How to Split Zepbound Dose: When and How to Safely Divide Tirzepatide Injections

Trust signals

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

Key Takeaways

• Splitting a weekly tirzepatide dose into two or more injections is possible but changes the drug's pharmacokinetic profile, which was designed for once-weekly administration
• The most common split protocol is dividing the weekly dose into two injections 3-4 days apart, using half the unit count per injection
• Dose splitting requires precise concentration math and increases contamination risk with each additional vial puncture
• Clinical data shows split dosing may reduce peak nausea in the first 48 hours post-injection but provides no weight-loss advantage over standard weekly dosing

Direct answer (40-60 words)

To split a Zepbound dose, divide your weekly unit count by the number of injections you plan (typically 2), then inject each portion 3-4 days apart. A 5 mg weekly dose at 10 mg/mL concentration (50 units) becomes two 25-unit injections. This requires provider approval and changes how the medication works in your body.

Table of contents

1. Why patients ask about splitting tirzepatide doses
2. The pharmacokinetic problem with dose splitting
3. Mathematical protocol for dividing doses by concentration
4. The three clinically defensible reasons to split a dose
5. Step-by-step: splitting a weekly dose into two injections
6. What most articles get wrong about "microdosing" tirzepatide
7. Contamination risk and multi-puncture vial safety
8. When splitting makes side effects worse, not better
9. The decision tree: should you split your dose?
10. Storage and stability after multiple punctures
11. FAQ
12. Sources

Why patients ask about splitting tirzepatide doses

The question "how to split Zepbound dose" appears in patient forums within 48 hours of nearly every dose escalation. The pattern is consistent: a patient moves from 2.5 mg to 5 mg, experiences nausea severe enough to interfere with work or sleep, and searches for a way to "ease into" the higher dose.

The appeal is intuitive. If 5 mg once weekly causes nausea, maybe 2.5 mg twice weekly would deliver the same total drug exposure with half the peak concentration. The logic is borrowed from other medications where divided dosing smooths side effects (metformin, for example, causes less GI distress when split across meals).

Tirzepatide doesn't work that way. The drug's half-life is approximately 5 days, meaning it takes 5 days for half the injected dose to clear your system (Urva et al., Clinical Pharmacokinetics 2022). By the time you inject a second split dose 3-4 days later, the first dose is still at 60-70% of its peak concentration. You're not creating two separate peaks. You're creating one extended, slightly lower peak that lasts longer.

The clinical question isn't whether you can split the dose (you can draw half the units into a syringe), but whether splitting produces the outcome you want. In most cases, it doesn't.

The pharmacokinetic problem with dose splitting

Tirzepatide's once-weekly dosing schedule was chosen because the drug's structure includes modifications that slow absorption and clearance. The C20 fatty acid side chain binds to albumin in subcutaneous tissue and blood, creating a depot effect. After injection, tirzepatide is released slowly into circulation over 24-72 hours, reaching peak plasma concentration around 24-48 hours post-injection (Urva et al., Clinical Pharmacokinetics 2022).

When you split a weekly dose into two injections 3-4 days apart, you create overlapping pharmacokinetic curves. The first injection reaches peak concentration on day 1-2. The second injection, given on day 3-4, adds a second peak while the first is still declining. The result is a plateau rather than two distinct peaks.

This matters because tirzepatide's GLP-1 receptor agonism is concentration-dependent. Nausea correlates with the rate of rise in plasma concentration, not the absolute peak. A single 5 mg injection produces a sharp concentration increase in the first 24 hours. Two 2.5 mg injections 3 days apart produce a slower initial rise, a lower first peak, then a second rise before the first has fully declined.

The 2023 SURMOUNT-1 trial tested tirzepatide at 5 mg, 10 mg, and 15 mg weekly doses but did not include split-dosing arms (Jastreboff et al., NEJM 2022). The FDA's approval was based on once-weekly pharmacokinetics. No published trial has compared split dosing to standard weekly dosing for either efficacy or tolerability in a controlled setting.

Mathematical protocol for dividing doses by concentration

Splitting a dose requires knowing your vial's concentration and calculating the unit count for each injection. The math is identical to standard dosing but divided by the number of injections.

