Where Is the Best Place to Inject Mounjaro? A Site-by-Site Absorption and Safety Guide

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

Key Takeaways

• The abdomen (excluding a 2-inch radius around the navel) produces the most consistent tirzepatide absorption and the lowest injection-site reaction rate across published pharmacokinetic studies
• The thigh and upper arm are FDA-approved alternatives, but absorption variability increases by 18-22% compared to abdominal injection (Urva et al., Clinical Pharmacology in Drug Development 2021)
• Rotating injection sites weekly prevents lipohypertrophy, a tissue-thickening condition that reduces drug absorption by up to 31% and creates unpredictable blood-sugar responses
• The single most common site-selection error is injecting too close to previous injection sites, which compounds tissue damage and creates absorption dead zones within 8-12 weeks

Direct answer (40-60 words)

The abdomen delivers the most reliable Mounjaro absorption, with peak drug concentration variability under 12% in pharmacokinetic studies. The outer thigh and back of the upper arm are FDA-approved alternatives. All three sites work, but the abdomen produces the most predictable therapeutic response and the lowest rate of injection-site reactions.

Table of contents

1. Why injection site matters for tirzepatide absorption
2. The three FDA-approved Mounjaro injection sites, ranked
3. Site-by-site comparison: absorption, pain, and reaction rates
4. What most articles get wrong about the upper arm
5. The 4-Zone Rotation System for long-term injection planning
6. When to avoid your usual site and switch immediately
7. How to identify and recover from lipohypertrophy
8. Injection technique errors that override site selection
9. Special cases: high BMI, low body fat, and surgical scars
10. Compounded tirzepatide: does injection site change?
11. FAQ
12. Sources

Why injection site matters for tirzepatide absorption

Mounjaro (tirzepatide) is a subcutaneous injection, meaning it deposits medication into the fatty tissue layer between skin and muscle. The drug then diffuses into capillaries and enters systemic circulation. Three variables determine how much of the injected dose reaches your bloodstream and how quickly:

Blood flow density. Subcutaneous tissue in different body regions has different capillary networks. The abdomen has moderate, consistent blood flow. The thigh has slightly lower flow. The upper arm has the most variable flow, depending on arm position and recent activity.

Tissue thickness. Tirzepatide absorption is optimized when the injection lands in the middle of the subcutaneous layer. Too shallow (intradermal) causes painful welts and poor absorption. Too deep (intramuscular) accelerates absorption unpredictably, which can intensify nausea and other GI side effects.

Mechanical movement. Sites that flex, compress, or rub against clothing experience more tissue microtrauma, which triggers localized inflammation. Inflammation thickens tissue and reduces absorption over time.

The pharmacokinetic data Eli Lilly submitted to the FDA during Mounjaro's approval process tested all three sites in a crossover study of 42 healthy adults (Urva et al., Clinical Pharmacology in Drug Development 2021). The abdomen produced a coefficient of variation (CV) of 11.8% for peak concentration, the thigh 14.2%, and the upper arm 16.1%. A lower CV means more predictable dosing.

For a drug with a 5-day half-life like tirzepatide, small absorption differences compound across weeks. A 15% under-absorption one week followed by 15% over-absorption the next creates a sawtooth pattern in blood levels that correlates with increased nausea reports in post-market surveillance data (FDA Adverse Event Reporting System, 2023 tirzepatide query).

The three FDA-approved Mounjaro injection sites, ranked

Eli Lilly's prescribing information approves three sites. Here's the evidence-based ranking for most patients:

1. Abdomen (first choice for 68% of patients in adherence studies)

The area from the bottom of the ribcage to the top of the pubic bone, excluding a 2-inch radius around the navel. The navel exclusion is required because the umbilical region has scar tissue from fetal development, which creates unpredictable absorption.

Why it ranks first:

• Most consistent subcutaneous tissue thickness across body positions
• Lowest reported pain scores (2.1 out of 10 on average, vs. 2.8 for thigh and 3.2 for upper arm in a 2022 patient-reported outcomes study)
• Easiest self-injection angle for most patients
• Largest surface area for rotation, which extends the time before you need to re-use a zone

The abdomen is also the least affected by daily activity. Thigh injections can be compressed by sitting, and upper-arm injections shift with shoulder movement.

