Zepbound is no longer on the FDA’s official drug shortage list. The FDA resolved the tirzepatide shortage on December 19, 2024, after re-evaluating a previous determination from October of that year. However, “resolved” in regulatory terms doesn’t always match what happens at your pharmacy. Eli Lilly acknowledges that some people still experience difficulty filling prescriptions depending on their location and dose.
What the FDA Shortage Resolution Means
The FDA added tirzepatide (the active ingredient in both Zepbound and Mounjaro) to its drug shortage list in 2024 as demand far outpaced supply. On October 2, 2024, the agency initially evaluated the shortage status, and by December 19, 2024, it issued a new decision declaring the shortage resolved. As of April 2026, tirzepatide does not appear on the FDA’s drug shortage list or its 503B bulks list.
This resolution had a major ripple effect: it ended the legal basis for most compounding pharmacies to produce copycat versions of tirzepatide. While the drug was listed as being in shortage, compounders could legally make their own versions. With the shortage officially over, that door has largely closed.
Why You Might Still Have Trouble Filling a Prescription
Eli Lilly states clearly on its supply website that even though all doses are being manufactured and shipped, “you may experience difficulty when trying to fill any dose.” The company points to local supply chain dynamics, meaning distribution bottlenecks, pharmacy stock levels, and regional demand patterns that vary from one area to another.
Zepbound vials across all six dose strengths (2.5 mg through 15 mg) are listed by Lilly as having “limited availability.” During these periods, prescriptions can still be filled but may come with delays. The practical experience for many patients is that their pharmacy either doesn’t have the dose in stock, needs to order it, or can’t guarantee when it will arrive.
Certain doses are harder to get than others. The titration doses, specifically the 2.5 mg, 7.5 mg, and 12.5 mg strengths used when stepping up to higher levels, have been particularly difficult. Washington University’s weight management program has reported being unable to send refills for those doses, and some providers have stretched dosing intervals to every 10 days instead of every 7 to make existing supply last longer.
Insurance Complications During Limited Supply
Supply constraints have created a frustrating loop with insurance coverage. Because titration doses are intermittently unavailable, patients sometimes need to request additional prior authorizations each month rather than getting straightforward refills. Clinicians at Washington University have reported that insurers are increasingly denying these repeated authorization requests, leaving patients stuck between a drug they can’t easily get and an insurer that won’t approve workarounds.
If your pharmacy can’t fill your prescribed dose, talk to your prescriber about whether a different available dose could work temporarily. Some patients have been switched to maintenance doses that happen to be in better supply, though this depends on where you are in treatment.
When Supply Should Improve
Eli Lilly has committed $9 billion to a manufacturing site in Lebanon, Indiana, more than doubling its original $3.7 billion investment there. The company expects to begin producing medicines at that facility toward the end of 2026, with operations scaling up through 2028. Additional new sites are under construction in Research Triangle Park and Concord, North Carolina, as well as Limerick, Ireland, and Alzey, Germany.
Lilly says it has been building these facilities in roughly two years from groundbreaking to production, about three years faster than the pharmaceutical industry average. The company describes these as “historic investments” in manufacturing capacity. Still, the timeline means meaningful relief from supply constraints is likely a gradual process through 2027 and 2028 rather than an overnight fix.
What to Do If You Can’t Get Your Dose
Your best options depend on your situation. If your pharmacy is out of stock, call other pharmacies in your area, including independent ones that may have different distributors. Specialty pharmacies and mail-order services sometimes have better access than retail chains.
If a specific titration dose is unavailable, your prescriber may adjust your dosing schedule or move you to a dose that’s more reliably in stock. Stretching doses to every 10 days is one approach some clinics are using, though this should be a decision made with your provider rather than on your own. Skipping doses entirely or stopping abruptly can cause rebound appetite changes and blood sugar fluctuations, so maintaining some level of consistent dosing matters more than hitting the exact schedule.
With compounded tirzepatide largely off the table since the shortage resolution, the brand-name product from Lilly is now essentially the only legal source. Patients who had been using compounded versions have needed to transition to the branded medication or discuss alternative treatments with their provider.