How to inject Zepbound: pen, KwikPen and vial, step by step

Before you start

Check the medicine

Whichever format you have, the instructions ask you to check the label shows the right medicine and dose, that it has not expired, and that the liquid is colorless to slightly yellow, not cloudy, not frozen, and free of particles.^{[1, 2, 3]} If anything looks wrong, do not use it.

Choose your injection site

Inject under the skin of your abdomen or thigh. Another person can also inject into the back of your upper arm. Change (rotate) your site each week: you can stay in the same area, but pick a different spot within it.^{[1, 4]} Lilly's guidance for the abdomen is to stay at least 2 inches from the belly button.^[5]

The free injection site logbook keeps track for you and shows which spot has rested longest.

Single-dose pen

The single-dose pen has a built-in hidden needle. There is nothing to attach and no priming.^[1]

1. Remove the gray base cap

   Pull it straight off and throw it away in your household trash.

2. Place and unlock

   Place the clear base flat against your skin at the injection site, then unlock by turning the lock ring.

3. Press and hold

   Press and hold the purple injection button for up to 10 seconds. The first click means the injection has started. The second click means it is complete.

4. Check

   The gray plunger should now be visible. That tells you the dose has been delivered.

Summarized from the single-dose pen Instructions for Use.^[1]

KwikPen

The KwikPen holds four weekly doses and needs a new pen needle for every injection. Needles are not included.^[2]

1. Attach a new needle

   Wipe the red inner seal with an alcohol swab. Push a new KwikPen-compatible needle straight on and twist until tight. Remove the outer shield (keep it) and the inner shield (throw it away).

2. Prime

   Turn the dose knob until you hear 2 clicks and the extended line shows. Point the needle up, tap to bring bubbles up, push the knob in until it stops and slowly count to 5. Look for a drop at the needle tip.

3. Dial

   Turn the dose knob all the way until it stops and the dose icon shows in the window. Do not count clicks.

4. Inject

   Insert the needle, push the dose knob in until it stops, and slowly count to 5 while holding it. Check the icon is showing before you remove the needle.

More detail, including what to do if no drop appears or the pen will not dial, is in theKwikPen guide.

Single-dose vial

Vials need a syringe and needle, supplied separately. The instructions give the example of a 1 mL syringe and needle as recommended by your healthcare provider. Always use a new syringe and needle for each injection.^[3]

1. Prepare the vial

   Pull off the plastic protective cap, leaving the rubber stopper in place. Wipe the stopper with an alcohol swab.

2. Prepare the syringe

   Attach the needle to the syringe and turn until it is tight. Remove the needle shield. Holding the needle up, pull the plunger down to draw 0.5 mL of air into the syringe.

3. Put air into the vial

   Push the needle through the rubber stopper and push the plunger all the way in.

4. Draw up the dose

   Turn the vial and syringe upside down. Slowly pull the plunger down past the 0.5 mL line, then slowly push it back up until the plunger tip reaches the 0.5 mL line. Tap gently to move any air bubbles to the top. Pull the syringe out of the stopper.

5. Inject

   Insert the needle into your skin and push the plunger down to inject. Keep the needle in your skin for at least 5 seconds, then pull it out.

Each vial is single use. Throw it away after use, even if medicine is left in it.^[3]

After you inject

• If you see a little blood, press the site lightly with gauze or a cotton ball. Do not rub.^{[2, 3]}
• Put used pens, pen needles, syringes and needles in an FDA-cleared sharps disposal container right away.^{[1, 3]}
• Do not recap a vial syringe needle. For the KwikPen, the instructions do say to put the outer needle shield back on before unscrewing the needle.^{[3, 2]}
• Never share your pen, needles or syringes with anyone.^{[2, 3]}
• Log the site so you rotate next week. The logbook takes a few seconds.

Timing and missed doses

Take Zepbound once a week, at any time of day, with or without meals.^[4]

If you miss a dose, the prescribing information says to take it as soon as possible within 4 days (96 hours) of the missed dose. If more than 4 days have passed, skip it and take the next dose on your regular day. You can change your injection day if you need to, as long as there are at least 3 days (72 hours) between two doses.^[4]

Questions about the product itself can go to Lilly on 1-800-545-5979.^[1] Questions about your own dose or symptoms belong with your prescriber or pharmacist.

Common questions