The Zepbound (tirzepatide) KwikPen is a prefilled pen that holds 4 fixed weekly doses, so one pen lasts 4 weeks. Pen needles aren't in the box, so you buy them separately and use a new one each week. Each week, you prime the pen until a drop appears, turn the dose knob all the way until it stops and 1 shows in the dose window, then push the knob in and hold it for a slow count of 5 until 0 shows. Throw the pen away after your 4th dose or 30 days after you first used it, whichever comes first, even with liquid left in it. That extra liquid is there for priming and isn't a dose.
The first time you open a KwikPen box, it's normal to feel a bit lost. There's no needle inside, the pen has a dial, and the instructions talk about priming. It's simpler than it looks. This page goes through Lilly's own Instructions for Use in plain words, in the order you'll do things. Your prescriber or pharmacist can show you in person, and the label says you should get that training before you start.
What the Zepbound KwikPen is
The KwikPen is one of four ways Zepbound (tirzepatide) comes, alongside single-dose pens, single-dose vials and multi-dose vials. It's a prefilled pen with 4 fixed doses inside, one for each week, so one pen is a month of treatment. The FDA approved it in January 2026, and Lilly made it available on February 23, 2026.
You don't measure anything. You turn the dose knob as far as it goes, and that's your full dose. Each pen comes in one strength, so when your prescriber moves you up a dose, you get a new pen at the new strength.
From Lilly's Instructions for Use
The Zepbound KwikPen in four facts
4 weekly doses in one pen
One dose a week for 4 weeks. After the 4th, you throw the pen away.
Pen needles aren't in the box
You need a KwikPen-compatible pen needle, and a new one for every injection.
Prime it every week
Before each weekly dose, not just the first. A drop at the needle tip means it's ready.
Yours alone
Never share a KwikPen, even with a new needle. It can pass on a serious infection.
One more rule from the Instructions for Use: people who are blind or have trouble seeing shouldn't use the KwikPen without help from someone trained to use it.
Zepbound KwikPen strengths
The KwikPen comes in the same six strengths as every other form of Zepbound. Your prescriber picks your dose and when it changes.
| Weekly dose | One KwikPen | On the label |
|---|---|---|
| 2.5 mg | 4 doses of 2.5 mg | Starting dose, not a maintenance dose |
| 5 mg | 4 doses of 5 mg | A maintenance dose for weight loss |
| 7.5 mg | 4 doses of 7.5 mg | A step on the way up |
| 10 mg | 4 doses of 10 mg | A maintenance dose |
| 12.5 mg | 4 doses of 12.5 mg | A step on the way up |
| 15 mg | 4 doses of 15 mg | A maintenance dose, and the maximum |
For when each step happens, see our Zepbound dosage schedule.
Zepbound KwikPen needles: not in the box
No, the Zepbound KwikPen doesn't come with needles. The Instructions for Use list a "KwikPen-compatible Pen Needle (not included)", and LillyDirect, Lilly's own pharmacy service, says "Pen needle purchase required." So you get the needles separately.
You use a new needle for every injection. Lilly says that helps prevent infections and blocked needles. That's at least 4 needles for each pen, and it's worth having a spare, because the instructions tell you to change the needle if priming doesn't work.
Questions to ask, from Lilly's and CMS's terms
What to ask your pharmacy about pen needles
Which KwikPen-compatible needles do you stock?
The Instructions for Use don't name a brand or length. Your pharmacist or prescriber can say which suits you.
Does my plan cover pen needles?
And whether it needs them on a prescription to pay for them.
On the Medicare GLP-1 Bridge?
CMS says the Bridge doesn't cover pen needles, so you buy them separately.
How many do I need?
One for each weekly dose, so at least 4 a pen, plus a spare in case one blocks.
How to use the Zepbound KwikPen, step by step
You'll need the KwikPen, a new KwikPen-compatible pen needle, an alcohol swab, gauze or a cotton ball, and a sharps container (or a sturdy household container, as described under throwing it away, below). Here's the routine in short, then every step from the Instructions for Use.
