Home / How to inject tirzepatide
Draw. Check. Inject. Rotate.
How to inject compounded tirzepatide from a vial, step by step
Medically reviewed by the NexLife clinical team, led by Adam Kennah, MD · Updated
Draw your prescribed units into a new U-100 insulin syringe and inject under the skin of your stomach or thigh, changing spots every week. NexLife answers questions about your vial 24/7: call or text
$139/mo on 12 months, every dosePrice Match Guarantee†
- Your pharmacy label and your provider’s instructions come first
- At 10 mg/mL, 2.5 mg is 25 units
- Stomach or thigh; a helper can use your upper arm
$139/mo on a 12-month plan, all-inclusive, same price at every dose
Or $169/mo month to month
Questions about your vial? Call or text
About 3 minutes online · No insurance needed · Not prescribed? No charge for medication
Price Match Guarantee†. Paying less elsewhere? We match your regular monthly price. How it works
4.8 out of 5 on Trustpilot, 403 reviews
Compounded, not FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you. The vial shown is an illustration.
- Licensed U.S. providers
- LegitScript certified
- State-licensed 503A pharmacies
- Free expedited shipping
- HSA, FSA, Affirm, Klarna, Afterpay
- 24/7 support, real people
Key takeaways
- Your pharmacy label and your provider come first. These steps adapt Lilly’s Zepbound vial instructions for a multi-dose vial: a new syringe every time, a fresh swab on the stopper, and the needle in at least 5 seconds.
- Units depend on your vial’s strength. On a U-100 syringe, units = mg ÷ mg/mL × 100. So 2.5 mg is 25 units at 10 mg/mL, but 12.5 units at 20 mg/mL.
- Stomach or thigh, a new spot each week. Stay at least 2 inches from your belly button. A helper can use the back of your upper arm.
- No injection site is proven to cause less nausea. We found no study comparing sites, and the Zepbound label says tirzepatide reaches similar levels in the blood from the stomach, thigh or upper arm.
- At NexLife, questions about your vial come to us, 24/7: call or text
(949) 818-8000 , and we’ll talk you through your first dose. Compounded tirzepatide is $139 a month on the 12-month plan, or $169 month to month.
What you need
What do you need to inject tirzepatide from a vial?
Six things, set out on a clean surface before you start. Lilly’s instructions for its Zepbound vial list the same basics.
Your vial
Check its label: the medicine’s name, its strength in mg per mL and its beyond-use date.
A new U-100 insulin syringe
One for every dose, needle attached, big enough to hold your units. Use the one your pharmacy or provider recommends.
Alcohol swabs
A fresh one each time, to wipe the vial’s rubber stopper.
Gauze or a cotton ball
To press on the spot if you see a little blood.
A sharps container
An FDA-cleared one, or a heavy-duty plastic household container with a tight, puncture-resistant lid.
Your prescription
Your dose in mg, and how many units that is with your vial.
Which syringe size? One that holds your whole dose in a single draw. A 0.3 mL syringe holds 30 units, 0.5 mL holds 50 and 1 mL holds 100. On many 1 mL syringes, each line is 2 units. For the 0.5 mL dose in its single-dose vial, Lilly gives a 1 mL syringe as the example.
Step by step
How to draw and inject tirzepatide from a multi-dose vial
These steps follow Lilly’s instructions for its Zepbound vial (revised April 2026), adapted for a vial that holds several doses. Your pharmacy label and your provider’s instructions come first: if they differ, follow them.
Before you start
- Check the label. The right medicine, the strength you expect, and not past its beyond-use date or 28 days from your first dose out of it.
- Look at the liquid. Don’t use it if it’s cloudy, has particles or has ever been frozen. Red or pink usually means added vitamin B12; color doesn’t tell you the strength.
- Wash your hands with soap and water.
Then, 10 steps
Wipe the rubber stopper
The first time, pull off the plastic cap, but leave the rubber stopper in place. Every time, wipe the stopper with a new alcohol swab.
Uncap a new syringe
Use a new needle and syringe for every dose. Pull the needle cap straight off.
Pull in air to your dose
Hold the syringe with the needle pointing up. Pull the plunger down to your number of units (how many?), so the syringe holds that much air.
Push the air into the vial
Push the needle through the rubber stopper, then push the plunger all the way in. Lilly says this makes the liquid easier to draw.
Draw a little past your dose
Turn the vial and syringe upside down. Keep the needle tip in the liquid, and slowly pull the plunger a little past your units line.
