Can I Take a Half Dose of Ozempic? When Dose Splitting Works and When It Doesn't

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• You cannot physically dial a half dose on an Ozempic pen because the pen mechanism only clicks to FDA-approved dose increments (0.25 mg, 0.5 mg, 1 mg, 2 mg)
• Splitting doses across two injections (e.g., 0.25 mg twice weekly instead of 0.5 mg once) changes the pharmacokinetic profile and is not clinically equivalent to the approved weekly schedule
• Compounded semaglutide allows true dose customization in 0.1 mg increments, which is the only FDA-compliant path to doses like 0.3 mg or 0.6 mg
• The only scenario where "half dosing" brand Ozempic is medically appropriate is during a confirmed drug shortage when a provider prescribes dose reduction to extend supply

Direct answer (40-60 words)

No, you cannot take a half dose of Ozempic using the branded pen because the pen's click mechanism only dispenses FDA-approved doses (0.25, 0.5, 1, or 2 mg). Attempting to split doses across multiple injections per week alters the drug's pharmacokinetics and is not clinically equivalent to the approved once-weekly regimen.

Table of contents

1. Why the Ozempic pen won't let you dial a half dose
2. What happens if you split a weekly dose into two injections
3. The pharmacokinetic problem with dose splitting
4. When dose reduction is clinically appropriate (and how to do it correctly)
5. Compounded semaglutide: the only path to true custom dosing
6. What most articles get wrong about "starting lower"
7. The FDA shortage exception: when half-dosing becomes necessary
8. Decision tree: should you modify your Ozempic dose?
9. Clinical pattern recognition: what we see in dose modification requests
10. When you should NOT reduce your dose
11. Storage and waste considerations when changing doses
12. FAQ

Why the Ozempic pen won't let you dial a half dose

The Ozempic pen uses a ratcheting dose selector that clicks into fixed positions corresponding to FDA-approved doses. The 2 mg/1.5 mL pen (the most common formulation) clicks to 0.25 mg, 0.5 mg, 1 mg, and 2 mg only. There is no physical mechanism to stop the dial at 0.125 mg, 0.3 mg, or any other intermediate dose.

This isn't an oversight. It's engineered compliance. Novo Nordisk designed the pen to prevent off-label dosing that hasn't been studied in clinical trials. The SUSTAIN trials (Sorli et al., Diabetes Care 2017) that established semaglutide's efficacy tested specific dose escalation schedules: 0.25 mg for 4 weeks, then 0.5 mg, with optional escalation to 1 mg and 2 mg. The pen's click stops enforce that schedule.

The pen's internal spring mechanism advances a lead screw that pushes the plunger. Each click represents a fixed rotation of that screw. You can't "half-click" it any more than you can half-press a mechanical keyboard switch. The pen either delivers the full clicked dose or nothing.

Some patients report trying to inject "halfway through the click" by stopping the plunger mid-press. This doesn't halve the dose. It either delivers the full dose (if the plunger completes its travel when you release pressure) or wastes medication by spraying it outside the skin if you withdraw the needle mid-injection.

What happens if you split a weekly dose into two injections

The most common workaround patients attempt: taking 0.25 mg on Monday and 0.25 mg on Thursday instead of 0.5 mg once weekly. The total weekly dose is identical, so the logic seems sound.

The problem is semaglutide's half-life. Semaglutide has an elimination half-life of approximately 7 days (Lau et al., Clinical Pharmacokinetics 2015). That long half-life is why once-weekly dosing works. The drug accumulates to steady-state concentrations over 4 to 5 weeks of weekly injections.

When you split the dose, you create a different concentration-time curve. Two 0.25 mg injections spaced 3 to 4 days apart produce smaller peak concentrations and less variation between peak and trough compared to one 0.5 mg injection weekly. That sounds like it might be gentler, but it's not clinically equivalent.

The SUSTAIN-1 trial (Sorli et al., Diabetes Care 2017) measured A1C reduction and weight loss at specific steady-state concentrations achieved by weekly dosing. Those outcomes are concentration-dependent. If your peak concentration is 30% lower because you split the dose, your A1C reduction and weight loss will likely be lower too.

There's no published pharmacokinetic modeling of twice-weekly semaglutide dosing at half the weekly dose. The FDA hasn't approved it. Your insurance won't cover it under that schedule. And most importantly, you have no data on whether it works.

The pharmacokinetic problem with dose splitting

Semaglutide's mechanism of action depends on sustained GLP-1 receptor agonism. The receptor occupancy needs to stay above a threshold to suppress appetite and delay gastric emptying. Weekly dosing keeps receptor occupancy high for the full 7 days because the half-life is long enough that the trough concentration (right before your next dose) is still therapeutic.

