How to Inject Zepbound: Step-by-Step for Each Device

How you inject Zepbound depends on which of the four devices you received: a single-dose prefilled pen, a single-dose vial, a multi-dose vial, or a single-patient-use KwikPen. With the single-dose pen there is no need to see or handle the needle, and it works with a lock ring and a purple button you press and hold for up to 10 seconds ^[1][3]. The vials require you to draw your dose into a syringe yourself — 0.5 mL from a single-dose vial or 0.6 mL from a multi-dose vial ^[1][2]. The KwikPen holds four fixed weekly doses, takes a separate pen needle, and the label calls for priming before every weekly injection ^[1].

All four devices inject the medicine under the skin (subcutaneously) once a week, at any time of day, with or without meals ^[1][4]. Lilly’s prescribing information says patients should be told which presentation they are getting and trained on that specific device, and if the presentation changes, they should be retrained and should read the new Instructions for Use ^[1]. This page summarizes what Lilly’s FDA-approved labeling says; the Instructions for Use packed with your own carton is the document to follow, and your provider or pharmacist can answer device-specific questions ^[1][2].

Which Zepbound device do I have?

Zepbound comes in cartons containing 4 prefilled single-dose pens, 1 or 4 single-dose vials, 1 multi-dose vial, or 1 single-patient-use KwikPen ^[1]. The single-dose pen and single-dose vial each deliver 0.5 mL per dose, while the multi-dose vial and KwikPen deliver 0.6 mL per dose and hold four doses — 2.4 mL total ^[1].

Device	Doses per package	Volume per dose	Supplies bought separately	10 mg NDC example
Single-dose pen	4 pens per carton	0.5 mL	None — needle included in each pen [3][6]	0002-2471-80 [1]
Single-dose vial	1 or 4 vials per carton	0.5 mL	Syringe and needle, supplied separately [1][2][6]	0002-1340-01 [1]
Multi-dose vial	4 doses per vial	0.6 mL	Syringe and needle, supplied separately [1]	0002-6304-11 [1]
Single-patient-use KwikPen	4 doses per pen	0.6 mL	KwikPen-compatible pen needle, purchased separately [1][6]	0002-3533-11 [1]

The NDC numbers above are the 10 mg examples from the label; each strength has its own NDC ^[1].

On LillyDirect, the single-dose vial is listed as exclusively available through LillyDirect and self-pay only, while the KwikPen is listed as accepting select insurance and self-pay, and the single-dose pen is listed as insurance accepted ^[6]. LillyDirect also notes that a pen needle purchase is required with the KwikPen, and a needle and syringe purchase is required with vials ^[6].

The KwikPen is a disposable multi-dose single-patient-use prefilled pen containing four fixed doses, one taken weekly ^[1]. Lilly announced the FDA-approved label expansion that added the four-dose KwikPen on February 23, 2026 ^[4].

What should I check before every dose?

Before each injection, the Instructions for Use say to check the label for the right medicine name, the right dose strength, and the expiration date, and to inspect the device for damage ^[1][2]. The medicine should be clear and colorless to slightly yellow. The label says not to use it if it has particles, is cloudy, is discolored, or has been frozen ^[1][2]. Wash your hands with soap and water before injecting ^[1][2].

The prescribing information also states that the KwikPen is not recommended for self-administration by people who are visually impaired, and that pen users with vision problems should not use the pen without help from a person trained to use it ^[1].

Where do I inject Zepbound, and how do I rotate sites?

For self-injection, the labeled sites are the stomach (abdomen) or the thigh. Another person can inject into the back of your upper arm ^[1][3]. The KwikPen Instructions for Use specify the thigh or abdomen at least 2 inches from the belly button ^[1].

Rotate your injection site each week. You may keep using the same general area of your body, but choose a different spot within that area ^[1][3]. The vial Instructions for Use state that rotating sites within your chosen area reduces the risk of lipodystrophy (pits or thickened skin) and localized cutaneous amyloidosis (skin with lumps) at injection sites ^[2].