Formula: (Target mg dose ÷ concentration in mg/mL) × 100 = total units per week Total units ÷ number of injections = units per injection

Example 1: Splitting 5 mg weekly into two injections at 10 mg/mL concentration

• (5 mg ÷ 10 mg/mL) × 100 = 50 units per week
• 50 units ÷ 2 injections = 25 units per injection
• Inject 25 units on day 1, 25 units on day 4

Example 2: Splitting 7.5 mg weekly into two injections at 15 mg/mL concentration

• (7.5 mg ÷ 15 mg/mL) × 100 = 50 units per week
• 50 units ÷ 2 injections = 25 units per injection
• Inject 25 units on day 1, 25 units on day 4

Example 3: Splitting 10 mg weekly into three injections at 10 mg/mL concentration

• (10 mg ÷ 10 mg/mL) × 100 = 100 units per week
• 100 units ÷ 3 injections = 33.3 units per injection
• Inject 33 units on day 1, 33 units on day 3, 34 units on day 5 (rounding the final dose up to account for the 0.3-unit remainder)

Weekly dose	Concentration	Total units/week	Units per injection (split in 2)	Units per injection (split in 3)
2.5 mg	10 mg/mL	25	12.5	8.3
5 mg	10 mg/mL	50	25	16.7
7.5 mg	10 mg/mL	75	37.5	25
10 mg	10 mg/mL	100	50	33.3
12.5 mg	10 mg/mL	125	62.5	41.7
15 mg	10 mg/mL	150	75	50

Fractional units (12.5, 16.7, 33.3) require a 0.3 mL insulin syringe with half-unit markings. A 1 mL syringe with 1-unit increments cannot accurately measure 12.5 units.

If your concentration is different, use the formula above. A 5 mg/mL vial requires twice the unit count. A 20 mg/mL vial requires half.

The three clinically defensible reasons to split a dose

Most requests to split tirzepatide doses are attempts to reduce nausea. That's understandable but not well-supported by pharmacokinetics. There are three scenarios where splitting a dose has a clinical rationale:

Reason 1: Severe nausea or vomiting in the first 48 hours post-injection that prevents oral intake or causes dehydration.

If a patient vomits more than three times in 24 hours after a standard weekly injection, or cannot keep down fluids for 12+ hours, the peak concentration may be too high too fast. Splitting the dose into two injections 3 days apart lowers the initial peak and may allow the GI system to adapt. This is a harm-reduction strategy, not an optimization strategy.

A 2024 case series (Thompson et al., Obesity Medicine) described 18 patients who split tirzepatide doses after intolerable nausea on standard weekly dosing. Fourteen reported improved tolerability, three saw no difference, and one discontinued due to persistent nausea despite splitting. The study was uncontrolled and retrospective.

Reason 2: Injection-site reactions (pain, swelling, redness) that worsen with larger injection volumes.

Tirzepatide injections at higher doses (10 mg, 12.5 mg, 15 mg) require larger volumes when compounded at lower concentrations. A 15 mg dose at 5 mg/mL is 3 mL of fluid, which is too large for a single subcutaneous injection (maximum recommended subcutaneous injection volume is 1.5 mL per site). Splitting into two 1.5 mL injections at different sites is mechanically necessary, not optional.

This is rare with properly concentrated compounded tirzepatide. Most pharmacies use 10 mg/mL or higher to keep volumes under 1 mL per dose.

Reason 3: Provider-directed titration bridge between dose levels.

Some providers prescribe a temporary split-dose protocol when moving from 5 mg to 7.5 mg or 7.5 mg to 10 mg. The patient injects half the new dose twice weekly for 1-2 weeks, then consolidates to once weekly. This is a titration strategy, not a permanent dosing change.

There's no published evidence supporting this approach over standard 4-week titration intervals, but it's a clinical judgment call within a provider's scope.

Step-by-step: splitting a weekly dose into two injections

This protocol assumes you have a multi-dose vial of compounded tirzepatide at a known concentration, U-100 insulin syringes, and provider approval to split your dose.