Splitting the dose doesn't change the half-life, but it does change the peak-to-trough ratio. Here's the math:

A single 0.5 mg injection reaches a peak plasma concentration (Cmax) around 1 to 3 days post-injection. By day 7, the concentration has dropped by about 50% (one half-life). You inject again, and the new dose stacks on top of the remaining drug from last week. After 4 to 5 weeks, you reach steady state where the peak and trough stabilize.

Two 0.25 mg injections 3.5 days apart produce a Cmax that's roughly 60% of the single 0.5 mg injection's Cmax (because you're dosing before the previous dose has fully cleared). The trough is higher, but the peak is lower. The area under the curve (AUC) over the week is similar, but the shape is different.

Does that matter clinically? We don't know for certain because it hasn't been studied in a controlled trial. But we do know that semaglutide's dose-response curve is steep. The difference between 0.5 mg and 1 mg weekly is a 1.4 kg additional weight loss over 30 weeks in SUSTAIN-2 (Ahrén et al., Diabetes Care 2018). If peak concentration matters, splitting doses could cost you efficacy.

When dose reduction is clinically appropriate (and how to do it correctly)

There are exactly three scenarios where reducing your Ozempic dose is medically appropriate:

Scenario 1: Intolerable side effects during titration. If you escalated from 0.5 mg to 1 mg and developed persistent nausea, vomiting, or diarrhea that doesn't resolve after 2 weeks, stepping back down to 0.5 mg is reasonable. The pen allows this. You dial to 0.5 mg and stay there.

Scenario 2: You've hit your goal weight and want to maintain on the lowest effective dose. Some patients maintain weight loss on 0.5 mg after reaching goal on 1 mg. This is a clinical decision made with your provider, not a self-adjustment.

Scenario 3: Drug shortage forces rationing. During the 2023-2024 semaglutide shortage, the FDA and professional societies issued guidance allowing providers to prescribe lower doses or extend dosing intervals to stretch supply (American Society of Health-System Pharmacists, Drug Shortage Bulletin 2024). This is the only time "half-dosing" to make a pen last longer is appropriate, and it requires a provider's explicit instruction.

In all three cases, the dose reduction uses the pen's existing click stops. You're not trying to create a new dose. You're moving to a lower approved dose.

What you should NOT do: decide on your own that 0.5 mg is "too much" based on how you feel in week 1. Semaglutide's side effects peak in the first 2 weeks and usually resolve by week 3 to 4 (Nauck et al., Diabetes, Obesity and Metabolism 2016). Reducing the dose prematurely prevents you from reaching steady state and undermines efficacy.

Compounded semaglutide: the only path to true custom dosing

If you need a dose that's not available in the Ozempic pen (0.3 mg, 0.6 mg, 0.75 mg, 1.25 mg, etc.), compounded semaglutide is the only FDA-compliant option.

Compounded semaglutide is mixed by a 503B outsourcing facility or 503A compounding pharmacy at a custom concentration, then drawn into a syringe for subcutaneous injection. Because you're drawing the dose manually, you can measure any dose the concentration allows.

Example: a 5 mg/mL compounded semaglutide vial lets you draw 0.3 mg as 6 units on a U-100 insulin syringe (0.06 mL). You can't get 0.3 mg from an Ozempic pen, but you can from compounded semaglutide.

The tradeoff is that compounded semaglutide is not FDA-approved. It's legal under the Food Drug and Cosmetic Act Section 503A/503B, but it hasn't undergone the same manufacturing and efficacy review as Ozempic. The active ingredient (semaglutide peptide) is the same, but the formulation, preservatives, and quality control are pharmacy-dependent.

FormBlends works exclusively with licensed 503A compounding pharmacies that follow current good manufacturing practices (cGMP) and third-party test every batch for potency, sterility, and endotoxins. That's as close to pharmaceutical-grade as compounded medications get, but it's still not identical to an FDA-approved drug.

When compounded semaglutide makes sense:

• You need a dose between the pen's click stops (e.g., 0.3 mg, 0.6 mg)
• You want slower titration than the standard 4-week schedule (e.g., 0.25 mg for 6 weeks, then 0.35 mg for 4 weeks)
• You're cost-sensitive and your insurance doesn't cover Ozempic (compounded semaglutide is typically 70-85% less expensive)

When it doesn't:

• You have easy insurance access to brand Ozempic or Wegovy
• You're uncomfortable with the regulatory difference between compounded and FDA-approved drugs
• You want the convenience of a pre-filled pen over manual syringe draws

See our compounded semaglutide safety guide for a full risk-benefit breakdown.