Tap out bubbles, then set your dose
Tap the syringe gently so any bubbles rise to the top. Slowly push the plunger up to exactly your units line, and check it against your prescription.
Take the needle out of the vial
Pull the syringe straight out. Never leave a needle in the stopper. Put the vial back where its label says to store it.
Choose your spot
Your stomach, at least 2 inches from your belly button, or your thigh. A helper can use the back of your upper arm. Pick a different spot from last week.
Inject, then hold
Insert the needle the way your provider showed you, pinching the skin only if they told you to. Push the plunger all the way in, and keep the needle in for at least 5 seconds.
Finish safely
Pull the needle out. If you see blood, press the spot with gauze; don’t rub it. Don’t recap the needle: put the syringe straight into your sharps container.
What’s different with a multi-dose vial
You draw units, not a set 0.5 mL
Each Zepbound single-dose vial holds one 0.5 mL dose (50 units on a U-100 syringe). In a multi-dose vial, your units depend on your dose and your vial’s strength.
You go back in every week
So it’s a new needle and syringe and a fresh swab on the stopper every time, and no needle left in the stopper between doses.
Date it the first time
Write the date of your first dose on the vial or its box. Throw the vial out 28 days later, even with medicine left, or sooner if its label says so.
Lilly’s KwikPen is a different device
It’s a 4-dose pen, 0.6 mL a dose, with its own instructions (Lilly’s vial holds a single 0.5 mL dose). A compounded vial follows its pharmacy label and the FDA’s 28 days.
Not sure about a step? Ask before you inject.
Call or text NexLife at
Units
How many units of tirzepatide do you draw?
It depends on your vial’s strength. On a U-100 insulin syringe, 100 units is 1 mL, so units = your dose in mg ÷ your vial’s strength in mg/mL × 100.
| Vial strength | 2.5 mg dose | 5 mg dose | Each unit holds |
|---|---|---|---|
| 5 mg/mL | 50 units | 100 units a full 1 mL syringe | 0.05 mg |
| 10 mg/mL | 25 units | 50 units | 0.1 mg |
| 15 mg/mL | 16.7 units | 33.3 units | 0.15 mg |
| 20 mg/mL | 12.5 units | 25 units | 0.2 mg |
| 25 mg/mL | 10 units | 20 units | 0.25 mg |
| 30 mg/mL | 8.3 units | 16.7 units | 0.3 mg |
Swipe the table sideways to see every column.
Units on a U-100 insulin syringe (100 units = 1 mL) for the first two doses on the Zepbound label. Find the strength on your vial’s label, in mg per mL. Example math only: your prescription sets your dose.
50 units on a U-100 syringe is 0.5 mL. How much medicine that holds depends on the vial’s strength, so give your provider the milligrams on your label, not the units.
Got a fraction, like 16.7 units? That’s hard to measure on a syringe marked in whole or half units. Ask your provider or pharmacy exactly what to draw before you inject.
Need another dose or strength? Our tirzepatide dosage chart has every dose from 2.5 mg to 15 mg at six strengths, and a converter for any vial.
Where to inject
Where to inject tirzepatide, and how to rotate
Under the skin of your stomach or thigh. Someone else can use the back of your upper arm. Change the spot every week, even if you stay in the same area.
Stomach
You or a helper. Stay at least 2 inches from your belly button.
Thigh
You or a helper. Easy to see when you inject yourself.
Back of the upper arm
A helper only: Lilly says another person should give this one.
A rotation map: four spots, one a week
- Week 1Stomach, left of your belly button
- Week 2Stomach, right of your belly button
- Week 3Left thigh
- Week 4Right thigh
Then start again, at least an inch from the spot you used last time in that area. Have a helper? Add the back of each upper arm. A note on your phone with the date and the spot makes the next one easy.
- Skip skin that’s tender, bruised, scaly or hard, and any scars or damaged skin.
- Skip spots with pits, thickened skin or lumps. Lilly says changing spots each week lowers the risk of them.
- Under the skin only, never into a muscle or a vein.
- Other injections, like insulin? Use a different spot, and never mix medicines in one syringe.
Site and nausea
Does where you inject change nausea?
Not that anyone has shown. We found no study comparing nausea by injection site (we searched on October 22, 2026), and the label points to no difference.
What the label says. The Zepbound prescribing information says tirzepatide reaches similar levels in the blood whether it’s injected in the stomach, thigh or upper arm.
