Zepbound Interactions: Alcohol, Medications, and Others

Does Zepbound interact with other drugs?

Before you start Zepbound, tell your doctor and pharmacist about any prescription, over-the-counter (OTC), or other drugs you take. Sharing this information with them may help prevent possible interactions. (Learn whether Zepbound interacts with herbs or vitamins or supplements. See the “Are there other interactions with Zepbound?” section.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist. They can discuss what not to take with Zepbound.

The following table lists drugs that may interact with Zepbound. Keep in mind that this table does not include all drugs that may interact with Zepbound. For more information about some of these interactions, see the “Drug interactions explained” section.

Does Zepbound interact with alcohol?

Zepbound is not known to interact with alcohol. But Zepbound and alcohol can cause some similar side effects, such as nausea and vomiting. So you may be more likely to have these side effects if you drink alcohol during Zepbound treatment.

If you have questions about consuming alcohol during Zepbound treatment, talk with your doctor or pharmacist.

When should I avoid Zepbound?

Certain health conditions or other factors could raise your risk of harm if you have treatment with Zepbound. In such cases, your doctor may not prescribe Zepbound for you. These are known as contraindications. The list below includes contraindications of Zepbound.

If you have multiple endocrine neoplasia type 2 (MEN 2): If you have a rare inherited condition called MEN 2, your doctor likely won’t prescribe Zepbound for you. This is because having MEN 2 may increase your risk of thyroid cancer if you have treatment with Zepbound. Your doctor can suggest other treatments that are safer options for you.

If you or a family member has had medullary thyroid carcinoma (MTC): If you have a family or personal history of MTC, your doctor likely won’t prescribe you Zepbound. This is because having MTC may increase your risk of thyroid cancer if you have treatment with Zepbound. Your doctor can suggest other treatments that are safer options for you.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Zepbound or any of its ingredients, your doctor likely won’t prescribe you Zepbound. This is because treatment with the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start Zepbound, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Zepbound is safe for you.

Note: Zepbound has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the FDA. To learn more, see the boxed warning at the top of this article.

Drug interactions explained

Learn more about certain drug interactions that can occur with Zepbound.

Interaction with any oral prescription or OTC drug

Zepbound can interact with any oral prescription or OTC drug. This includes any tablet, capsule, or liquid that you take by mouth.

Examples of oral medications include:

• ibuprofen
• oral antidepressants, such as bupropion (Wellbutrin)
• omeprazole
• oral antibiotics, such as doxycycline
• warfarin (Jantoven)
• cyclosporine (Gengraf, Neoral, Sandimmune)
• theophylline (Elixophyllin, Theo-24)

What could happen

Zepbound may affect your body’s ability to absorb oral medication. This can lead to a lower level of the oral drug in your body, which can make it less effective.

The risk of this effect is highest at certain times during Zepbound treatment. This includes when you first start treatment with Zepbound and after your doctor increases your Zepbound dosage.

What you can do

If you take any oral medication, talk with your doctor. They may watch closely for the effects of the oral drug during your treatment with Zepbound.

For questions about Zepbound treatment together with any oral prescription or OTC drug, talk with your doctor or pharmacist.

Interaction with oral birth control

Zepbound can interact with oral birth control, which helps prevent pregnancy. Examples of oral birth control drugs include:

• ethinyl estradiol/norgestimate (Sprintec, Tri-Sprintec, others)
• ethinyl estradiol/drospirenone (Yasmin, Yaz, others)
• ethinyl estradiol/norethindrone (Aurovela, Junel, others)

What could happen

Having Zepbound treatment while taking oral birth control can make oral birth control less effective. This is because Zepbound may affect your body’s ability to absorb oral birth control medication. In turn, this can lead to a lower level of the birth control medication in your body. As a result, the birth control medication could be less effective at helping prevent pregnancy.

The risk of this effect is highest at certain times during Zepbound treatment. These are when you first start treatment with Zepbound and after your doctor increases your Zepbound dosage.

What you can do

If you take oral birth control, talk with your doctor about it when starting Zepbound treatment. They may advise you to take the oral birth control and use backup birth control for 4 weeks. They may also suggest using backup birth control for at least 4 weeks after they increase your Zepbound dosage. Examples of backup birth control methods include a diaphragm or condom.

If you have questions about taking oral birth control with Zepbound, talk with your doctor or pharmacist.

Interaction with insulin

Zepbound can interact with insulin, which is prescribed to help manage blood sugar levels. Examples of insulins include:

• insulin detemir (Levemir)
• insulin lispro (Humalog, others)
• insulin lispro-aabc (Lyumjev)
• insulin glargine (Lantus, Toujeo, others)

What could happen

Zepbound and insulin both can cause low blood sugar. Having both of these drugs in your body at once can raise your risk of this side effect.

What you can do

If you have treatment with both Zepbound and insulin, your doctor may prescribe a dosage of insulin that’s lower than usual. This will reduce your risk of low blood sugar when these medications are injected together.