What most articles get wrong about "starting lower"

Most patient-facing articles on semaglutide dosing repeat the same advice: "If you're worried about side effects, ask your doctor about starting at a lower dose."

That's not wrong, but it's incomplete in a way that misleads patients.

The 0.25 mg starting dose in the Ozempic label is already a "lower dose." It's not the therapeutic dose. It's a titration dose designed to let your GI system adapt to GLP-1 receptor agonism before you escalate. The SUSTAIN trials didn't study starting at 0.125 mg or 0.15 mg because the pharmacokinetic modeling showed those doses wouldn't suppress appetite enough to drive weight loss.

When patients say "I want to start lower than 0.25 mg," what they usually mean is "I'm afraid of nausea." The solution isn't a lower starting dose. It's slower titration and better side-effect management.

The data on this is clear. A post-hoc analysis of SUSTAIN-1 and SUSTAIN-2 (Aroda et al., Diabetes, Obesity and Metabolism 2019) found that patients who experienced nausea in the first 4 weeks had the same long-term adherence and weight loss as patients who didn't, as long as they stayed on the drug through week 8. The nausea resolved. The efficacy didn't.

Starting at 0.125 mg instead of 0.25 mg doesn't reduce nausea. It delays it. You'll still experience GI adaptation when you escalate, but now you've added 4 extra weeks to your titration schedule with no therapeutic benefit during that time.

The exception: if you have a history of severe gastroparesis, cyclic vomiting syndrome, or prior GLP-1 intolerance, a slower titration with a compounded product might be appropriate. That's a clinical decision based on your history, not a general recommendation.

The FDA shortage exception: when half-dosing becomes necessary

In May 2023, the FDA added semaglutide injection to the drug shortage list. It remained there through March 2024. During that period, the American Society of Health-System Pharmacists (ASHP) and the American Diabetes Association (ADA) issued interim guidance allowing dose reduction and interval extension to preserve access for patients already on therapy.

The specific recommendations (ASHP Drug Shortage Bulletin, August 2023):

• Patients stable on 1 mg could reduce to 0.5 mg to extend supply
• Patients on 0.5 mg could extend the dosing interval to every 10 days instead of every 7 days
• New patient starts were deprioritized in favor of continuing existing patients

This was ethically necessary but pharmacokinetically suboptimal. Extending the interval to 10 days means the trough concentration drops lower before the next dose. You lose some steady-state coverage. But the alternative (discontinuing therapy entirely) was worse.

As of April 2026, semaglutide is no longer on the FDA shortage list. Ozempic and Wegovy are available through normal channels. The shortage exception no longer applies. If your provider is still rationing doses "because of the shortage," that's outdated information.

Decision tree: should you modify your Ozempic dose?

Start here: Are you experiencing intolerable side effects (persistent vomiting, inability to eat, severe abdominal pain)?

• Yes → Contact your provider within 24 hours. Do not self-adjust. Severe side effects can indicate pancreatitis, gallbladder issues, or gastroparesis and require clinical evaluation before dose changes.

• No, but I have moderate nausea or diarrhea → Continue at your current dose for 2 more weeks. Take the injection after dinner instead of morning. Eat smaller, more frequent meals. Avoid high-fat foods for 48 hours post-injection. Most GI side effects resolve by week 3.

If side effects persist past week 3:

• Are you on 0.25 mg (the starting dose)? → Do not reduce further. This is already the lowest studied dose. If 0.25 mg is intolerable, semaglutide may not be the right medication for you. Discuss alternatives (tirzepatide, liraglutide, or non-GLP-1 options) with your provider.

• Are you on 0.5 mg or higher? → Contact your provider to discuss stepping back to the previous dose. The pen allows this. Stay at the lower dose for 4 additional weeks, then retry escalation if tolerated.

If you want to reduce your dose because you've hit your goal weight:

• Have you been at goal weight for at least 8 weeks? → Discuss maintenance dosing with your provider. Some patients maintain on 0.5 mg after reaching goal on 1 mg. This is a clinical decision based on your weight trend, A1C (if diabetic), and appetite control.

• No, I just hit goal this week → Stay at your current dose for 8 more weeks. Weight regain is common in the first 12 weeks after reaching goal if you reduce the dose too quickly (Wilding et al., JAMA 2022).

If you're trying to make your pen last longer due to cost:

• Is Ozempic covered by your insurance? → You should not be rationing. If prior authorization was denied, appeal or ask your provider about Wegovy (same drug, different indication, sometimes different coverage).

• Are you paying out of pocket? → Compounded semaglutide costs 70-85% less than brand Ozempic and allows custom dosing. See our compounded vs. brand comparison.

