Public record
Tirzepatide: the public record
Each table is computed from the named federal dataset as of its data date; the method is under each one.
Label
FDA label facts for tirzepatide
The FDA label read for tirzepatide (Mounjaro, application NDA215866) was last revised on 2026-08-27. It carries a boxed warning headed "WARNING: RISK OF THYROID C-CELL TUMORS". Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.
| Measure | Value | Note |
|---|---|---|
| Label revision date | 2026-08-27 | |
| Label read | Mounjaro | NDA215866, brand-name application |
| Boxed warning | Yes | heading as printed: "WARNING: RISK OF THYROID C-CELL TUMORS" |
| Pregnancy section | Present | |
| Lactation section | Present | |
| Pediatric use section | Present | |
| Geriatric use section | Present |
How this was calculated
Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.
One label: the newest prescription label for single-ingredient tirzepatide from an original manufacturer, matched to Mounjaro
Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.
Approvals
FDA approval history for tirzepatide
The earliest FDA approval on file for a tirzepatide product is 2022-05-13. Drugs@FDA lists 2 applications for it and 26 approved supplements, the most recent on 2026-08-27.
| Measure | Value | Note |
|---|---|---|
| Earliest FDA approval on file | 2022-05-13 | |
| Applications with an approval on file | 2 | |
| New drug applications (NDA) | 2 | |
| Generic applications (ANDA) | 0 | |
| Approved supplements | 26 | label, manufacturing and efficacy changes |
| Most recent supplement approval | 2026-08-27 | |
| Sponsoring companies | 1 |
How this was calculated
Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.
Applications with a single-ingredient tirzepatide product in Drugs@FDA, all sponsors and strengths
Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.
Patents and generics
Patents and generic approvals for tirzepatide
The FDA Orange Book lists 0 approved generic applications for tirzepatide across 48 listed products. 10 listed patents have not yet expired, the last on 2041-12-30.
| Measure | Value | Note |
|---|---|---|
| Brand-name applications (NDA) | 2 | |
| Approved generic applications (ANDA) | 0 | |
| Listed patents not yet expired | 10 | |
| Latest listed patent expiry | 2041-12-30 | |
| Latest listed exclusivity expiry | 2028-12-19 | exclusivity code NPP |
| Earliest approval date on file | 2022-05-13 | |
| Products not marked discontinued | 48 of 48 |
How this was calculated
Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.
All single-ingredient tirzepatide products in the Orange Book, every brand and strength, files dated 2026-10-09
An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.
Medicare Part D
Medicare Part D claims for tirzepatide by age group
Of 5,103,909 Medicare Part D claims for tirzepatide in 2024, 3,800,975 (74.5%) were for enrollees aged 65 and over and 1,302,934 were for enrollees under 65.
| Measure | Value | Note |
|---|---|---|
| All Part D claims, 2024 | 5,103,909 | |
| Claims for enrollees aged 65 and over | 3,800,975 | |
| Claims for enrollees under 65 | 1,302,934 | mostly people who qualify through disability |
| Share of claims for enrollees aged 65 and over | 74.5% | share of claims, not of patients |
How this was calculated
Summed the national rows for every brand and generic row with this generic name. Claims under 65 are total claims minus claims for enrollees 65 and over.
National Part D claims for single-ingredient tirzepatide products, 2024, split at age 65
Medicare mostly covers people 65 and over, so this split describes Medicare enrollees and not use in the general population.
Medicare Part D
Medicare Part D claims for tirzepatide by state
Texas had the most Medicare Part D claims for tirzepatide in 2024 (491,789), followed by Florida (395,266) and New York (303,204). Prescribers in 58 states and territories wrote 5,103,803 claims in all.
| Measure | Value | Note |
|---|---|---|
| All states and territories, 2024 | 5,103,803 claims | |
| States and territories with reported claims | 58 | |
| Texas | 491,789 claims | $624.0M gross drug cost |
| Florida | 395,266 claims | $494.2M gross drug cost |
| New York | 303,204 claims | $387.2M gross drug cost |
| California | 284,590 claims | $339.2M gross drug cost |
| Georgia | 220,657 claims | $274.7M gross drug cost |
How this was calculated
Summed claims and drug cost by prescriber state over every brand and generic row with this generic name. Combination products excluded. Rows CMS suppressed for small counts are left out.