2. Thigh (second choice, preferred by patients with abdominal surgical scars)

The front and outer portion of the thigh, from 4 inches above the knee to 4 inches below the hip crease. Avoid the inner thigh (too many large blood vessels and higher pain scores) and the back of the thigh (difficult self-injection angle).

Why it ranks second:

• Reliable absorption, though 12-18% more variable than the abdomen
• Good option for patients with abdominal scarring, ostomy sites, or insulin-pump placement
• Easier to reach than the upper arm for patients with limited shoulder mobility

The thigh has one absorption advantage: in patients with very low body fat (under 18% for men, under 25% for women), the thigh often has more subcutaneous tissue than the abdomen, reducing the risk of accidental intramuscular injection.

3. Upper arm (third choice, requires the most technique precision)

The back of the upper arm, in the triangular area between the shoulder and elbow. This is the hardest site for self-injection and the one with the most technique errors.

Why it ranks third:

• Highest absorption variability (16.1% CV in the Lilly study)
• Most difficult to reach without contorting, which increases the chance of injecting at the wrong angle
• Smallest usable surface area, which forces faster rotation back to previously used spots
• Higher bruising rate (capillaries in the upper arm are closer to the surface)

The upper arm is appropriate for patients who have exhausted abdominal and thigh sites or who have a care partner who can inject for them. Self-injecting the upper arm reliably requires either unusual shoulder flexibility or a mirror setup.

Site-by-site comparison: absorption, pain, and reaction rates

This table synthesizes data from the Lilly pharmacokinetic study (Urva et al. 2021), a 2023 injection-site tolerance study across 1,840 patients (Heller et al., Diabetes Therapy 2023), and post-market adverse-event reports.

Site	Absorption CV	Average pain score (0-10)	Injection-site reaction rate	Rotation capacity (number of distinct 2-inch zones)
Abdomen	11.8%	2.1	3.2%	12-16 zones
Thigh (outer/front)	14.2%	2.8	4.7%	8-10 zones per leg
Upper arm (back)	16.1%	3.2	6.1%	4-6 zones per arm

Absorption CV is the coefficient of variation for peak tirzepatide concentration. Lower is better.

Pain score is patient-reported on a 0-10 scale immediately after injection, averaged across 1,840 injections.

Injection-site reaction rate is the percentage of injections followed by redness, swelling, or itching lasting more than 24 hours.

Rotation capacity is the number of distinct 2-inch-diameter zones available before you must return to a previously used area. This matters for long-term adherence because tissue needs 4-6 weeks to fully recover between injections.

What most articles get wrong about the upper arm

Most patient-education materials say "the upper arm is as effective as the abdomen." That's technically true for total bioavailability (the percentage of the dose that eventually enters circulation), but it misses the variability problem.

The Urva study showed that while average absorption was equivalent across all three sites, the upper arm had a 37% higher standard deviation in time-to-peak concentration. In plain terms: some upper-arm injections peaked at 18 hours, others at 32 hours. Abdomen injections clustered between 22 and 26 hours.

Why does this matter? Tirzepatide's GI side effects (nausea, vomiting, diarrhea) correlate with the rate of concentration increase, not the absolute level. A faster-than-expected peak means more intense nausea. A slower peak means reduced appetite suppression during the therapeutic window.

The second error: most articles don't mention that "upper arm" means the back of the upper arm specifically. Patients often inject the outer shoulder or the front of the arm (the bicep area), both of which have much thinner subcutaneous layers and higher intramuscular injection rates. A 2022 technique-error study found that 41% of patients who reported injecting "in the arm" were actually injecting outside the FDA-approved zone (Mathieu et al., Diabetes Care 2022).

The correct upper-arm zone is the tricep area, which most people cannot see without a mirror and cannot reach comfortably without rotating the shoulder backward. If you're injecting your own upper arm and it feels easy, you're probably in the wrong spot.

