Tirzepatide

Yes — tirzepatide is the active ingredient in two FDA-approved drugs: Mounjaro (approved May 2022 for type 2 diabetes) and Zepbound (approved November 2023 for chronic weight management). In December 2024, the FDA expanded Zepbound's label to include moderate-to-severe obstructive sleep apnea in adults with obesity — the first pharmacotherapy approved for that indication. In August 2026 Mounjaro's label added a second use: lowering the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes at high risk of them.

Brand Mounjaro and Zepbound, with a prescription, yes. Compounded tirzepatide, only narrowly. It is not FDA-approved, and since the shortage ended in December 2024 the FDA's position is that pharmacies may not routinely make copies of it. A pharmacy may still compound it for an individual patient when the prescriber documents a clinical reason the brand product will not do, such as a different dose or an added ingredient, and many telehealth companies sell it on that basis. The FDA pushes back: in June 2026 it posted 25 warning letters over how compounded semaglutide and tirzepatide were marketed. We list who sells it and what they charge; a listing is not a statement that a given seller is operating within the rules. Availability also varies by state.

The most common are gastrointestinal: nausea, diarrhea, decreased appetite, vomiting, constipation — typically mild to moderate and clustered during dose escalation rather than at steady state. Rarer serious events include acute pancreatitis, gallbladder disease, and dehydration-related kidney injury. The drug carries a boxed warning for thyroid C-cell tumors based on rodent data, with absolute contraindications for personal or family history of medullary thyroid carcinoma or MEN type 2. Discuss your medical history with your provider.

Tirzepatide can cause hypoglycemia with insulin or sulfonylureas — those doses typically need to be reduced. It also slows gastric emptying, which can affect absorption of oral medications. Always disclose your full medication list to your provider. A history of pancreatitis, severe gastroparesis, gallbladder disease, or eating disorders warrants a specialist review before starting.

In the price table on this page, monthly figures run from about $79 to $448, read between November 4, 2026 and November 11, 2026. Brand tirzepatide — Mounjaro or Zepbound — lists at over $1,000 per month without insurance. Many commercial plans cover it with prior authorization, and Lilly's savings card and LillyDirect program cut the cash price for eligible patients; what you actually pay depends on your plan, so ask your pharmacy to run it. Compounded tirzepatide costs a fraction of that and is still sold by the telehealth companies listed on this page; it is not FDA-approved (see "Is it legal?"). Current branded prices by provider are on the hub's price index.

In the only head-to-head trial, SURMOUNT-5, adults with obesity and without diabetes lost 20.2% of their body weight on tirzepatide and 13.7% on semaglutide over 72 weeks, at the highest dose each tolerated. Side effects were similar and mostly gastrointestinal. Semaglutide has the stronger evidence on heart outcomes.

Retatrutide is not approved and cannot be prescribed. In its own Phase 3 trial it produced 25.0% weight loss at the top dose over 80 weeks, against 20.9% over 72 weeks for tirzepatide in SURMOUNT-1; those are separate trials, and the one comparing the two directly has not reported. Zepbound is tirzepatide.