Part D claims for single-ingredient tirzepatide products by the prescriber's state, 2024; all brands, not only Zepbound
State counts follow population size and where the prescriber practises. They are not per-person rates and do not show any state's coverage rules.
Medicare Part D
Medicare Part D spending on tirzepatide
Medicare Part D spending on tirzepatide products was $6.34B in 2024 across 5,105,750 claims, compared with $2.36B in 2023 (+168.4%). Average spending per claim was $1,241, before rebates.
| Measure | Value | Note |
|---|---|---|
| Total spending, 2024 | $6.34B | |
| Total spending, 2023 | $2.36B | |
| Change in spending, 2023 to 2024 | +168.4% | |
| Claims (prescription fills), 2024 | 5,105,750 | |
| Average spending per claim, 2024 | $1,241 | |
| Mounjaro: spending, 2024 | $6.34B | 5,105,397 claims |
| Zepbound: spending, 2024 | $387,343 | 353 claims |
How this was calculated
Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.
Every single-ingredient tirzepatide product in Part D (Mounjaro, Zepbound), 2024. Not limited to Zepbound.
Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.
Medicaid
Medicaid prescriptions for tirzepatide by state
State Medicaid programmes paid for 3,136,633 tirzepatide prescriptions in 2025, with $3.32B reimbursed before rebates. California reported the most (935,362), followed by Massachusetts (269,389) and Pennsylvania (243,243); 52 states and territories reported any.
| Measure | Value | Note |
|---|---|---|
| Prescriptions paid by Medicaid, 2025 | 3,136,633 | |
| Total reimbursed before rebates, 2025 | $3.32B | |
| States and territories reporting | 52 | with at least one count CMS did not suppress |
| California | 935,362 prescriptions | $991.7M reimbursed |
| Massachusetts | 269,389 prescriptions | $278.8M reimbursed |
| Pennsylvania | 243,243 prescriptions | $261.4M reimbursed |
| Michigan | 228,461 prescriptions | $240.9M reimbursed |
| New York | 218,875 prescriptions | $237.2M reimbursed |
How this was calculated
Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.
All single-ingredient tirzepatide products in the FDA NDC Directory, fee-for-service and managed care, 2025
Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.
Pharmacy cost
Pharmacy acquisition cost (NADAC) for tirzepatide
Retail pharmacies paid an average of $281.78 per mL for ZEPBOUND 10 MG/DOSE (40 MG/2.4 ML) KWIKPEN as of 2026-11-11. This is a pharmacy purchase cost, not a patient price.
| Measure | Value | Note |
|---|---|---|
| ZEPBOUND 10 MG/DOSE (40 MG/2.4 ML) KWIKPEN | $281.78 per mL | no price on file 12 months earlier |
| ZEPBOUND 12.5 MG/DOSE (50 MG/2.4 ML) KWIKPEN | $282.23 per mL | no price on file 12 months earlier |
| ZEPBOUND 15 MG/DOSE (60 MG/2.4 ML) KWIKPEN | $281.68 per mL | no price on file 12 months earlier |
| ZEPBOUND 2.5 MG/DOSE (10 MG/2.4 ML) KWIKPEN | $201.39 per mL | no price on file 12 months earlier |
| ZEPBOUND 5 MG/DOSE (20 MG/2.4 ML) KWIKPEN | $201.20 per mL | no price on file 12 months earlier |
| ZEPBOUND 7.5 MG/DOSE (30 MG/2.4 ML) KWIKPEN | $201.16 per mL | no price on file 12 months earlier |
How this was calculated
Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.
Brand-name product of tirzepatide in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12
NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.