The vial Instructions for Use also say not to inject where skin is pitted, thickened, lumpy, tender, bruised, scaly, or hard, or into scars or damaged skin; not to inject in the same site used for other medicines; and not to mix Zepbound with any other medicine ^[2]. Zepbound is injected under the skin only — the Medication Guide says not to inject into a muscle (intramuscularly) or a vein (intravenously) ^[4].

How do I use the Zepbound single-dose pen?

The single-dose pen has a gray base cap, a clear base, a lock ring, and a purple injection button ^[1][3]. Leave the gray base cap on until you are ready to inject ^[1]. Lilly describes four steps ^[1][3]:

1. Choose your injection site. Your healthcare provider can help you choose; you or another person can inject into the abdomen or thigh, and another person can inject into the back of the upper arm ^[1].
2. Pull off the gray base cap. Make sure the pen is locked. Pull the gray base cap straight off and throw it away in your household trash. The label says not to put it back on, because that could damage the needle, and not to touch the needle ^[1].
3. Place the clear base on your skin, then unlock. Place the clear base flat against your skin at the injection site, then unlock the pen by turning the lock ring ^[1].
4. Press and hold up to 10 seconds. 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 completed. The injection is complete when the gray plunger is visible ^[1][3].

After the injection, place the used pen in an FDA-cleared sharps container right away; the pen Instructions for Use say not to throw pens in household trash ^[1]. Lilly’s video states the process is the same regardless of the dose prescribed ^[3].

What do the clicks mean, and what if the gray plunger is not visible?

Some people hear a soft click right before the second loud click. The Instructions for Use say that is the normal operation of the pen, and that the pen should stay on your skin until you hear the second loud click ^[1].

If the gray plunger is not visible after your injection, the Instructions for Use say to contact Lilly at 1-800-545-5979 for further instructions, and until then to store the pen safely to avoid an accidental needle stick ^[1].

Other points from the pen Instructions for Use’s commonly asked questions ^[1]:

• Air bubbles in the pen are normal.
• It is not necessary to warm the pen to room temperature before injecting.
• Holding the injection button down until the injection is complete is not necessary, but it may help keep the pen steady against your skin.
• If you unlock the pen and press the purple button before removing the gray base cap, leave the cap on — the label says to throw the pen away and get a new one.
• The pen has glass parts. If you drop it on a hard surface, the label says not to use it; use a new pen.
• A drop of liquid on the needle tip when you remove the gray base cap is normal.
• A drop of liquid or blood on your skin after the injection is normal. Press a cotton ball or gauze over the site; do not rub it.

How do I use the Zepbound single-dose vial?

The vial’s needle and syringe are supplied separately ^[2]. The prescribing information says to use a syringe appropriate for your dose — for example, a 1 mL syringe capable of measuring a 0.5 mL or 0.6 mL dose — and to always use a new syringe and needle for each injection ^[1]. The vial Instructions for Use list the supplies as the vial, a syringe and needle supplied separately, an alcohol swab, gauze, and a sharps container ^[2].

Drawing the dose follows these steps from the vial Instructions for Use ^[2]:

1. Pull off the vial’s plastic protective cap; leave the rubber stopper in place.
2. Wipe the rubber stopper with an alcohol swab.
3. Remove the outer wrapping from the syringe.
4. Remove the outer wrapping from the needle. If your syringe has a pre-attached needle, skip to the next step.
5. Place the needle on top of the syringe and turn until it is tight and firmly attached.
6. Remove the needle shield by pulling straight off.
7. Hold the syringe with the needle pointing up and pull the plunger until 0.5 mL of air is drawn into the syringe.
8. Push the needle through the rubber stopper.
9. Push the plunger all the way in — this puts air into the vial and makes it easier to pull the solution out.
10. Turn the vial and syringe upside down, keep the needle tip in the liquid, and slowly pull the plunger down until the plunger tip is past the 0.5 mL line. If there are air bubbles, tap the syringe gently a few times to let them rise to the top.
11. Slowly push the plunger up until the plunger tip reaches the 0.5 mL line.
12. Pull the syringe out of the stopper.

