adults considered to be overweight or obese and who also have heart disease. Zepbound's cardiovascular benefits are still being studied. If you also have heart disease, your prescriber may switch you to Wegovy for its added heart benefits. It may also be more likely to be covered by insurance for this reason.

Wegovy also has the advantage of being approved for adults and adolescents ages 12 and older. Zepbound is still being studied for use in children, so it's currently only approved for adults.

As with Zepbound, there's a shortage of Wegovy. So while this could be the most ideal Zepbound alternative for you, it may be difficult to find it at pharmacies.

2. Saxenda

Saxenda (liraglutide) is another weight-loss injection. It belongs to the same class as Wegovy and acts like the gut hormone GLP-1 in the body. But unlike Zepbound and Wegovy, you'll need to inject Saxenda once a day.

Similar to Zepbound, Saxenda doesn't have proven cardiovascular benefits. But Saxenda is approved for adolescents ages 12 and older. However, based on individual clinical trials, Zepbound may cause more weight loss than Saxenda.

People taking Zepbound for 72 weeks (16.5 months) in clinical trials lost an average of 15% to 20% of their starting body weight. People taking Saxenda for 56 weeks (almost 13 months) lost an average of 8% of their body weight. But keep in mind that these medications haven't been compared directly in a head-to-head clinical trial.

If you switch from Zepbound to Saxenda, be aware that their injection pens are different. Zepbound's pen comes with a needle already attached to it and is meant for a single use. You will discard the pen in a sharps container after you inject it. Saxenda's pen, however, is meant for multiple uses. So before each Saxenda dose, you will attach a fresh pen needle.

As with Zepbound and Wegovy, Saxenda is also in short supply. So it could be tough to find a pharmacy who has it in stock.

3. Contrave

Contrave is a potential oral Zepbound alternative. Contrave is a tablet that contains two medications: naltrexone and bupropion. These active ingredients work together to help lower your appetite and reduce food cravings. It may be helpful if you experience emotional eating.

After the first few weeks of taking Contrave, the standard dosage is 2 pills twice a day. In general, people typically lose less weight with oral weight-loss medications than injections, such as Zepbound. On average, people taking Contrave in studies lost between 5% and 8% of their starting body weight.

Contrave has different risks and side effects than Zepbound. For instance, both can cause stomach upset and diarrhea. But Contrave can also cause trouble sleeping and higher blood pressure. You may not be able to take Contrave if you have a history of seizures or an eating disorder. Contrave also has unique interactions to consider.

If you're changing from Zepbound to Contrave, it's a good idea to review your full medical history and medication list with your prescriber. They can use this information to let you know if you can safely make the switch.

Unlike the injectable medications we've discussed, there have been no reported shortages of Contrave at this time. It should be available at most pharmacies if you decide it's the right choice for you.

4. Qsymia

Qsymia (phentermine / topiramate ER) is another oral Zepbound alternative. Like Contrave, it's a combination pill. The two medications - phentermine and topiramate - work together to reduce your appetite.

Qsymia's typical dosage may be more convenient for some people than Contrave's. You typically take 1 pill once a day in the morning. As with other oral options, you may lose less weight with Qsymia than with Zepbound. Most people lost about 8% to 10% of their starting body weight while taking Qsymia in clinical trials.

You and your prescriber should discuss Qsymia's side effects, risks, and interactions before switching to it. This medication commonly causes numbness or tingling, constipation, and dry mouth.

Qsymia can also cause severe birth defects. Because of this, there's a mandatory risk management program for the medication. If you're able to get pregnant, you'll have to take a pregnancy test before starting Qsymia, and then subsequently once a month for as long as you're taking it. You'll also need to use an effective form of birth control while taking Qsymia.

There's no shortage of Qsymia right now. So it should be more readily available than Zepbound. But because of Qsymia's risk management program, pharmacies must be certified through the FDA to dispense it. So not all pharmacies may be able to fill a prescription for it.

5. Xenical

Another oral Zepbound alternative to consider is Xenical (orlistat). Its active ingredient is also available over the counter in lower doses under the brand name Alli.

Xenical works differently than the other Zepbound alternatives discussed above. It blocks your body from absorbing fat from the foods you eat. But in order for it to be effective, you need to take Xenical 3 times daily with meals that contain fat. On average, people lost about 8.5% of their starting body weight when taking Xenical in clinical trials.

Xenical can cause some uncomfortable side effects. These include loose or oily stools, stomach pain, and gas with oily spotting. It can also prevent your body from absorbing certain vitamins from your diet. It's common for prescribers to recommend taking a multivitamin if you're also taking Xenical.

Similar to the oral weight-loss medications listed above, there's no shortage of Xenical. So you may have an easier time getting a prescription for it filled.

When will the Zepbound shortage be resolved?

It's unclear when the Zepbound shortage will be resolved. Lilly (Zepbound's manufacturer) has been increasing their production of the medication over the past few months. They've also stated they'll continue to increase production as much as they can.

Keep in mind that only certain doses are impacted by the Zepbound shortage. The 10 mg and 15 mg doses are only available in limited supplies. But as of July 2024, the 2.5 mg, 5 mg, 7.5 mg, and 12.5 mg doses are currently listed as available.

Lilly recommends calling around to pharmacies in your area if your preferred pharmacy doesn't have your Zepbound dose in stock. They also suggest requesting your refills about 1 week ahead of time. This will give pharmacies extra time to order Zepbound for you.

Public link

Please use the above public link if you want to share this noodl on another website.