Adverse event reports
FDA adverse event reports naming constipation and tirzepatide
Through 2026-10-28, FDA had received 7,625 adverse event reports for tirzepatide that name constipation, out of 181,060 reports for the drug in all. 4,754 of these reports concerned female patients and 1,504 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming constipation | 7,625 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 4.2% | share of reports received, not of people taking the drug |
| Of those: female patients | 4,754 | reflects who takes the drug and who files reports |
| Of those: male patients | 1,504 | |
| Of those: sex not recorded | 1,367 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: constipation. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Zepbound), MedDRA term constipation
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming diarrhoea and tirzepatide
Through 2026-10-28, FDA had received 11,312 adverse event reports for tirzepatide that name diarrhoea, out of 181,060 reports for the drug in all. 6,668 of these reports concerned female patients and 2,762 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming diarrhoea | 11,312 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 6.2% | share of reports received, not of people taking the drug |
| Of those: female patients | 6,668 | reflects who takes the drug and who files reports |
| Of those: male patients | 2,762 | |
| Of those: sex not recorded | 1,882 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: diarrhoea. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Zepbound), MedDRA term diarrhoea
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming gallstones or gallbladder inflammation and tirzepatide
Through 2026-10-28, FDA had received 1,087 adverse event reports for tirzepatide that name gallstones or gallbladder inflammation, out of 181,060 reports for the drug in all. 731 of these reports concerned female patients and 242 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming gallstones or gallbladder inflammation | 1,087 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 0.6% | share of reports received, not of people taking the drug |
| Of those: female patients | 731 | reflects who takes the drug and who files reports |
| Of those: male patients | 242 | |
| Of those: sex not recorded | 114 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: cholelithiasis, cholecystitis, cholecystitis acute. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports with tirzepatide as a single-ingredient active substance (any brand), 3 MedDRA terms for gallstones or gallbladder inflammation
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming hair loss and tirzepatide
Through 2026-10-28, FDA had received 3,066 adverse event reports for tirzepatide that name hair loss (alopecia), out of 181,060 reports for the drug in all. 2,106 of these reports concerned female patients and 98 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming hair loss (alopecia) | 3,066 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 1.7% | share of reports received, not of people taking the drug |
| Of those: female patients | 2,106 | reflects who takes the drug and who files reports |
| Of those: male patients | 98 | |
| Of those: sex not recorded | 862 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: alopecia. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Zepbound), MedDRA term alopecia
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming injection site reactions and tirzepatide
Through 2026-10-28, FDA had received 23,001 adverse event reports for tirzepatide that name injection site reactions, out of 181,060 reports for the drug in all. 16,574 of these reports concerned female patients and 3,814 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming injection site reactions | 23,001 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 12.7% | share of reports received, not of people taking the drug |
| Of those: female patients | 16,574 | reflects who takes the drug and who files reports |
| Of those: male patients | 3,814 | |
| Of those: sex not recorded | 2,613 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: injection site reaction, injection site pain, injection site erythema, injection site swelling, injection site pruritus. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports with tirzepatide as a single-ingredient active substance (any brand), 5 MedDRA terms for injection site reactions
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming low blood sugar and tirzepatide
Through 2026-10-28, FDA had received 812 adverse event reports for tirzepatide that name low blood sugar (hypoglycaemia), out of 181,060 reports for the drug in all. 456 of these reports concerned female patients and 219 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming low blood sugar (hypoglycaemia) | 812 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 0.4% | share of reports received, not of people taking the drug |
| Of those: female patients | 456 | reflects who takes the drug and who files reports |
| Of those: male patients | 219 | |
| Of those: sex not recorded | 137 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: hypoglycaemia. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Mounjaro), MedDRA term hypoglycaemia
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming nausea and tirzepatide
Through 2026-10-28, FDA had received 19,737 adverse event reports for tirzepatide that name nausea, out of 181,060 reports for the drug in all. 13,746 of these reports concerned female patients and 2,972 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming nausea | 19,737 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 10.9% | share of reports received, not of people taking the drug |
| Of those: female patients | 13,746 | reflects who takes the drug and who files reports |
| Of those: male patients | 2,972 | |
| Of those: sex not recorded | 3,019 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: nausea. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Zepbound), MedDRA term nausea
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming pancreatitis and tirzepatide
Through 2026-10-28, FDA had received 1,815 adverse event reports for tirzepatide that name pancreatitis, out of 181,060 reports for the drug in all. 945 of these reports concerned female patients and 472 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming pancreatitis | 1,815 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 1.0% | share of reports received, not of people taking the drug |
| Of those: female patients | 945 | reflects who takes the drug and who files reports |
| Of those: male patients | 472 | |
| Of those: sex not recorded | 398 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: pancreatitis, pancreatitis acute. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Mounjaro), MedDRA terms pancreatitis, pancreatitis acute
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
FDA adverse event reports naming vomiting and tirzepatide
Through 2026-10-28, FDA had received 9,395 adverse event reports for tirzepatide that name vomiting, out of 181,060 reports for the drug in all. 6,251 of these reports concerned female patients and 1,607 male patients.