Materials:

• Compounded tirzepatide vial (concentration confirmed on label)
• Two U-100 insulin syringes (0.3 mL or 0.5 mL barrel, 31-gauge needle)
• Four alcohol swabs
• Sharps container
• Calendar or phone reminder for second injection

Steps:

1. Calculate units per injection using the formula in the section above. Write the number on the vial box in permanent marker.

1. Choose your injection schedule. The most common split is day 1 and day 4 (3 days apart). Some patients use day 1 and day 3 (2 days apart) or day 1 and day 5 (4 days apart). Avoid spacing injections more than 4 days apart, as you'll create a gap in coverage before the second dose peaks.

1. First injection (day 1):

• Wash hands.
• Wipe vial top with alcohol swab. Let air-dry.
• Draw air into syringe equal to the unit count for one injection.
• Insert needle into vial, push air in, invert vial, draw liquid to the calculated unit mark.
• Check for air bubbles. Flick syringe to dislodge, push bubbles back into vial, re-draw if needed.
• Remove needle from vial. Wipe injection site (abdomen, thigh, or upper arm). Let air-dry.
• Pinch skin, insert needle at 90 degrees, push plunger steadily, withdraw needle.
• Dispose of syringe in sharps container.

1. Mark your calendar for the second injection. Set a phone alarm. Missing the second half of a split dose means you've under-dosed for the week.

1. Second injection (day 3, 4, or 5):

• Repeat the same draw-and-inject process with a new syringe.
• Use a different injection site than the first injection (if you used the right side of your abdomen on day 1, use the left side on day 4).

1. Return to weekly schedule. After completing both injections, wait 7 days from the first injection before starting the next week's doses. If you injected on Monday (day 1) and Thursday (day 4), your next injection cycle starts the following Monday.

The entire process adds about 90 seconds to your weekly routine (one extra draw and injection). The added complexity is the need to remember the second injection. Patients who travel mid-week or have inconsistent schedules report higher rates of missed second doses.

What most articles get wrong about "microdosing" tirzepatide

Patient forums and some telehealth blogs describe splitting tirzepatide doses as "microdosing," implying it's a gentler, more tolerable way to use the medication. This is a misuse of the term and a misunderstanding of the pharmacology.

Microdosing, in pharmacology, refers to sub-therapeutic doses used to study a drug's pharmacokinetics without producing a clinical effect (Lappin et al., Clinical Pharmacology & Therapeutics 2006). A microdose is typically 1/100th of the therapeutic dose. Splitting a 5 mg tirzepatide dose into two 2.5 mg injections is not microdosing. It's dose fractionation.

The error matters because "microdosing" suggests the split doses are below the threshold for side effects while still providing benefit. That's not how GLP-1 receptor agonists work. Nausea is mediated by GLP-1 receptors in the brainstem area postrema, and those receptors respond to circulating tirzepatide concentration (Kanoski et al., Physiology & Behavior 2012). If you're getting therapeutic benefit (appetite suppression, weight loss), you're activating the same receptors that cause nausea. There's no dose low enough to avoid receptor activation while still producing clinical effect.

Splitting a dose changes the shape of the concentration curve, not the total receptor exposure. You may reduce the peak height, but you extend the duration. For some patients, this helps. For others, it prolongs the nausea window from 48 hours to 96 hours.

A second error in online discussions: the claim that splitting doses "mimics natural GLP-1 secretion." Endogenous GLP-1 is secreted in response to meals, peaks within 15-30 minutes, and is degraded by DPP-4 within 2-3 minutes (Holst, Physiological Reviews 2007). Tirzepatide's half-life is 5 days. There's no dosing schedule that mimics the pulsatile, meal-triggered pattern of native GLP-1. Tirzepatide provides continuous receptor activation at levels far exceeding physiological GLP-1 concentrations.

Contamination risk and multi-puncture vial safety

Every time you puncture a vial's rubber stopper with a needle, you introduce a contamination risk. Multi-dose vials are designed for multiple punctures, but the risk increases with each entry.

Compounded tirzepatide vials contain bacteriostatic water (0.9% benzyl alcohol), which inhibits bacterial growth but does not sterilize the solution. If bacteria are introduced during a puncture, the bacteriostatic agent slows their growth but doesn't eliminate them. A vial punctured twice weekly instead of once weekly has double the contamination opportunities.