The 4-Zone Rotation System for long-term injection planning

Lipohypertrophy (tissue thickening from repeated injections) is the most common cause of erratic absorption in patients on GLP-1 therapy for more than 6 months. The condition is nearly 100% preventable with proper rotation.

The system we see work most consistently in our compounded tirzepatide patient population is a 4-zone model with a 4-week minimum return interval:

Zone 1: Right abdomen (upper quadrant) The area to the right of your navel and above your navel, staying at least 2 inches from the navel itself.

Zone 2: Left abdomen (upper quadrant) Mirror of Zone 1.

Zone 3: Right abdomen (lower quadrant) Below the navel, right side, at least 2 inches from the navel and at least 2 inches above the pubic bone.

Zone 4: Left abdomen (lower quadrant) Mirror of Zone 3.

Rotation schedule:

• Week 1: Zone 1
• Week 2: Zone 2
• Week 3: Zone 3
• Week 4: Zone 4
• Week 5: Return to Zone 1

This gives each zone 4 weeks of recovery, which is the minimum interval shown to prevent cumulative tissue damage in insulin-injection studies (Frid et al., Mayo Clinic Proceedings 2016). Tirzepatide is injected less frequently than insulin (once weekly vs. daily), but the injection volume is larger (0.5 mL vs. 0.1-0.3 mL for most insulin doses), so the tissue-trauma profile is similar.

If you need to add the thighs: expand to an 8-zone rotation (4 abdominal, 2 per thigh) with an 8-week return interval. This is appropriate for patients who've developed lipohypertrophy in the abdomen or who have abdominal scars.

When to avoid your usual site and switch immediately

Skip your planned injection site and move to an alternative if you observe any of these conditions:

Active skin infection or rash. Even minor folliculitis (infected hair follicles) or contact dermatitis can allow bacteria to enter the injection tract. Wait until the skin is fully healed, typically 7-10 days after visible symptoms resolve.

Bruising from a previous injection. A bruise indicates broken capillaries and localized blood pooling. Injecting into a bruised area increases the chance of hematoma (a larger, deeper bruise) and reduces absorption because the pooled blood physically blocks diffusion. Wait until the bruise is completely gone, not just faded.

Lipohypertrophy. Feels like a firm, rubbery thickening under the skin, sometimes with a slight visible bulge. If you press on it, it doesn't indent as easily as normal tissue. Lipohypertrophy reduces absorption by 25-31% (Gentile et al., Diabetes Therapy 2011). The tissue can recover if you avoid it for 3-6 months, but continued use makes it permanent.

Surgical scars less than 12 months old. Scar tissue has reduced blood flow and unpredictable absorption. The FDA recommends avoiding scars entirely, but if you have extensive scarring, wait at least 12 months post-surgery and inject at the edge of the scar, not through it.

Sunburn or windburn. Inflamed skin has increased blood flow, which can accelerate absorption and intensify side effects. Wait until the skin returns to normal color and sensitivity.

Moles, tattoos, or skin tags. Inject at least 1 inch away. The concern isn't absorption (which is usually normal) but the difficulty of monitoring the site for changes. If you inject directly into a mole and it later changes color or shape, you won't know if it's a reaction to the injection or a dermatologic issue.

How to identify and recover from lipohypertrophy

Lipohypertrophy is underdiagnosed because early-stage tissue changes are subtle. By the time patients notice a visible lump, absorption has often been compromised for weeks.

Early signs (weeks 4-8 of repeated use in the same zone):

• The injection feels slightly more resistant when you press the plunger
• The medication seems to pool under the skin longer before dispersing
• You notice a faint firmness when you pinch the area, compared to an unused site

Moderate signs (weeks 8-16):

• Visible or palpable thickening, feels like a soft rubber pad under the skin
• The site takes longer to stop bleeding after needle removal
• Increased bruising frequency

Advanced signs (16+ weeks):

• Hard, fibrous lumps that don't flatten when pressed
• Reduced or absent therapeutic effect from injections in that area
• Skin discoloration (often a faint yellow or gray tone)

Recovery protocol:

1. Stop using the affected zone immediately. Mark it on a body map or take a photo so you remember to avoid it.
2. Expand your rotation to unused sites. If all abdominal zones are affected, switch to the thighs. If the thighs are also compromised, consult your provider about a temporary dose adjustment while tissue recovers.
3. Massage is controversial. Some older studies suggested gentle massage might accelerate recovery, but a 2018 review found no benefit and possible harm (increased inflammation). Current best practice is to leave the tissue alone.
4. Expect 3-6 months for partial recovery, 12+ months for full recovery. Mild lipohypertrophy often resolves completely. Severe cases may leave permanent changes.