How do I inject from a single-dose vial, and what happens after?

The vial Instructions for Use say to inject exactly as your healthcare provider has shown you, and that your provider should tell you whether to pinch the skin before injecting ^[2]. Choose your site — the abdomen or thigh for self-injection, or the back of the upper arm if another person is injecting — insert the needle, and push down on the plunger. The needle should stay in your skin for at least 5 seconds to make sure you have injected the full dose, then pull it out ^[2].

If you see blood after removing the needle, press the site with a piece of gauze and do not rub it. The label says not to recap the needle, because recapping can lead to a needle-stick injury ^[2]. Put the used needle and syringe in an FDA-cleared sharps disposal container right away; the Instructions for Use say not to throw loose needles and syringes in household trash ^[2].

An opened single-dose vial is thrown away after use, even if medicine remains in it ^[2].

How does the multi-dose vial differ?

The multi-dose vial contains four doses, one taken weekly, and each dose is 0.6 mL ^[1]. For example, the 40 mg/2.4 mL (16.7 mg/mL) vial provides four 10 mg/0.6 mL doses ^[1].

The steps are the same 16 steps as the single-dose vial, except you draw 0.6 mL of air into the syringe in step 7 and fill to the 0.6 mL line in steps 10 and 11 ^[1]. Use a new syringe and needle for each injection, and never share needles or syringes with other people ^[1][2].

How do I set up the Zepbound KwikPen?

The KwikPen Instructions for Use list the supplies as the KwikPen, a KwikPen-compatible pen needle (purchased separately), an alcohol swab, gauze or a cotton ball, and an FDA-cleared sharps disposal container or a household container ^[1].

Setup steps ^[1]:

1. Wash your hands with soap and water.
2. Pull the pen cap straight off. Inspect the pen and label. The label says not to use it if the medicine name or dose strength does not match your prescription, the pen is expired or looks damaged, or the medicine has been frozen, has particles, is cloudy, or is discolored. Zepbound should be colorless to slightly yellow.
3. Wipe the red inner seal with an alcohol swab.
4. Select a new pen needle — a new one is used for every injection to help prevent infections and blocked needles. Pull off the paper tab from the outer needle shield.
5. Push the capped pen needle straight onto the pen and twist it on until it is tight.
6. Pull off the outer needle shield and keep it — it will be reused. Pull off the inner needle shield and put it in your household trash.

Do I have to prime the KwikPen before every weekly dose?

Yes. The KwikPen Instructions for Use say to prime before each weekly injection, because priming removes air from the cartridge and makes sure the pen is working correctly ^[1].

To prime ^[1]:

1. Slowly turn the dose knob until you hear 2 clicks and the extended line shows in the dose window. This is the prime position, and it can be corrected by turning the knob in either direction until the extended line lines up with the dose indicator.
2. Hold the pen with the needle pointing up and tap the cartridge holder gently to collect air bubbles at the top.
3. Push the dose knob in until it stops, then slowly count to 5 while holding it. The icon must show in the dose window. The label says not to inject this into your body.

The pen has been primed if a small drop of medicine comes out of the needle tip. If you do not see medicine, repeat the priming steps no more than 2 additional times. If you still do not see medicine, change the pen needle and repeat the steps 1 more time. If you still do not see medicine, contact Lilly at 1-800-545-5979 ^[1].

How do I dial and inject the weekly KwikPen dose?

For the weekly dose, the Instructions for Use say to turn the dose knob all the way until it stops AND the icon shows in the dose window — and not to count clicks as you select the dose ^[1].

Insert the needle into your skin, then push the dose knob in until it stops and slowly count to 5 while holding it. You may notice the plunger moving with each injection. The icon must show in the dose window before you remove the needle ^[1].

When you pull the needle out, a drop of medicine on the needle tip is normal and will not affect your dose ^[1].

If the icon is not in the dose window, insert the needle back into your skin and finish the injection; the label says not to redial the dose. If you still do not think you received the full dose, the Instructions for Use direct you not to start over or repeat the injection, and to see the Troubleshooting section ^[1].