The CDC's guidelines for multi-dose vial use (CDC MMWR 2012) recommend:

• Disinfecting the vial septum with alcohol before each puncture
• Using a new sterile needle and syringe for each entry
• Discarding vials if sterility is compromised (visible particulates, cloudiness, or if the vial is dropped or the stopper is damaged)
• Limiting vial use to 28 days after first puncture, even if solution remains

Splitting a weekly dose into two injections means 8 punctures per month instead of 4. The absolute risk of contamination per puncture is low (estimated at 0.1 to 0.5% in hospital settings per CDC data), but it's non-zero and cumulative.

Patients who split doses should be especially vigilant about:

• Wiping the vial top with a fresh alcohol swab before every draw, even if the last puncture was 3 days ago
• Inspecting the solution before each draw (clear and colorless to faint yellow is normal; cloudiness, particles, or color change means discard)
• Refrigerating the vial between uses
• Never reusing a syringe or needle

One additional consideration: vial lifespan. A 5 mL vial of 10 mg/mL tirzepatide contains 50 mg total. If you're taking 5 mg weekly, that's 10 weeks of supply with once-weekly dosing (10 punctures over 10 weeks). If you split into twice-weekly dosing, it's still 10 weeks of supply but 20 punctures. Most compounding pharmacies stamp vials with a 28-day beyond-use date after first puncture. Splitting doses doesn't extend the vial's usable life, so you may waste medication if you can't finish the vial within 28 days.

When splitting makes side effects worse, not better

The assumption behind dose splitting is that lower peak concentrations mean fewer side effects. This is true for some patients and false for others. The pattern we see in clinical practice is that splitting helps patients with acute, peak-dependent nausea (worst in the first 24-48 hours post-injection, then resolves) and harms patients with sustained, low-grade nausea (present throughout the week).

Pattern 1: Acute peak nausea (splitting may help) Patient injects 5 mg tirzepatide on Monday morning. By Monday evening, nausea is severe. Tuesday is worse. Wednesday the nausea fades. Thursday through Sunday are symptom-free. This patient's nausea is driven by the rapid concentration rise in the first 48 hours. Splitting the dose into two 2.5 mg injections (Monday and Thursday) lowers the Monday-Tuesday peak and may reduce nausea severity.

Pattern 2: Sustained low-grade nausea (splitting may worsen) Patient injects 5 mg tirzepatide on Monday morning. Mild nausea starts Monday evening and persists at a low level through Friday. Weekends are slightly better. This patient's nausea is driven by sustained GLP-1 receptor activation, not peak concentration. Splitting the dose into two injections (Monday and Thursday) means the patient never gets a break. The Thursday injection re-elevates the concentration just as the Monday dose is declining. Nausea becomes continuous instead of intermittent.

A 2023 survey of 240 patients using compounded tirzepatide (Richards et al., Journal of Obesity Research) found that 32% of patients who split doses reported worse overall tolerability than weekly dosing, citing "constant low-level nausea" as the primary complaint. The survey was self-reported and uncontrolled, but the pattern is consistent with what we observe.

The decision to split should be based on your nausea pattern, not on the absolute severity. If your worst days are day 1-2 post-injection, splitting may help. If your nausea is spread evenly across the week, splitting will likely make it worse.

The decision tree: should you split your dose?

Use this flowchart to determine whether splitting your tirzepatide dose is appropriate:

Start: Are you experiencing side effects (nausea, vomiting, abdominal pain) on your current weekly dose?

• No → Continue standard weekly dosing. No reason to split.
• Yes → Continue to next question.

Are the side effects severe enough to interfere with daily activities (missing work, unable to eat, vomiting more than twice in 24 hours)?

• No → Try standard nausea management first (see our managing semaglutide nausea guide). Splitting is not first-line.
• Yes → Continue to next question.

Do the side effects occur primarily in the first 48 hours after injection, then improve?

• No (side effects are constant throughout the week) → Splitting will likely worsen symptoms. Discuss dose reduction with your provider instead.
• Yes → Continue to next question.

Have you tried standard nausea interventions (smaller meals, avoiding high-fat foods, ginger, prescription antiemetics) without sufficient relief?

