Tirzepatide (Zepbound) Missed Dose Management
A missed dose should be administered as soon as possible within 4 days (96 hours) after the missed dose. [1] If more than 4 days have passed, the missed dose should be skipped and the next dose should be administered on the regularly scheduled day, with resumption of the regular once-weekly dosing schedule. [1]
Missed Dose Timing During a 1–2 Week Trip
If the 1–2 week trip causes a gap of more than 4 days, the missed dose should be skipped. [1] After the skip, the next scheduled dose should be taken on the regular dosing day. [1] In this scenario, resuming the same prescribed weekly dose corresponds to taking the next regular scheduled dose rather than restarting early. [1]
Dose Resumption Within the 4-Day Window
If the missed dose is identified within 4 days (96 hours) of the scheduled injection, the missed dose should be given as soon as possible. [1] After administering the missed dose within the window, the patient should resume the regular once-weekly dosing schedule. [1]
Allowable Change in Injection Day
The day of weekly administration can be changed if necessary. [1] The time between the two doses must be at least 3 days (72 hours). [1]
Practical Safety Implication for “Resuming the Same Dose”
Taking a dose after a lapse of more than 4 days should follow the label instruction to skip the missed dose and take the next regularly scheduled dose. [1] Taking an early replacement dose after a lapse of more than 4 days conflicts with the label missed-dose recommendation. [1]
Sources for Missed-Dose Instructions
ZEPBOUND prescribing information specifies missed-dose timing using a 4-day (96-hour) threshold and instructions to skip if the threshold is exceeded, then resume the regular once-weekly schedule. [1]