What does matter is the dose. In two Zepbound trials, nausea was the most common side effect: 25% to 29% of people on 5 mg to 15 mg had it, against 8% on placebo. Most of it came while the dose was going up, and it eased over time. These trials studied FDA-approved Zepbound; compounded tirzepatide wasn’t studied.
So choose the spot that’s easiest for you. If one area seems to suit you better, you can keep using it, at a new spot each week.
Nausea that won’t go away? Tell your provider, since vomiting or diarrhea can dehydrate you. What helps, and when to call: tirzepatide side effects.
Skin reactions
Injection-site reactions: what’s normal, and when to call
A little soreness where you injected is expected, NIH’s MedlinePlus says. Here’s what the Zepbound label lists, and when to get help.
How common? In two Zepbound trials, 6% to 8% of people on Zepbound had an injection-site reaction, against 2% on placebo: bruising, redness, itching, pain or a rash where they injected. These trials studied FDA-approved Zepbound; compounded tirzepatide wasn’t studied.
| What you notice | What to do |
|---|---|
| A little blood as the needle comes out | Press the spot with gauze or a cotton ball. Don’t rub it. |
| Soreness, redness or itching that fades | Keep changing spots. Tell your provider if it bothers you or doesn’t go away. |
| Pits, thickened skin or a lump where you often inject | Don’t inject there. Move to another area, and tell your provider. |
| Redness or swelling that spreads, red streaks or a fever | These can be signs of an infection. Call your provider. |
| Severe stomach pain that won’t go away with or without vomiting | Stop tirzepatide and call your provider right away. It can be a sign of pancreatitis. |
| Signs of a serious allergic reaction: swelling of your face, lips, tongue or throat; trouble breathing or swallowing; fainting or dizziness; a very fast heartbeat; a severe rash or itching | Stop tirzepatide and get medical help right away: call 911. |
Swipe the table sideways to see every column.
From Lilly’s Zepbound Medication Guide and vial instructions (signs of infection from NIH’s MedlinePlus). Your provider’s instructions come first.
Avoid these
Common mistakes with tirzepatide vials
Most come down to units, needles and storage. The FDA has had reports of people measuring and injecting the wrong dose of compounded semaglutide, some of whom needed hospital care. The same math applies to tirzepatide.
- Mixing up mL and units. On a U-100 syringe, 0.25 mL is 25 units. Your dose is in mg, your syringe counts units, and your vial’s strength links the two.
- Not rechecking a new vial. A new strength changes your units: 2.5 mg is 25 units at 10 mg/mL but 12.5 units at 20 mg/mL.
- Reading the wrong lines. On many 1 mL syringes, each line is 2 units, not 1.
- Reusing a needle or syringe. Even on yourself. It can carry germs into your vial, the FDA warns, and Lilly adds that a used needle can block.
- Leaving a needle in the stopper. The CDC warns that it gives germs a way into the vial. Take it out every time.
- Using a vial that froze or arrived warm. Don’t, even if a frozen vial has thawed. Keep it and the box, and contact the program that prescribed it.
- Going past day 28. Throw out an opened vial 28 days after its first dose, even with medicine left, or sooner if its label says so.
- Recapping a needle, or tossing it in the trash. Recapping can stick you. Put the syringe straight into a sharps container, never loose in the trash or recycling.
Think you injected too much? Call your provider or Poison Help at 1-800-222-1222, or go to the nearest emergency room right away, as the Zepbound Medication Guide says.
At NexLife
Questions about your vial? Call or text us, 24/7
Questions about your vial, your units or your label come to us, not the pharmacy. Real people answer at
Before your first dose
Call or text, and we’ll talk you through it, one step at a time.
If your label doesn’t match
Text us a photo of the label. We check with your provider and the pharmacy, and get back to you before your next dose.
If a delivery arrives warm
Don’t use it. Keep the vial and the box, and call or text us. We talk to the pharmacy for you.
Medical questions
We get your question to your provider. Physicians answer medical questions during clinical hours.
New to tirzepatide? Start with a short online assessment, about 3 minutes. A licensed provider reviews it and prescribes only if treatment is right for you. Compounded tirzepatide is $139 a month on the 12-month plan, or $169 month to month, the same at every dose.
The NexLife Price Match Guarantee†
Keep your price.
Upgrade your care.
Already on compounded tirzepatide or semaglutide? Pay less with another licensed U.S. telehealth provider or clinic, and we match your regular monthly price for as long as your plan stays active.† Plus a provider who follows your dose, a nutrition plan, a coaching call and real people 24/7.