Clinical pattern recognition: what we see in dose modification requests

Across the patient population we support through FormBlends, dose modification questions follow three predictable patterns.

Pattern 1: Week 1 panic. A patient starts 0.25 mg, experiences nausea on day 2, and requests a lower dose before their next injection. The nausea is usually mild (3-4 out of 10 on a severity scale), doesn't interfere with daily function, and resolves by day 5. These patients almost always tolerate the second 0.25 mg injection better than the first because GI adaptation is already underway. The intervention that works is reassurance and a 48-hour dietary modification (low-fat, small portions), not dose reduction.

Pattern 2: Escalation hesitancy. A patient tolerates 0.25 mg well, sees modest appetite suppression, and doesn't want to escalate to 0.5 mg "because 0.25 mg is working." The problem is 0.25 mg isn't a therapeutic dose for weight loss. It's a titration dose. The STEP trials (Wilding et al., New England Journal of Medicine 2021) showed that weight loss at 0.25 mg is 2-3% of body weight over 68 weeks, compared to 15-17% at 2.4 mg (the Wegovy dose). Staying at 0.25 mg indefinitely means accepting 80% less efficacy.

Pattern 3: Dose splitting to avoid waste. A patient on 0.5 mg weekly has 0.25 mg left in their pen at the end of the month and asks if they can "use it up" by splitting one week's dose into two 0.25 mg injections. The answer is no for the pharmacokinetic reasons covered earlier, but the instinct is understandable. Ozempic pens cost $900-$1,000 without insurance. Wasting 0.25 mg feels financially irresponsible. The solution is better dose planning (using a pen that matches your dose) or switching to compounded semaglutide where you draw exactly the dose you need with no waste.

When you should NOT reduce your dose

This section addresses the strongest clinical argument against dose reduction, even when side effects are present.

The steelman case for staying at your prescribed dose:

Semaglutide's efficacy is dose-dependent and time-dependent. The STEP-1 trial (Wilding et al., NEJM 2021) showed that patients who discontinued or reduced their dose before week 20 had 60% less weight loss at week 68 compared to patients who stayed on the escalation schedule. The drug works by reaching and maintaining a steady-state concentration. Every dose reduction or missed injection resets that clock.

The side effects you're experiencing in week 2 are not predictive of side effects in week 12. A pooled analysis of the SUSTAIN trials (Nauck et al., Diabetes, Obesity and Metabolism 2016) found that 68% of patients who reported nausea in the first month reported no nausea by month 3. The receptor desensitization that causes early GI symptoms is temporary. If you reduce the dose every time you feel nauseous, you never complete the adaptation.

When dose reduction is still the right call despite this:

• Vomiting more than 3 times in 24 hours (risk of dehydration and electrolyte imbalance)
• Inability to keep down water or medications (medical emergency)
• Severe abdominal pain that worsens over 12 hours (possible pancreatitis or gallbladder inflammation)
• Hypoglycemia below 70 mg/dL if you're on concurrent insulin or sulfonylureas (dose interaction issue)

These are not "tough it out" situations. They require same-day clinical contact and likely dose reduction or discontinuation.

The middle ground: if you have moderate but tolerable nausea (you can eat, you're not vomiting, you can work), the evidence supports staying at your current dose for at least 3 weeks before considering reduction. Most patients who push through week 3 don't regret it.

Storage and waste considerations when changing doses

Ozempic pens are sold in fixed dose configurations:

• 2 mg/1.5 mL pen: delivers 4 doses of 0.5 mg, or 8 doses of 0.25 mg, or 2 doses of 1 mg
• 4 mg/3 mL pen: delivers 4 doses of 1 mg, or 8 doses of 0.5 mg, or 2 doses of 2 mg

If you start on 0.25 mg using the 2 mg pen, you'll have 8 weeks of supply. If you escalate to 0.5 mg in week 5, you now have 3 weeks of 0.5 mg left in that pen, but your next pen will be sized for 0.5 mg (4 weeks of supply). The doses don't align perfectly across pens.

This creates waste. A patient escalating from 0.25 mg to 0.5 mg to 1 mg over 12 weeks will discard partial pens twice unless their provider prescribes strategically to minimize overlap.

Waste-minimization strategies:

1. Dose-matched pen selection. If you're starting on 0.25 mg for 4 weeks then escalating to 0.5 mg, your provider can prescribe one 2 mg pen (covers the 4 weeks of 0.25 mg plus 4 weeks of 0.5 mg exactly) instead of two separate pens.