What happens after the KwikPen injection, and what if something goes wrong?

After injecting, the KwikPen Instructions for Use say to ^[1]:

• Press the site with gauze or a cotton ball if you see blood; do not rub it.
• Carefully replace the outer needle shield.
• Unscrew the capped needle and put it in a sharps container. The label says not to store the pen with the needle attached, to prevent leaking, a blocked needle, and air entering the pen.
• Replace the pen cap. The label says not to store the pen without the cap attached.

The Troubleshooting section covers three problems ^[1]:

• Dose knob hard to push: pushing more slowly makes it easier to inject; the needle may be blocked, in which case you put on a new pen needle and prime the pen; or dust, food, or liquid may be inside the pen, in which case you throw the pen away and get a new one.
• Pen cap stuck: gently twist the cap back and forth, then pull it straight off.
• Pen will not let you dial a full dose: after four weekly doses the pen blocks a full dose. Throw the pen away, including the unused medicine — there may not be enough left for a full dose. The label says not to inject the leftover medicine and not to transfer Zepbound from the pen into a syringe.

The prescribing information and the KwikPen Instructions for Use both state never to share a Zepbound KwikPen with other people, even if the pen needle is changed, because of infection risk ^[1][3].

How should I store Zepbound?

For all presentations: do not freeze Zepbound, do not use it if it has been frozen, protect it from heat and light, and store it in the original carton ^[1].

Single-dose pens and single-dose vials are stored in the refrigerator at 36°F to 46°F (2°C to 8°C). If needed, each can be stored unrefrigerated at temperatures up to 86°F (30°C) for up to a total of 21 days, and it is discarded after a total of 21 days at room temperature ^[1]. Lilly’s how-to video adds that once Zepbound has been stored at room temperature, it should not be returned to the refrigerator ^[3].

Unopened multi-dose vials and KwikPens are stored in the refrigerator and can be used until the expiration date on the label if kept refrigerated. If stored at room temperature (up to 86°F), an unopened multi-dose vial or KwikPen is thrown away after 30 days ^[1].

After opening, a multi-dose vial or KwikPen is stored in the original carton in the refrigerator or at room temperature up to 86°F. Throw it away after a total of 30 days at room temperature, 30 days after first use, or after taking 4 weekly doses — even if medicine is left in it ^[1].

How do I throw away pens, syringes, and needles?

Used single-dose pens go into an FDA-cleared sharps disposal container right away; the pen Instructions for Use say not to throw pens in household trash ^[1]. Used needles and syringes from vials also go into a sharps container right away, with no loose needles in household trash ^[2]. For the KwikPen, used pen needles go into a sharps container, and the used pen body may go into household trash or a sharps container after the needle has been removed ^[1].

If you do not have an FDA-cleared sharps container, the Instructions for Use say a household container is acceptable if it is made of heavy-duty plastic, closes with a tight-fitting puncture-resistant lid that keeps sharps from coming out, is upright and stable during use, is leak-resistant, and is properly labeled to warn of hazardous waste inside ^[1][2][3].

The FDA says to follow your community guidelines for disposing of the container when it is about three-quarters (3/4) full, and notes that disposal programs vary by location. For state-specific information, the FDA points to Safe Needle Disposal at 1-800-643-1643, and it suggests carrying a small travel-size sharps container when you leave home ^[5].

If you have questions or problems with any Zepbound device, the Instructions for Use say to contact Lilly at 1-800-LillyRx (1-800-545-5979) or call your healthcare provider ^[1][2].

Sources

1. Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, for subcutaneous use. Prescribing information. Initial U.S. Approval: 2022.
2. Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, for subcutaneous use. Instructions for use, single-dose vial.
3. Eli Lilly and Company. Dosing, how to use and how to inject Zepbound (tirzepatide).
4. Drugs.com. Zepbound (tirzepatide) now available in multi-dose KwikPen. February 23, 2026.
5. US Food and Drug Administration. Best way to get rid of used needles and other sharps.
6. Eli Lilly and Company. Authentic Zepbound (tirzepatide) shipped to you. LillyDirect.