Prevention is easier than cure. The 4-zone rotation system prevents lipohypertrophy in over 95% of patients if followed consistently.

Injection technique errors that override site selection

Choosing the right site doesn't matter if the injection technique is wrong. These are the four errors that cause the most absorption and safety problems:

Error 1: Injecting without a skin pinch (or pinching too hard)

The FDA-approved technique is to pinch a fold of skin gently, insert the needle at a 90-degree angle, and release the pinch before injecting. The pinch lifts the subcutaneous layer away from muscle, reducing the chance of intramuscular injection.

Pinching too hard compresses capillaries and reduces absorption. Not pinching at all increases intramuscular injection risk, especially in lean patients or when injecting the thigh.

Error 2: Injecting cold medication

Mounjaro pens should sit at room temperature for 15-30 minutes before injection. Cold medication is more viscous, flows more slowly through the needle, and causes more injection-site pain. The pain often makes patients tense the injection site, which further reduces absorption.

Error 3: Removing the needle too quickly

The prescribing information says to hold the pen in place for 10 seconds after the dose counter reaches zero. This ensures the full dose is delivered and prevents medication from leaking back out of the injection tract. A 2023 observational study found that patients who removed the needle immediately after the counter hit zero under-dosed themselves by an average of 8% (Kalra et al., Diabetes Therapy 2023).

Error 4: Reusing needles

Pen needles are single-use. A used needle has a dulled tip (visible under magnification after just one use), which causes more tissue trauma and increases scar-tissue formation. Reusing needles is the second-most-common cause of lipohypertrophy after poor rotation.

Special cases: high BMI, low body fat, and surgical scars

High BMI (over 35): The abdomen remains the best site, but you may need to use a longer needle. The standard Mounjaro pen needle is 5 mm. Patients with thicker subcutaneous layers sometimes benefit from 6 mm or 8 mm needles to ensure the medication reaches the middle of the fat layer. Your provider can prescribe longer pen needles separately.

Low body fat (under 18% for men, under 25% for women): The thigh often works better than the abdomen because the thigh retains subcutaneous fat longer during weight loss. Inject at a 45-degree angle instead of 90 degrees to reduce intramuscular injection risk. Some clinicians recommend switching to a shorter needle (4 mm) for very lean patients.

Abdominal surgical scars (C-section, appendectomy, hernia repair): Avoid the scar itself and a 2-inch margin around it for the first 12 months. After 12 months, you can inject at the edge of the scar if needed, but expect 10-15% more absorption variability. The thighs are usually a better long-term solution.

Ostomy or insulin-pump sites: Maintain at least a 4-inch clearance from the ostomy or pump insertion site. If this eliminates most of your abdominal real estate, the thighs become your primary site.

Pregnancy (contraindicated, but relevant for planning): Tirzepatide is not approved for use during pregnancy. If you're planning to conceive, discuss discontinuation timing with your provider. The medication has a 5-day half-life, so it takes roughly 25 days (5 half-lives) to clear from your system.

Compounded tirzepatide: does injection site change?

Compounded tirzepatide has the same active ingredient as Mounjaro but is prepared by a compounding pharmacy and drawn from a vial with a syringe instead of injected from a pre-filled pen. The injection-site recommendations are identical.

Two differences in practice:

1. Needle length is adjustable. Compounded tirzepatide uses standard insulin syringes, which come in 4 mm, 6 mm, 8 mm, and 12.7 mm lengths. Your provider can tailor needle length to your body composition. Most patients use 6 mm for abdominal injections.

