Shortages of the popular injected weight-loss medicines Wegovy (semaglutide) and Zepbound (tirzepatide) aren’t going to end any time soon, according to the U.S. Food and Drug Administration (FDA).
Right now, the three smallest doses of Wegovy that people need to start treatment have limited availability, and there’s no estimated timeline for the shortage to end, according to anupdate from the FDA on April 29.
All but the smallest doses of Zepbound and Mounjaro — a type 2 diabetes drug with the same active ingredient in Zepbound — will be in short supply through at least the end of June, the FDA alsoreported.
All three of these medicines are hard to get right now due to increased demand, the FDA said. However, there is currently no shortage of Ozempic, the type 2 diabetes drug made from semaglutide, the same active ingredient in Wegovy, according to the FDA.
“The shortages have waxed and waned and been a little unpredictable over the past several months,” saysJody Dushay MD, an endocrinologist at Beth Israel Deaconess Medical Center in Boston and an assistant professor at Harvard Medical School.
Weight Loss Drug Shortages Through 2024
“I have no idea when all the doses of all these medicines will be available, but I'm pretty pessimistic and am guessing there will be shortages of some or all of these medicines through 2024,” Dr. Dushay says, based on the difficulties her Boston-area patients have had obtaining most doses of Zepbound, Wegovy, and Mounjaro.
Ozempic, which has had shortages in the past, is likely to become scarce again as people who can’t get other drugs try that one instead, Dushay adds.
Other physicians around the country say their patients are experiencing similar difficulties.
“Everyone is having trouble with supply,” saysAdam Gilden, MD, an obesity specialist and associate professor at the University of Colorado School of Medicine in Aurora. For Dr. Gilden’s patients, Zepbound has been especially hard to get over the last two months.
In Chicago, there have been periodic shortages of Wegovy since the drug was first approved in 2021, while supply issues with Zepbound and Mounjaro have been more recent, saysAnthony Millard, MD, an obesity specialist at Northwestern Medicine in Chicago.
“We have patients calling all over the metro area of Chicago and some transferring prescriptions out of state and all over the country to get them filled at an appropriate dose,” Dr. Millard says. “It's been a major impediment to the proper dose titration and thus to obtaining the expected weight loss targets and commensurate health benefits from the medicine.”
Drug Companies Increasing Production in the Face of Huge Demand
A spokesperson for Eli Lilly, the company that makes Zepbound and Mounjaro, said that shortages have been driven by an “unparalleled surge in demand.” While the company expects limited availability in the near term, it anticipates that investments in manufacturing will help “progressively increase production of our medicines throughout 2024 and beyond.”
A spokesperson for Novo Nordisk, which makes Wegovy and Ozempic, said that shortages of other medicines may be increasing demand for Wegovy, despite the company’s efforts to ramp up production of the drug. “We will continue to follow our plan to gradually increase overall supply throughout the rest of the year, but it’s important to recognize that overall demand will continue to exceed supply,” Novo Nordisk said.
Starter Doses of Wegovy in Limited Supply
Wegovy comes in five different doses. Patients are directed to start with 0.25 milligram (mg) injections, and gradually increase the dose every four weeks until they reach a maintenance dose of 1.7 or 2.4 mg, according to the company.
Availability is limited for the 0.25, 0.5, and 1 mg doses of Wegovy, according to the FDA.
How Hard Is It to Find Starter Doses of Mounjaro or Zepbound?
Similarly, Zepbound comes in six different doses. Patients start with a 2.5 mg injection and gradually increase the doses every four weeks until they reach a maintenance dose that’s typically 10 or 15 mg.
Only the 2.5 mg starter doses of Zepbound and Mounjaro are currently available without any shortages, according to the FDA.
“The best way to minimize side effects is to start at a low dose and updose incrementally,” saysShauna Levy MD, medical director of the weight loss center at Tulane University in New Orleans.
Why It’s Important to Start With a Low Dose of Wegovy or Zepbound
Common side effects with both Wegovy and Zepbound can include gastrointestinal issues like nausea, vomiting, diarrhea, and constipation.
“If you skip doses and updose too quickly, you could have severe and persistent symptoms,” Dr. Levy says. “If you started at a very high dose, most people experience such severe symptoms they could end up in the emergency room with persistent vomiting and dehydration.”