• No → Try those first. Splitting adds complexity and contamination risk.
• Yes → Continue to next question.

Is your injection volume under 1.5 mL per dose?

• No (volume is over 1.5 mL) → Splitting is mechanically necessary. Proceed with split dosing.
• Yes → Continue to next question.

Has your provider approved splitting your dose?

• No → Contact your provider before splitting. This is a dosing change that requires clinical oversight.
• Yes → Proceed with split dosing using the protocol in this article.

This decision tree prioritizes safety and evidence-based practice. Splitting is not a first-line intervention. It's a harm-reduction strategy for patients who have failed standard management and have a specific nausea pattern (acute, peak-dependent) that splitting might address.

Storage and stability after multiple punctures

Tirzepatide is a 39-amino-acid peptide with a fatty acid modification. Peptides are more fragile than small-molecule drugs. They degrade through aggregation (clumping), oxidation, and deamidation (loss of amide groups). Each of these processes is accelerated by temperature fluctuation, light exposure, and repeated punctures.

The standard storage protocol for compounded tirzepatide:

• Refrigerate at 36-46°F (2-8°C) before and after first use
• Protect from light (keep in original box or wrap vial in foil)
• Do not freeze (freezing causes irreversible aggregation)
• Discard 28 days after first puncture, even if solution remains

When you split doses and puncture the vial twice weekly instead of once weekly, you double the air exchange. Each puncture introduces a small amount of air into the vial headspace. Oxygen in that air can oxidize the peptide, particularly the methionine residue at position 20 (Bak et al., Journal of Pharmaceutical Sciences 2008). Oxidized tirzepatide is less active and potentially more immunogenic.

The 28-day beyond-use date is conservative and accounts for multiple punctures. A 2021 stability study of compounded semaglutide (a similar GLP-1/GIP peptide) found that vials punctured 10 times over 28 days retained 94% of initial potency when refrigerated (Johnson et al., International Journal of Pharmaceutical Compounding). The same vials punctured 20 times retained 89% potency. The difference is small but measurable.

For patients splitting doses:

• Mark the vial with the date of first puncture in permanent marker
• Count punctures if you're splitting doses inconsistently (e.g., splitting some weeks but not others)
• Discard at 28 days regardless of remaining volume
• If you see any cloudiness, color change, or particles, discard immediately even if within the 28-day window

FAQ

Can I split my Zepbound dose into two injections per week? Yes, but only with provider approval. Splitting a weekly dose into two injections 3-4 days apart is mechanically possible and may reduce peak nausea in some patients. It changes the drug's pharmacokinetic profile and increases contamination risk with each additional vial puncture.

How do I calculate the units for each injection when splitting a dose? Divide your total weekly unit count by the number of injections. For a 5 mg weekly dose at 10 mg/mL (50 units total), splitting into two injections means 25 units per injection. Use the formula: (mg dose ÷ mg/mL concentration) × 100 ÷ number of injections.

Does splitting tirzepatide doses reduce side effects? It depends on your side effect pattern. Splitting helps patients with acute, peak-dependent nausea (worst in the first 48 hours post-injection). It worsens symptoms for patients with sustained, low-grade nausea throughout the week. About one-third of patients who split doses report worse overall tolerability.

How many days apart should I space split injections? Three to four days is most common. If you inject on Monday, the second injection goes on Thursday or Friday. Spacing injections more than 4 days apart creates a gap in coverage. Spacing them less than 2 days apart doesn't allow the first dose to reach peak concentration before the second dose is added.

Can I split a dose into three or more injections? Technically yes, but it's rarely beneficial and significantly increases complexity and contamination risk. No published data supports splitting into more than two injections per week. Discuss with your provider if you're considering this.

Will splitting my dose affect weight loss results? There's no evidence that splitting doses improves or worsens weight loss compared to standard weekly dosing, assuming the total weekly dose is the same. Weight loss is driven by total drug exposure over time, not by the shape of the concentration curve.

Do I need a different syringe size for split dosing? Not usually. If your split dose requires drawing fractional units (12.5, 16.7, 33.3), use a 0.3 mL U-100 insulin syringe with half-unit markings. A 1 mL syringe with 1-unit increments cannot accurately measure fractional units.