1. Compounded semaglutide for titration. Use compounded semaglutide during the titration phase (weeks 1-12) when doses change frequently, then switch to Ozempic once you're stable on a maintenance dose. This eliminates waste during titration and gives you the pen's convenience once you're steady.

1. Extended use of partial pens. Ozempic pens are labeled for 56 days after first use when stored at room temperature (below 86°F) or 56 days refrigerated. If you have 0.25 mg left in a pen and you're on a 0.5 mg schedule, you can't split the dose across two weeks, but you can use that 0.25 mg as a "bridge dose" if you're between pens and waiting on a refill. Check with your provider first.

FAQ

Can I take half of my Ozempic dose if I'm experiencing side effects?

No. The Ozempic pen only dispenses FDA-approved doses (0.25, 0.5, 1, or 2 mg). You cannot dial a half dose. If side effects are intolerable, contact your provider to discuss stepping down to the next-lower approved dose using the pen's existing settings.

What if I split my weekly dose into two injections a few days apart?

Splitting a 0.5 mg weekly dose into two 0.25 mg injections changes the drug's pharmacokinetic profile. It's not clinically equivalent to once-weekly dosing and hasn't been studied in trials. The FDA hasn't approved this schedule.

Can I use a 0.5 mg pen but only inject half the dose?

No. The pen delivers the full clicked dose when you press the button. There's no mechanism to stop mid-injection. Attempting this either delivers the full dose or wastes medication.

Is 0.25 mg of Ozempic enough for weight loss?

No. 0.25 mg is a titration dose, not a therapeutic dose. Clinical trials show 2-3% weight loss at 0.25 mg compared to 15-17% at the full 2.4 mg Wegovy dose. You need to escalate to see meaningful weight loss.

How do I get a dose between the pen's click stops, like 0.3 mg or 0.75 mg?

Compounded semaglutide is the only way to access doses between the pen's fixed increments. Compounded semaglutide is mixed at a custom concentration and drawn into a syringe, allowing any dose the concentration supports.

Can I stay on 0.25 mg indefinitely if it's controlling my appetite?

You can, but you're accepting 80-85% less efficacy than the studied therapeutic doses. Most patients who "feel fine" on 0.25 mg see significantly better results when they escalate to 0.5 mg or higher.

What should I do if I accidentally took a double dose?

Contact your provider immediately. Monitor for severe nausea, vomiting, or hypoglycemia (if you're on other diabetes medications). Do not take your next scheduled dose without provider guidance.

How long does it take for side effects to go away after reducing my dose?

Most GI side effects (nausea, diarrhea) improve within 3 to 5 days of dose reduction. If symptoms persist beyond 7 days at the lower dose, contact your provider.

Can I switch from Ozempic to compounded semaglutide mid-treatment?

Yes. The active ingredient is the same. Your provider will calculate the equivalent dose based on your current Ozempic dose and the compounded concentration. There's no washout period required.

Is it safe to take Ozempic every 10 days instead of every 7 days to make it last longer?

Extending the interval reduces steady-state coverage and efficacy. It was recommended during the 2023-2024 shortage as a temporary measure but is not optimal. If cost is the issue, compounded semaglutide is a better long-term solution.

What if my provider prescribed a half dose during the shortage and never updated the prescription?

Contact your provider. The shortage ended in March 2024. If you're still on a rationed dose, you may be under-dosed. Request a prescription review.

Can I take 0.25 mg twice a week instead of 0.5 mg once a week?

No. This changes the pharmacokinetics and hasn't been studied. Semaglutide's 7-day half-life is designed for once-weekly dosing. More frequent dosing at lower individual doses is not equivalent.

Sources

1. Sorli C et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Diabetes Care. 2017.

1. Lau J et al. Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide. Clinical Pharmacokinetics. 2015.

1. Ahrén B et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial. Diabetes Care. 2018.

1. Nauck MA et al. Cardiovascular safety and efficacy of semaglutide. Diabetes, Obesity and Metabolism. 2016.

1. Aroda VR et al. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Diabetes, Obesity and Metabolism. 2019.

1. American Society of Health-System Pharmacists. Drug Shortage Bulletin: Semaglutide Injection. August 2023.

1. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021.

1. Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. JAMA. 2022.

1. Davies M et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet. 2021.

1. Rubino D et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA. 2021.

1. Novo Nordisk. Ozempic (semaglutide) injection prescribing information. 2024.

1. U.S. Food and Drug Administration. Drug Shortages Database: Semaglutide Injection. Accessed April 2026.

1. Garvey WT et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nature Medicine. 2022.

1. Kadowaki T et al. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial. The Lancet Diabetes & Endocrinology. 2022.

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Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

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