- 1Send a receipt from the last 60 days
- 2A NexLife provider reviews your prescription
- 3Pay your matched price, at every dose
Locked while your plan is activeSame price at every doseNo membership fee
†Terms: see the Price Match Guarantee† details below. Compounded medications aren’t FDA-approved; a provider prescribes one only when it offers a significant difference for you.
Two medications.
One flat price at every dose.
No membership fee. Provider care, a nutrition plan, coaching and shipping are included. Paying less with another licensed provider? We match your regular monthly price.†
12-month plan $139/mo
Tirzepatide
Weekly and dual-action. Care, coaching and shipping included. On a 12-month plan; $169/mo month to month.
Check my eligibility12-month plan $119/mo
Semaglutide
Weekly
Fair questions
- Will my price go up with my dose?
- No. You pay the same at every dose.
- What if I’m not prescribed?
- You aren’t charged for medication.
- Can I cancel?
- Yes, by email or phone, with 30 days’ notice. Plans renew until you cancel; our cancellation policy has the details.
- Do I need insurance?
- No. Pay with an HSA or FSA card, or with Affirm, Klarna or Afterpay at checkout.
- Tell us about you About 3 minutes online
- A licensed provider decides You’re prescribed only if it’s right for you
- Your partner pharmacy ships Usually within 1 to 2 business days, free
Compounded, not FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you. Vials shown are illustrations; your pharmacy’s label will look different. Every plan and price · Price Match Guarantee† terms
Injecting tirzepatide: your questions
How do you inject tirzepatide from a vial?
Draw your prescribed units into a new U-100 insulin syringe and inject under the skin of your stomach or thigh, changing spots every week. Wipe the vial’s stopper first, push in air equal to your dose, tap out any bubbles, and keep the needle in for at least 5 seconds. Your pharmacy label and your provider’s instructions come first.
Where is the best place to inject tirzepatide?
Your stomach or thigh, whichever is easier for you; a helper can use the back of your upper arm. The Zepbound label says tirzepatide reaches similar levels in the blood from all three. Change spots every week, and stay at least 2 inches from your belly button.
Does the injection site affect nausea?
Not that any study has shown: we found none comparing nausea by injection site. The Zepbound label says tirzepatide reaches similar levels in the blood from the stomach, thigh or upper arm. The dose matters more: in Zepbound’s trials, most nausea came while the dose was going up. Those trials studied FDA-approved Zepbound; compounded tirzepatide wasn’t studied.
What size syringe do I need for tirzepatide?
A U-100 insulin syringe that holds your whole dose: a 0.3 mL syringe holds 30 units, 0.5 mL holds 50 and 1 mL holds 100. Use the one your pharmacy or provider recommends, and a new one for every dose.
How many units is 2.5 mg of tirzepatide?
It depends on your vial’s strength: at 10 mg/mL, 2.5 mg is 25 units on a U-100 syringe. At 15 mg/mL it’s about 16.7 units, and at 20 mg/mL it’s 12.5. Check the strength on your label; every dose is in our dosage chart.
Should I pinch the skin?
Do what your provider showed you: Lilly’s instructions say your healthcare provider should tell you whether to pinch. NIH’s MedlinePlus guide to under-the-skin shots pinches about an inch of skin and fat, not muscle. If no one has shown you, ask before your first dose; at NexLife, call or text
What if I see blood or a bump after injecting?
A little blood can happen: press the spot with gauze or a cotton ball, and don’t rub it. A small bump, redness or itching can be an injection-site reaction, one of the most common side effects on the Zepbound label; tell your provider if it bothers you or doesn’t go away. Call your provider about redness that spreads, red streaks or a fever, and 911 for swelling of your face or throat or trouble breathing.
Can I reuse a syringe?
No. Use a new needle and syringe for every dose, even on yourself. The FDA says reusing them can contaminate the medicine in your vial, and Lilly says a new one each time prevents infections and blocked needles.
Do I need to wipe my skin with alcohol?
Lilly’s vial steps wipe the vial’s rubber stopper, not your skin. NIH’s MedlinePlus guide to under-the-skin shots adds it: wipe the spot with an alcohol pad and let it air-dry. Follow what your provider showed you.