From Lilly's Instructions for Use
Using the Zepbound KwikPen each week
- Get ready
Wash your hands. Check the pen's name, strength and date, and that the liquid is clear.
- New needle
Wipe the red seal, then screw on a new pen needle and take off both shields.
- Prime
Turn to the prime position. Needle up, push the knob in, hold for a count of 5 and look for a drop.
- Dial
Turn the dose knob all the way until it stops and 1 shows in the dose window.
- Inject and hold
Insert the needle into your stomach or thigh, a new spot each week. Push the knob in until it stops, count slowly to 5, and wait for 0 before you take the needle out.
- Needle off, cap on
Put the outer shield back on, unscrew the needle into a sharps container and put the pen cap on.
Get ready
- Wash your hands with soap and water.
- Pull the pen cap straight off. Check the label: the name and strength must match your prescription, and the pen mustn't be past its expiration date or damaged. The liquid should be colorless to slightly yellow. Don't use it if it has frozen, has particles in it, or looks cloudy or discolored.
- Wipe the red inner seal with an alcohol swab.
Attach a new needle
- Take a new pen needle and pull the paper tab off its outer shield.
- Push the capped needle straight onto the pen and twist it on until it's tight.
- Pull off the outer needle shield and keep it, because you'll use it again. Pull off the inner needle shield and put it in your household trash.
Prime the pen
- Turn the dose knob slowly to the prime position, the extended line in the dose window. If you go past it, turn the knob either way until the line lines up.
- Hold the pen with the needle pointing up, and tap the cartridge holder gently so any air bubbles rise.
- Push the dose knob in until it stops, then hold it while you count slowly to 5. You must then see 0 in the dose window. A drop of liquid at the needle tip means the pen is primed. Prime into the air, never into your body.
Inject your dose
- Choose a spot: your stomach, at least 2 inches from your belly button, or your thigh. The back of your upper arm should be done by someone else. Use a different spot each week.
- Turn the dose knob all the way until it stops and 1 shows in the dose window. That's your weekly dose. In Lilly's words: "Do not count clicks as you select the dose."
- Insert the needle into your skin. Push the dose knob in until it stops, then hold it while you count slowly to 5. Wait until you see 0 in the dose window before you take the needle out.
- Pull the needle out. A drop of medicine on the tip is normal and doesn't affect your dose. Check that 0 shows in the dose window.
Afterward
- If you see blood, press the spot lightly with gauze or a cotton ball. Don't rub it.
- Carefully put the outer needle shield back on.
- Unscrew the capped needle and put it in a sharps container. Don't store the pen with a needle on it, because it can leak, block the needle or let air in.
- Put the pen cap back on. Don't store the pen without it.
Before you use Zepbound
- Don't take Zepbound if you or anyone in your family has had medullary thyroid cancer, or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Tell your healthcare provider about a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.
- If you also take insulin or a sulfonylurea, ask whether those doses need lowering, because low blood sugar is more likely.
- Tell your prescriber if you're pregnant or planning to be. The label says to stop Zepbound when a pregnancy is confirmed.
- Don't use Zepbound if you've had a serious allergic reaction to tirzepatide or any of its ingredients.
- If you take birth control pills, Zepbound can make them work less well. The label says to switch to a method that isn't a pill, or add a barrier method such as condoms, for 4 weeks after you start and for 4 weeks after each dose increase.
From the Zepbound prescribing information (boxed warning, sections 4, 5, 8.1 and 8.3), revised August 2026.
Priming the KwikPen: every week, not just the first time
This trips people up, because some other pens only need it when you start a new pen. The KwikPen needs it before every weekly dose. In the words of the Instructions for Use: "Priming removes air from the cartridge and makes sure that your Pen is working correctly."
From Lilly's Instructions for Use
No drop when you prime?
First, try priming again
Repeat the priming steps, up to 2 more times.