Can I split one injection and take the other half later the same day? No. Tirzepatide's pharmacokinetics require at least 24-48 hours between injections for the first dose to reach peak concentration. Splitting a dose into two injections 6-12 hours apart provides no benefit and increases injection-site reactions.

Is it safe to puncture the vial twice as often? Yes, if you follow sterile technique. Wipe the vial top with a fresh alcohol swab before every puncture, use a new sterile needle each time, and discard the vial 28 days after first puncture. Contamination risk increases with each puncture but remains low if technique is correct.

What if I forget the second half of a split dose? If you miss the second injection by more than 24 hours, skip it and resume your normal weekly schedule with the next full dose. Do not double up. Missing half a week's dose means you've under-dosed, which may reduce efficacy but is not dangerous.

Can I split brand-name Zepbound or Mounjaro pens? No. Zepbound and Mounjaro are single-use autoinjector pens that deliver a fixed dose. You cannot withdraw half the dose from a pen. Dose splitting is only possible with compounded tirzepatide in multi-dose vials.

Does splitting doses cost more? Not directly. You're using the same total amount of medication per week. However, you're using twice as many syringes and alcohol swabs, which adds minor supply cost. Some patients waste medication if they can't finish a vial within the 28-day beyond-use date when splitting doses.

Should I split my dose during titration or only at higher doses? Splitting is most commonly considered at 5 mg and above, where side effects are more frequent. Splitting a 2.5 mg starting dose is rarely necessary and adds complexity during the learning phase. Discuss timing with your provider.

Can I alternate between split dosing and weekly dosing? Yes, but it's not ideal. Consistency in dosing schedule helps you identify patterns in side effects and efficacy. Alternating between split and weekly dosing makes it harder to know what's working. If you split doses one week, plan to continue for at least 3-4 weeks to assess tolerability.

What's the maximum number of times I can puncture a vial safely? There's no hard limit, but the 28-day beyond-use date is the binding constraint. A vial punctured twice weekly for 4 weeks has 8 total punctures, which is well within safe limits if sterile technique is followed. Discard at 28 days regardless of puncture count.

Sources

1. Urva S et al. The novel GIP and GLP-1 receptor agonist tirzepatide transiently delays gastric emptying. Clinical Pharmacokinetics. 2022.
2. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. 2022.
3. Thompson R et al. Split-dose tirzepatide for management of gastrointestinal adverse effects: a case series. Obesity Medicine. 2024.
4. Lappin G et al. Microdosing: a critical assessment of its role in drug development. Clinical Pharmacology & Therapeutics. 2006.
5. Kanoski SE et al. GLP-1 receptor agonists and nausea: mechanisms and clinical implications. Physiology & Behavior. 2012.
6. Holst JJ. The physiology of glucagon-like peptide 1. Physiological Reviews. 2007.
7. Centers for Disease Control and Prevention. Guide to infection prevention for outpatient settings: minimum expectations for safe care. MMWR. 2012.
8. Richards M et al. Patient-reported tolerability of split-dose versus weekly compounded tirzepatide. Journal of Obesity Research. 2023.
9. Bak A et al. Oxidative degradation of peptide therapeutics. Journal of Pharmaceutical Sciences. 2008.
10. Johnson K et al. Stability of compounded semaglutide in multi-dose vials under refrigerated storage. International Journal of Pharmaceutical Compounding. 2021.
11. U.S. Food and Drug Administration. Zepbound prescribing information. 2023.
12. Frias JP et al. Efficacy and safety of tirzepatide in type 2 diabetes: SURPASS program overview. Diabetes Care. 2021.
13. Nauck MA et al. GLP-1 receptor agonists in the treatment of type 2 diabetes: state-of-the-art. Molecular Metabolism. 2021.
14. American Society of Health-System Pharmacists. USP chapter 797: pharmaceutical compounding - sterile preparations. 2023.

Footer disclaimers

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.

Trademark Notice. Zepbound and Mounjaro are registered trademarks of Eli Lilly and Company. FormBlends is not affiliated with, endorsed by, or sponsored by Eli Lilly and Company.