How to initiate treatment with Zepbound (liraglutide)?

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Last updated: March 28, 2025 • View editorial policy

From the Guidelines

To initiate treatment with Zepbound (liraglutide), start with a dose of 0.6 mg daily for 1 week, then increase by 0.6 mg weekly until reaching the target dose of 3.0 mg daily. This approach is based on the most recent and highest quality study available, which recommends a gradual dose escalation to manage gastrointestinal side effects 1. The medication should be administered as a subcutaneous injection once daily. Key considerations for initiating treatment with Zepbound include:

  • Monitoring for common side effects such as nausea, vomiting, and diarrhea
  • Counseling patients on maintaining a healthy diet and regular physical activity
  • Being aware of potential contraindications, including pregnancy and breastfeeding, and personal or family history of pancreatitis
  • Gradually increasing the dose to minimize side effects and improve tolerability, as recommended in the SCALE Obesity & Prediabetes study 1. It's essential to prioritize the patient's safety and well-being, and to discontinue the medication if 4% weight loss is not achieved after 16 weeks, as suggested by the study 1.

From the FDA Drug Label

2.1 Recommended Dose Escalation Schedule The recommended starting dosage of ZEPBOUND for all indications is 2.5 mg injected subcutaneously once weekly for 4 weeks. The 2. 5 mg dosage is for treatment initiation and is not approved as a maintenance dosage. Follow the dosage escalation below for all indications to reduce the risk of gastrointestinal adverse reactions [see Warnings and Precautions (5.2) and Adverse Reactions (6.1)]. After 4 weeks, increase the dosage to 5 mg injected subcutaneously once weekly. The dosage may be increased in 2. 5 mg increments, after at least 4 weeks on the current dose [see Dosage and Administration (2.2)]. Consider treatment response and tolerability when selecting the maintenance dosage. If patients do not tolerate a maintenance dosage, consider a lower maintenance dosage.

To initiate treatment with Zepbound (liraglutide), the recommended starting dosage is 2.5 mg injected subcutaneously once weekly for 4 weeks. After 4 weeks, the dosage should be increased to 5 mg injected subcutaneously once weekly. The dosage may be further increased in 2.5 mg increments after at least 4 weeks on the current dose, considering treatment response and tolerability. It is essential to train patients and caregivers on proper injection technique and administer Zepbound in combination with a reduced-calorie diet and increased physical activity 2.

From the Research

Initiating Treatment with Zepbound (liraglutide)

There are no research papers provided to assist in answering this question about how to initiate treatment with Zepbound (liraglutide). The studies provided are related to tirzepatide and hyperthyroidism, but do not mention Zepbound (liraglutide) or its treatment initiation protocol.

  • The studies 3, 4 discuss the efficacy and safety of tirzepatide in patients with metabolic dysfunction-associated steatohepatitis and obesity.
  • Study 5 reviews hyperthyroidism, its causes, symptoms, and treatment options, but does not provide information on Zepbound (liraglutide).

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.