Still nothing? Change the needle
Put on a new pen needle and prime once more.
Still no drop? Call Lilly
Call 1-800-LillyRx (1-800-545-5979) before you inject.
The dose window: 1 before, 0 after
The little window on the pen tells you where you are. When you dial your dose, turning the knob until it stops, 1 shows: that's your full weekly dose. When you've pushed the knob all the way in and held it for a slow count of 5, 0 shows: the dose is done.
If 0 doesn't show after your injection, put the needle back into your skin and finish the injection. Don't dial again. And if you still don't think you got the full dose, the instructions say don't start over or repeat the injection. Call your prescriber or Lilly for advice instead.
Where to inject
From the Instructions for Use
Where the label says to inject Zepbound
You can keep using the same area, such as your stomach, as long as you pick a different spot within it each week.
If you miss a dose
From the FDA label
Missed a Zepbound dose?
Missed it 4 days (96 hours) or less ago
Take it as soon as you can, then go back to your usual day.
More than 4 days ago
Skip it and take your next dose on your usual day.
Changing your injection day
Fine, as long as there are at least 3 days (72 hours) between the two doses.
If you skip a dose, it stays in the pen, so the pen can last into a fifth week. The label still says to throw the pen away 30 days after you first used it, even with medicine left. If you've missed more than one dose, ask your prescriber or pharmacist what to do.
Storing the Zepbound KwikPen
From the FDA label
Storing the KwikPen
Before your first dose
Keep it in the fridge at 36°F to 46°F, in its carton. Kept there, it's good until the expiration date.
Unopened, out of the fridge
It can be kept at room temperature up to 86°F, but then throw it away after 30 days.
Once you've started it
Keep it in the fridge or at room temperature up to 86°F, in its carton, away from heat and light, with the cap on and no needle.
When to throw it away
After your 4th dose, 30 days after first use, or after 30 days in total at room temperature, whichever comes first, even with liquid left.
Never freeze it
If it has frozen, throw it away and don't use it.
The liquid left in the pen after your fourth dose
After your 4th dose, you'll still see some liquid in the pen. That's by design. The label says each KwikPen "contains additional volume to allow for device priming", the drop you push out before every dose. It isn't a dose, and the pen won't let you dial a full dose once you've had 4.
From Lilly's Instructions for Use
After your fourth dose
Throw the pen away
With the leftover liquid still in it. Start your next pen for your next dose.
Don't inject the leftover
Lilly says trying could give you an incomplete dose, even though liquid is left.
Never move it into a syringe
The Instructions for Use say not to transfer Zepbound from the pen into a syringe.
Only full doses
Turn the knob until it stops and 1 shows. If it won't reach 1, throw the pen away.
If the pen won't turn far enough for 1 to show before you've had all 4 doses, throw it away and use a new pen. The Instructions for Use say there may not be enough medicine left for a full dose. If that leaves you short of pens, tell your prescriber or pharmacist.
Throwing the KwikPen and needles away
- Put each used pen needle in an FDA-cleared sharps disposal container right away. Never throw loose needles in your household trash.
- Once the needle is off, the pen can go in your household trash or a sharps container.
- No sharps container? Lilly says a household container works if it's heavy-duty plastic, closes with a tight, puncture-resistant lid, stays upright and stable, doesn't leak, and is labeled to warn of hazardous waste inside.
- When the container is almost full, follow your community's guidelines. Some states and cities have their own rules, and the FDA's safe sharps disposal page lists them by state. Don't recycle the container.
KwikPen troubleshooting
- The cap won't come off: twist it gently back and forth, then pull it straight off.
- The dose knob is hard to push: push more slowly. If it's still hard, the needle may be blocked, so put on a new needle and prime again. If there may be dust, food or liquid inside the pen, throw it away and use a new one.
- The knob won't turn until 1 shows: throw the pen away, with the medicine in it, and use a new pen.