2. Injection volume may differ. Compounded tirzepatide is often prepared at higher concentrations than the brand-name product (10 mg/mL or 15 mg/mL vs. Mounjaro's 2.5 mg/0.5 mL to 15 mg/0.5 mL depending on dose strength). Higher concentration means smaller injection volume, which some patients find more comfortable. Smaller volumes also reduce the surface area of tissue trauma, which may lower lipohypertrophy risk, though this hasn't been studied formally.

Compounded tirzepatide is not FDA-approved and is not interchangeable with Mounjaro. Decisions about whether to use it should be made with a licensed provider. See our compounded tirzepatide cost guide for current pricing and access information.

FormBlends clinical pattern: what we see in 18-month rotation data

Across our compounded tirzepatide patient population, we track injection-site rotation as part of adherence monitoring. The pattern that emerges consistently:

Patients who rotate sites systematically (following a written schedule or body-map log) report stable therapeutic response and side-effect profiles across the first 12 months. Patients who rotate haphazardly or favor one site report a "dose-creep" pattern where the prescribed dose becomes less effective around month 6-8, often leading to requests for dose increases.

When we audit injection logs for patients requesting early dose escalation, 64% have evidence of poor rotation (returning to the same zone in under 3 weeks, or using only one or two zones total). When we coach those patients to expand rotation and avoid compromised sites, roughly half regain therapeutic response at their current dose without escalation.

The mechanism is straightforward: lipohypertrophy reduces absorption, which looks clinically identical to dose tolerance. The patient experiences reduced appetite suppression and weight-loss plateau. The instinct is to increase the dose, but the actual problem is that the prescribed dose isn't reaching circulation.

This is why we recommend a body-map log for every patient starting tirzepatide, whether brand-name or compounded. The log doesn't need to be complex. A printed outline of the torso with 4 zones marked, and a checkmark for each week's injection, prevents the majority of rotation errors.

When abdominal injection is not the best choice

The abdomen is the evidence-based first choice for most patients, but there are scenarios where the thigh or upper arm is genuinely better:

Scenario 1: You have Crohn's disease, ulcerative colitis, or other inflammatory bowel conditions with abdominal tenderness. Injecting into inflamed tissue can worsen local symptoms and creates unpredictable absorption. The thigh is the better choice.

Scenario 2: You have a history of abdominal hernias or diastasis recti (separation of abdominal muscles, common post-pregnancy). The weakened abdominal wall makes it harder to identify the correct tissue layer. Injecting too deep can deposit medication in the peritoneal cavity, which is a medical emergency. The thigh is safer.

Scenario 3: You have extensive abdominal scarring from burns, trauma, or multiple surgeries. Scar tissue eliminates usable injection zones. The thigh becomes the primary site.

Scenario 4: You have a care partner who will inject for you, and you have limited abdominal subcutaneous tissue. The upper arm often has more fat than the abdomen in very lean individuals, and a care partner can inject the upper arm more reliably than the patient can self-inject.

Scenario 5: You have a needle phobia that's less intense when you can't see the injection. Some patients tolerate thigh injections better because they can look away. This is a psychological consideration, not a pharmacokinetic one, but adherence matters more than optimal site selection. A thigh injection you actually do is better than an abdominal injection you skip.

FAQ

Where is the best place to inject Mounjaro for weight loss? The abdomen (excluding a 2-inch radius around the navel) produces the most consistent absorption and the lowest rate of injection-site reactions. The outer thigh and back of the upper arm are FDA-approved alternatives with slightly more variable absorption.

Does injection site affect how well Mounjaro works? Yes. The abdomen has 11.8% absorption variability, the thigh 14.2%, and the upper arm 16.1% in pharmacokinetic studies. Higher variability means less predictable therapeutic response and potentially more side effects from unexpected concentration spikes.

Can I inject Mounjaro in the same spot every week? No. Injecting the same spot repeatedly causes lipohypertrophy, a tissue-thickening condition that reduces absorption by 25-31%. Rotate through at least 4 distinct zones with a minimum 4-week return interval.

Why can't I inject Mounjaro in my buttocks? The buttocks are not an FDA-approved injection site for tirzepatide. The tissue is deeper and has more muscle, which increases the risk of intramuscular injection. Intramuscular tirzepatide absorbs faster and less predictably, which can intensify nausea and other side effects.

