Drug facts

How to inject tirzepatide: the vial instructions

By David Chen·Editor·Reviewed September 2026

What the instructions cover²

Zepbound comes as a single-dose pen, a single-dose vial, a multi-dose vial and a KwikPen, and each has its own Instructions for Use. Section 2.4 of the label says to tell patients which one they will receive, train them on it, and point them to that presentation’s instructions if it changes. This page covers the single-dose vial, the one drawn with a separate syringe.

For vials, section 2.4 says to use a syringe appropriate for the dose, “e.g., a 1 mL syringe capable of measuring a 0.5 mL or 0.6 mL dose,” and to use a new syringe and needle for every injection. The instructions list what to have ready: one single-dose vial, one syringe and one needle (supplied separately, “for example, use a 1 mL syringe and needle as recommended by your healthcare provider”), an alcohol swab, gauze, and a sharps container.¹

Before drawing: what to check¹

The instructions begin with taking the vial out of the refrigerator and checking its label for the right medicine, the right dose and the expiration date. They then list four things the liquid must be:

Not frozen

Frozen medicine is not to be used.

Not cloudy

The solution should be clear.

Colorless to slightly yellow

The label’s description of a normal solution.

Free of particles

Section 2.4 says not to use it if particles or discoloration are seen.

They also say to use a new syringe and needle every time “to prevent infections and blocked needles,” never to share them, and to wash your hands with soap and water before starting.

Drawing the dose: steps 1 to 12¹

As the instructions number them:

1. Pull off the plastic protective cap. Do not remove the rubber stopper.
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 the syringe has a needle already attached, skip to step 6.
5. Place the needle on the syringe and turn it until it is tight.
6. Pull the needle shield straight off.
7. Holding the syringe needle-up, pull the plunger down until its tip reaches the 0.5 mL line, drawing in 0.5 mL of air.
8. Push the needle through the vial’s rubber stopper.
9. Push the plunger all the way in. The instructions explain that this puts air into the vial and makes the solution easier to draw out.
10. Turn the vial and syringe upside down, keep the needle tip in the liquid, and slowly pull the plunger past the 0.5 mL line. If there are air bubbles, tap the syringe gently so they rise.
11. Slowly push the plunger up until its tip is at the 0.5 mL line.
12. Pull the syringe out of the rubber stopper.

Injecting: steps 13 to 16¹

Before the last four steps, the instructions set out rules for the injection itself: inject exactly as a healthcare provider has shown you, and let them tell you whether to pinch the skin. Change the injection site within the chosen area each time, to reduce the risk of pits or thickened skin (lipodystrophy) and lumps (localized cutaneous amyloidosis). Do not inject into skin that has pits, is thickened or lumpy, or is tender, bruised, scaly or hard, or into scars or damaged skin. Do not mix Zepbound with any other medicine, and do not use a site used for other medicines.

13. Choose the site: the stomach area (abdomen) or thighs when you inject yourself; the stomach area, thighs or back of the upper arms when someone else does. The sites the label names, and why rotation matters →
14. Insert the needle into the skin.
15. Push the plunger down to inject. The needle should stay in the skin for at least 5 seconds to make sure the whole dose is delivered.
16. Pull the needle out. If there is blood, press the site with gauze and do not rub it. Do not recap the needle, because recapping can cause a needle-stick injury.

The Medication Guide adds one line the steps assume: inject under the skin, and do not inject into a muscle or a vein.³

Why 0.5 mL is not a dose on a compounded vial²

The instructions can use a single 0.5 mL line because of how the vial is made. Section 3 of the label lists all six single-dose strengths, 2.5 mg to 15 mg, as a dose in 0.5 mL, and each vial is used once. Draw to the line and you have taken whatever the vial says on its label. Lilly’s own multi-dose vial works differently: four 0.6 mL doses per vial, at concentrations from 4.17 to 25 mg/mL.

This page gives no dose, in milligrams, units or milliliters, for any compounded product. The amount to draw from your vial comes from your prescriber and the pharmacy’s label. Every calculator on this site is listed on the tools page.

Afterward: sharps and storage¹

The instructions say to put the used needle and syringe in an FDA-cleared sharps disposal container straight away, not loose in household trash. Where there is no such container, they describe a household one that will do: heavy-duty plastic, a tight-fitting and puncture-resistant lid, upright and stable, leak-resistant, and labeled as hazardous waste. Disposal of the full container follows local rules.

For storage, the instructions say unopened single-dose vials go in the refrigerator; each may be kept at room temperature up to 86°F (30°C) for a total of 21 days, and an opened vial is thrown away after use even if medicine is left in it. A compounded multi-dose vial is dated differently, which is covered in storage and beyond-use dating.

How to take it: the schedule the label sets²

Section 2.4 says to inject once weekly, at any time of day, with or without meals, alongside a reduced-calorie diet and increased physical activity. Section 2.3 lets the injection day change as long as at least 3 days (72 hours) separate two doses, and says a missed dose can be taken within 4 days; after that, skip it and take the next one on the usual day. The dose itself, and how it rises, is in dosage and titration; a missed week is covered in the missed-dose rule; and what the label means by diet is in what to eat on tirzepatide.