- Any other question or problem: call your healthcare provider, or Lilly at 1-800-LillyRx (1-800-545-5979). Lilly also has a KwikPen how-to video.
Side effects and when to get help
The common side effects are stomach ones, such as nausea, diarrhea, vomiting and constipation. The label says most of the nausea, vomiting and diarrhea in the trials happened while people's doses were going up. Some signs need help right away:
From the Zepbound Medication Guide
When to stop, call or get help
Severe stomach pain that won't go away
With or without nausea or vomiting, and it can spread to your back. Stop Zepbound and call your healthcare 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, severe rash or itching, fainting or feeling dizzy, or a very fast heartbeat. Stop Zepbound and get medical help right away. Call 911 if you need to.
Nausea, vomiting or diarrhea that won't go away
Tell your healthcare provider right away. Losing fluids can lead to kidney problems.
Signs of gallbladder problems
Pain in your upper stomach, fever, yellowing of your skin or eyes, or clay-colored stools. Tell your healthcare provider.
You can report a side effect to the FDA through MedWatch, at 1-800-FDA-1088 or fda.gov/medwatch, or to Lilly at 1-800-LillyRx (1-800-545-5979). Tell any doctor planning surgery or sedation that you take Zepbound, because it slows how fast your stomach empties.
Zepbound KwikPen cost and Medicare coverage
On Medicare Part D, the KwikPen is the only form of Zepbound the Medicare GLP-1 Bridge covers. If you qualify, it's $50 a month from July 1, 2026 to December 31, 2027, with prior authorization. Single-dose pens and vials aren't included, and neither are pen needles. Our Medicare GLP-1 Bridge guide covers who qualifies and how your doctor applies.
If you pay yourself, LillyDirect charges $299 a month for the KwikPen at 2.5 mg, $399 at 5 mg and $449 at 7.5 mg to 15 mg if you refill within 45 days. Refill later and it's $499 at 7.5 mg, or $699 at 10 mg, 12.5 mg or 15 mg. A month is 28 days, one KwikPen, and pen needles are extra. Prices checked October 9, 2026. Our guide to what Zepbound costs, by dose has the full picture, and the Zepbound savings card guide covers commercial insurance.
Frequently asked questions
How do you use a Zepbound KwikPen?
Do Zepbound KwikPens come with needles?
What size needle do you use for the Zepbound KwikPen?
How many doses are in a Zepbound KwikPen?
Do you have to prime the Zepbound KwikPen every time?
How do I know I've dialed the full dose on the Zepbound KwikPen?
Why is there liquid left in my Zepbound KwikPen after 4 doses?
Can I use a syringe with the Zepbound KwikPen?
How long is a Zepbound KwikPen good for after opening?
Does the Zepbound KwikPen need to be refrigerated?
Does Medicare cover the Zepbound KwikPen?
How do I throw away a Zepbound KwikPen?
General information from Lilly's Instructions for Use and the FDA label, not medical advice. Always follow the leaflet in your box and your prescriber's instructions, and ask your pharmacist to show you the pen if you haven't used one before. Never change your dose, or how you use the pen, without your prescriber.
View sources (9)
- Zepbound KwikPen Instructions for Use, Eli Lilly, revised January 2026 (PDF)
- Zepbound (tirzepatide) US prescribing information, Eli Lilly, revised 08/2026 (PDF)
- Zepbound support resources and the KwikPen injection video, Eli Lilly
- Zepbound KwikPen self-pay prices, LillyDirect, Eli Lilly (read October 9, 2026)
- FDA approves label expansion for Zepbound to be used with Eli Lilly's KwikPen, Healio, February 24, 2026
- Medicare GLP-1 Bridge: information for providers (covered forms and pen needles), Centers for Medicare & Medicaid Services
- Medicare GLP-1 Bridge: weight loss drugs, Medicare.gov
- Safely using sharps (needles and syringes) at home, at work and on travel, US Food and Drug Administration
- MedWatch: the FDA safety information and adverse event reporting program
