Zepbound vials are glass vials of tirzepatide drawn into a syringe once a week. The single-dose vial holds one 0.5 mL dose, in six strengths from 2.5 mg to 15 mg[1].
Lilly sells the single-dose vial only through LillyDirect, and only self-pay[2]. One month is 28 days and four single-dose vials[2]. The label also lists a multi-dose vial holding four weekly doses[1].
| Single-dose vial | Multi-dose vial | |
|---|---|---|
| Holds | 1 dose in 0.5 mL | 4 weekly doses, 0.6 mL each, in 2.4 mL |
| Strengths | 2.5, 5, 7.5, 10, 12.5 and 15 mg | 2.5, 5, 7.5, 10, 12.5 and 15 mg per dose |
| Carton | 1 vial or 4 vials | 1 vial |
| Out of the fridge | Up to 21 days in total, at 86°F or below | 30 days unopened; opened, 30 days or 4 doses |
| After use | Throw away, even with medicine left | Throw away after 4 weekly doses |
What a vial costs, and what a milligram costs
LillyDirect prices the vial by the month, and the month is four vials[2]. From 7.5 mg up, the lower price needs each refill within 45 days of the last[2].
| Dose | Per month | Per vial | Per mg | Month, refill after 45 days |
|---|---|---|---|---|
| 2.5 mg | $299 | $74.75 | $29.90 | $299 |
| 5 mg | $399 | $99.75 | $19.95 | $399 |
| 7.5 mg | $449 | $112.25 | $14.97 | $499 |
| 10 mg | $449 | $112.25 | $11.23 | $699 |
| 12.5 mg | $449 | $112.25 | $8.98 | $699 |
| 15 mg | $449 | $112.25 | $7.48 | $699 |
The price flattens from 7.5 mg up, but the drug in each vial keeps rising[1][2]. So the cost per milligram falls with every step. At 15 mg a milligram costs $7.48, and at 2.5 mg it costs $29.90.
$74.75
One 2.5 mg vial
Source: LillyDirect
$112.25
One 15 mg vial, refilled within 45 days
Source: LillyDirect
$174.75
One 15 mg vial, refilled late
Source: LillyDirect
LillyDirect notes that 2.5 mg is a starting dose and is not approved as a maintenance dose[2]. The low per-milligram cost at the top doses is not a reason to change dose; the prescriber sets that. How the refill rule is counted is in Zepbound self pay journey program.
What is not in the box
The vial Instructions for Use list the syringe and needle as supplied separately, and mark them “not included”[1]. LillyDirect repeats it under every strength: needle and syringe purchase required[2].
The label calls for a syringe suited to the dose[1]. Its example is a 1 mL syringe that can measure 0.5 mL or 0.6 mL[1]. A new syringe and needle are used for every injection[1]. LillyDirect sells them at checkout, and says vial needles are different from KwikPen pen needles[2].
That is four syringes, four needles and four alcohol swabs a month, plus a sharps container[1]. Typical prices for each are in peptide needles and syringes and alcohol swabs.
One dose per vial, and the leftover
A single-dose vial is drawn up to the 0.5 mL line on the syringe[1]. The Instructions for Use say to throw away every opened vial after use[1]. That holds even with medicine left in it[1].
So a vial never carries into a second week. A dose change means a new strength of vial. The leftover tirzepatide in a vial guide sets that beside compounded vials.
The multi-dose vial is drawn to 0.6 mL each week, for four weeks[1]. After four doses, or 30 days after first use, it is thrown away even with medicine left[1].
Keeping vials cold
Unopened vials are stored in the refrigerator at 36°F to 46°F, in their carton, away from light[1]. A single-dose vial may be kept unrefrigerated at up to 86°F for a total of 21 days, then discarded[1].
A vial that has frozen must not be used[1]. Each vial holds a single week, so a warm day costs one vial rather than the month. That comparison, and the cost of a spoiled KwikPen, is in how long can Zepbound be out of the fridge.
Vial, KwikPen or pen
LillyDirect lists three formats: the KwikPen, the single-dose vial and the single-dose pen[2]. The vial and the KwikPen cost the same per month at every dose[2].
The difference is the device and the supplies. A vial needs a syringe and needle each week[2]. A KwikPen dials a fixed dose and takes a pen needle[2]. The Zepbound KwikPen guide covers the pen, and Zepbound price covers every format.
LillyDirect marks the vial as HSA and FSA eligible, noting that eligibility may vary by plan[2]. Whether it is a medical expense is worked through in is Zepbound HSA eligible. The compounded market is on the tirzepatide price board.
Before ordering vials
- Does the prescription name the single-dose vial, and at which strength?
- Who supplies the 1 mL syringes and needles, and how many are on hand?
- Will each refill land within 45 days, so the lower price holds?
- Is there a sharps container for the used syringes?