| Measure | Value | Note |
|---|---|---|
| Reports naming vomiting | 9,395 | |
| All reports for tirzepatide | 181,060 | |
| Share of this drug's reports naming it | 5.2% | share of reports received, not of people taking the drug |
| Of those: female patients | 6,251 | reflects who takes the drug and who files reports |
| Of those: male patients | 1,607 | |
| Of those: sex not recorded | 1,537 |
How this was calculated
Counted FAERS reports listing this active substance and at least one of these reaction terms: vomiting. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Zepbound), MedDRA term vomiting
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Adverse event reports
Most reported events in FDA adverse event reports for tirzepatide
Through 2026-10-28, FDA had received 181,060 adverse event reports for tirzepatide, 33,095 of them marked serious by the reporter. The symptom terms named most often were nausea (19,737), injection site pain (14,615) and diarrhoea (11,312).
| Measure | Value | Note |
|---|---|---|
| All reports received | 181,060 | |
| Reports the reporter marked serious | 33,095 | death, hospitalisation, disability or similar outcome |
| Nausea | 19,737 reports | |
| Injection site pain | 14,615 reports | |
| Diarrhoea | 11,312 reports | |
| Vomiting | 9,395 reports | |
| Constipation | 7,625 reports |
How this was calculated
Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug. Terms about product use or complaints rather than symptoms (for example incorrect dose administered) were left out of the list.
Reports where FDA recorded tirzepatide as a single-ingredient active substance (any brand, not only Mounjaro), all years to 2026-10-28
FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.
Recalls
FDA drug recalls naming tirzepatide
FDA enforcement reports list 28 drug recall entries naming tirzepatide from 2023 to 2026-10-21. 28 of them are for compounded or other unlisted products and 0 for products FDA lists under a label. The most common stated reason was lack of sterility assurance (19 of 28).
| Measure | Value | Note |
|---|---|---|
| Recall entries on record | 28 | |
| For products FDA lists under an approved or registered label | 0 | |
| For compounded or other unlisted products | 28 | matched by the name in the product description |
| Class I (most serious) | 1 | |
| Class II | 27 | |
| Class III | 0 | |
| Most recent recall reported | 2026-10-21 | |
| Most common stated reason | lack of sterility assurance | 19 of 28 entries |
How this was calculated
Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.
Recalls of single-ingredient tirzepatide products, plus compounded or unlisted products whose description names it
Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.
Clinical studies
Registered clinical studies of tirzepatide
ClinicalTrials.gov lists 314 registered studies that name tirzepatide as an intervention as of 2026-11-11. Of these, 103 are recruiting, 92 are completed and 60 are phase 3 studies.
| Measure | Value |
|---|---|
| Registered studies | 314 |
| Recruiting now | 103 |
| Not yet recruiting | 64 |
| Completed | 92 |
| Terminated, withdrawn or suspended | 6 |
| Phase 3 (including phase 2/3) | 60 |
| Phase 2 (including phase 1/2) | 75 |
| Phase 1 | 40 |
How this was calculated
Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.
Studies whose intervention field matches tirzepatide, any condition, any country, all statuses
A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.
Articles on Tirzepatide
- Does Anthem Cover Tirzepatide (Mounjaro)?
- Does Blue Cross Blue Shield of Michigan Cover Tirzepatide (Mounjaro)?
- What Is Mounjaro (Tirzepatide)? Complete Clinical Guide
- Tirzepatide (Mounjaro): What It Is and How It Works
- What Is the Most Common Mounjaro Dosage and Titration Schedule?
- Does Amerigroup Cover Tirzepatide (Mounjaro)?