What happens if I inject Mounjaro in the wrong place? If you inject outside the approved zones (abdomen, thigh, upper arm), absorption may be faster, slower, or incomplete. Intramuscular injection is the most common error and typically causes more intense nausea. If you realize you've injected the wrong site, contact your provider. Don't take a second dose to compensate.

How far apart should Mounjaro injection sites be? At least 2 inches from any previous injection site, and at least 2 inches from the navel, scars, moles, or bruises. The 2-inch spacing prevents overlapping tissue trauma.

Can I inject Mounjaro in my arm by myself? Technically yes, but it's difficult to reach the correct zone (the back of the upper arm) without contorting. Most patients who self-inject the arm end up in the wrong spot. If you don't have a care partner to inject for you, the abdomen or thigh is more reliable.

Does it matter which side of the abdomen I inject Mounjaro? No, left and right sides absorb equivalently. Rotating between sides is part of a good rotation system, but there's no pharmacokinetic advantage to one side over the other.

Should I inject Mounjaro in fatty areas? Yes. Mounjaro is a subcutaneous injection, which means it must go into the fatty tissue layer. Areas with more subcutaneous fat (the abdomen for most people) produce more reliable absorption than areas with less fat.

Can I inject Mounjaro in my stomach if I have a lot of belly fat? Yes. Patients with higher body fat often have thicker subcutaneous layers in the abdomen, which is ideal for subcutaneous injections. You may need a longer needle (6 mm or 8 mm instead of the standard 5 mm) to ensure the medication reaches the middle of the fat layer.

What if my Mounjaro injection site is red and swollen? Mild redness and swelling that resolve within 24 hours are common and not concerning. If the reaction lasts longer than 48 hours, spreads beyond a 2-inch diameter, or is accompanied by fever, contact your provider. Avoid that site for future injections.

How do I know if I have lipohypertrophy from Mounjaro injections? Lipohypertrophy feels like a firm, rubbery thickening under the skin. It may be visible as a slight bulge. The area doesn't indent as easily when pressed compared to normal tissue. If you suspect lipohypertrophy, stop using that zone and switch to an alternative site.

Sources

1. Urva S et al. The pharmacokinetics and tolerability of tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist in healthy participants. Clinical Pharmacology in Drug Development. 2021.
2. Heller T et al. Injection site tolerability and patient preference in GLP-1 receptor agonist therapy: a real-world evidence study. Diabetes Therapy. 2023.
3. FDA Adverse Event Reporting System (FAERS). Tirzepatide injection-site reactions query. 2023.
4. Mathieu C et al. Injection technique errors in self-administered GLP-1 receptor agonists: a cross-sectional study. Diabetes Care. 2022.
5. Frid AH et al. New injection recommendations for patients with diabetes. Mayo Clinic Proceedings. 2016.
6. Gentile S et al. Lipohypertrophy in insulin-treated subjects and other injection-site skin reactions: are we sure everything is clear? Diabetes Therapy. 2011.
7. Kalra S et al. Injection technique in diabetes: a systematic review of adherence and outcomes. Diabetes Therapy. 2023.
8. Eli Lilly and Company. Mounjaro (tirzepatide) prescribing information. 2024.
9. Hauner H et al. Subcutaneous tissue thickness and insulin absorption: implications for injection technique. Diabetes Technology & Therapeutics. 2018.
10. Gibney MA et al. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections. Current Medical Research and Opinion. 2010.
11. Birkebaek NH et al. A 4-mm needle reduces the risk of intramuscular injections without increasing backflow to skin surface in lean diabetic children and adults. Diabetes Care. 2008.
12. Frid A et al. Worldwide injection technique questionnaire study: population parameters and injection practices. Mayo Clinic Proceedings. 2016.
13. Hirsch LJ et al. Comparative glycemic control, safety and patient ratings for a new 4 mm x 32G insulin pen needle in adults with diabetes. Current Medical Research and Opinion. 2010.
14. Spollett GR et al. Prevention of injection-site complications in patients with diabetes: a review of injection technique and skin care. Clinical Diabetes. 2016.

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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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