If you have treatment with Zepbound and insulin together, tell your doctor right away if you have symptoms of low blood sugar. These may include shaking, dizziness, and sweating. Your doctor can advise you on ways to increase your blood sugar level. This may include consuming at least 15 grams (g) of carbohydrates, such as from fruit juices and hard candies.

Severely low blood sugar is a medical emergency and may cause you to lose consciousness. If your symptoms seem severe or life threatening, call 911 or a local emergency number right away. You may need a bystander to call for you.

If you have questions about treatment with Zepbound and insulin, talk with your doctor or pharmacist.

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Are there other interactions with Zepbound?

Zepbound may have other interactions that could occur with supplements, foods, vaccines, or even lab tests. Read on for details. Note that the following information does not include all other possible interactions with Zepbound.

Does Zepbound interact with supplements?

Before you start Zepbound, talk with your doctor and pharmacist about herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about what supplements you can take with Zepbound, talk with your doctor or pharmacist.

Zepbound and herbs

Zepbound currently has no reports of interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Zepbound treatment.

Zepbound and vitamins

Zepbound currently has no reports of interacting with vitamins. But this doesn’t mean that interactions with vitamins won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Zepbound treatment.

Does Zepbound interact with food?

Zepbound currently has no reports of interacting with food. If you have questions about eating certain foods during your treatment with Zepbound, talk with your doctor.

Does Zepbound interact with vaccines?

Zepbound currently has no reports of interacting with vaccines. If you have questions about getting certain vaccines during your treatment with Zepbound, talk with your doctor.

Does Zepbound interact with lab tests?

There are no reports that Zepbound interacts with lab tests. If you have questions about having certain lab tests during your treatment with Zepbound, talk with the healthcare professional ordering the test.

Does Zepbound interact with cannabis or CBD?

Currently, there are no reports that Zepbound has any interactions with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Zepbound.

Note: Cannabis is illegal at the federal level but is legal in many states to varying degrees.

Does my health history affect whether I should use Zepbound?

Certain medical conditions or other health factors may raise the risk of interactions with Zepbound. Before starting Zepbound, talk with your doctor about your health history. They’ll determine whether Zepbound is right for you.

Health conditions or other factors that might interact with Zepbound include:

Pancreatitis: Before starting Zepbound, tell your doctor if you’ve had pancreatitis (inflammation of your pancreas) in the past. Zepbound may cause pancreatitis as a side effect. It is not known for certain whether the drug is safe for people who have had this condition. Your doctor can recommend whether Zepbound is the right treatment option for you.

Diabetic retinopathy and type 2 diabetes: If you have diabetic retinopathy related to type 2 diabetes, talk with your doctor before starting Zepbound treatment. The drug may cause temporary vision changes in people with this condition. Your doctor can recommend whether Zepbound is the right treatment option for you.

Kidney problems: If you have a kidney problem, such as kidney failure, tell your doctor before starting Zepbound. The drug may cause severe digestive problems that lead to dehydration. This can worsen your kidney condition. If you have a kidney problem, your doctor can recommend whether it’s safe to start Zepbound.

Digestive system conditions: Before starting Zepbound, tell your doctor if you have a digestive system condition. An example is slow stomach emptying. The drug can cause severe digestive problems that may not be safe for people with these conditions. Your doctor can recommend whether Zepbound is the right treatment option for you.

Surgery: Zepbound can slow down how quickly food leaves your stomach. This can lead to pulmonary aspiration (inhaling stomach contents into your lungs) if you have surgery with general anesthesia or deep sedation.

If you have a surgery scheduled soon, be sure to tell your doctor before you start Zepbound. If you’re planning to have surgery, tell your healthcare team that you’re using Zepbound. Your doctor may need to adjust your treatment plan before the procedure. Also, if you need surgery during Zepbound treatment, remind your doctors before your surgery so they can take steps to help prevent pulmonary aspiration.

Pregnancy: It is unknown whether Zepbound is safe to inject during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before injecting Zepbound.

If you do inject Zepbound while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Zepbound. To learn more, call 800-545-5979 or talk with your doctor.

Breastfeeding: It is unknown whether it’s safe to inject Zepbound while breastfeeding. Researchers do not know whether the drug passes into breast milk. Also, it is unknown what effect it may have on a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Zepbound or any of its ingredients, your doctor likely won’t prescribe Zepbound. This is because the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Mood disorders, including depression: Medications prescribed for weight management, such as Zepbound, may lead to suicidal thoughts or behaviors. Your risk may be higher if you have a mood disorder such as depression. Your doctor can determine whether Zepbound is right for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Zepbound. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Zepbound treatment.

It’s also important to understand Zepbound’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Zepbound, ask your pharmacist to print a copy for you.)

If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Injecting Zepbound exactly as prescribed can also help prevent interactions.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.