Important safety information
Compounded tirzepatide and semaglutide are not FDA-approved, and the FDA hasn’t reviewed them for safety, effectiveness or quality. A provider prescribes them only when they offer a significant difference for you compared with an FDA-approved product. Both medicines may cause thyroid tumors, including cancer: don’t use either if you or a family member has had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
Read the full safety information
In studies with rodents, both medicines caused thyroid tumors; it isn’t known whether they cause them in people. Tell your provider if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath. Serious side effects can include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems from dehydration, severe stomach problems, serious allergic reactions, vision changes in people with type 2 diabetes, and a faster heart rate. Tell your care team before any surgery or procedure that uses anesthesia or deep sedation. Don’t combine either medicine with other
Tirzepatide can make birth control pills less effective: switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after you start and for 4 weeks after each dose increase. Both medicines may harm an unborn baby. Semaglutide should be stopped at least 2 months before a planned pregnancy. Tell your provider right away if you’re pregnant, planning to be, or breastfeeding.
This is a summary, not the complete safety information. Read the full Prescribing Information for FDA-approved tirzepatide (Zepbound) and semaglutide (Wegovy), and talk with your provider. You can report side effects to the FDA at
† NexLife Price Match Guarantee: for new NexLife members switching from a licensed U.S. telehealth provider or clinic with an active prescription for compounded tirzepatide or semaglutide. We match your regular all-in monthly price there (medication plus any required membership, program or visit fee, on a month-to-month plan); first-month offers, coupons, referral credits and prepaid multi-month rates aren’t matched. Proof from the last 60 days required. A licensed provider must determine that treatment is right for you. Not open to people with Medicare, Medicaid or TRICARE coverage. Full terms.
About NexLife. NexLife is a telehealth and care-coordination platform. Care is delivered through affiliated, physician-owned medical groups, and licensed providers decide whether treatment is right for you. NexLife doesn’t make or compound medication: state-licensed partner pharmacies fill each prescription, and we coordinate the rest. Available only in states where our affiliated providers are licensed.
Who checked this page
Leads the NexLife clinical team, which medically reviewed this page on October 24, 2026.
Labels and FDA, CDC and NIH guidance read October 22, 2026.
- How we checked. The steps follow Lilly’s Instructions for Use for its Zepbound single-dose vial (revised April 2026), adapted for multi-dose vials with the FDA’s and the CDC’s guidance. Injection sites, skin reactions and when to get help come from the Zepbound prescribing information and Medication Guide (both revised August 2026), Lilly’s KwikPen instructions and NIH’s MedlinePlus. We read them all on October 22, 2026, and searched the medical literature the same day for a study comparing nausea by injection site; we found none. We don’t give doses: your prescription sets your units.
- Every fact, sourced. Each price and rule links to the page it comes from.
- How we make money. NexLife is a telehealth and care-coordination platform. We earn revenue when people join NexLife.
- Corrections, fast. See something wrong or out of date? Email care@nexlife.us and we’ll fix it.
Paying less elsewhere? We match it.†
You know the steps. We’re here for the rest.
Questions about your vial? Call or text
4.8 out of 5 on Trustpilot · Medical director Adam Kennah, MD (NPI 1144260043) · LegitScript-certified
Compounded medications aren’t FDA-approved. A provider prescribes one only when it offers a significant difference for you.
- 1Tell us about you
Start online with your health history.
- 2A licensed provider decides
Online, or by secure video where your state requires a live visit. You’re prescribed only if treatment is right for you.
- 3We ship it, then stay with you
Our partner pharmacy usually ships within 1 to 2 business days. Free shipping, and questions come to us 24/7, never to the pharmacy.
Sources
- Zepbound (tirzepatide) single-dose vial: Instructions for Use, Eli Lilly (revised April 2026). Read October 22, 2026.
- Zepbound (tirzepatide) prescribing information, Eli Lilly (revised August 2026). Read October 22, 2026.
- Zepbound Medication Guide, Eli Lilly (revised August 2026). Read October 22, 2026.
- Zepbound KwikPen: Instructions for Use, Eli Lilly (revised January 2026). Read October 22, 2026.
- FDA: concerns with unapproved
GLP-1 drugs used for weight loss (updated October 1, 2026). Read October 22, 2026. - CDC: preventing unsafe injection practices (multi-dose vials). Read October 22, 2026.
- FDA: safely using sharps (needles and syringes) at home, at work and on travel. Read October 22, 2026.
- MedlinePlus (NIH): subcutaneous (SQ) injections (reviewed October 19, 2025). Read October 22, 2026.
- NexLife: pricing, every plan. Checked October 22, 2026.
- NexLife: Price Match Guarantee† terms.