Mounjaro Shortage: When Will It End

Introduction

The Mounjaro® shortage was declared resolved by the FDA in December 2024, alongside Zepbound®, which shares the same tirzepatide molecule. By the federal definition, the shortage ended over a year ago. By the definition that matters to a type 2 diabetes patient trying to refill 10 mg at a Walgreens in 2026, “ended” is generous.

This piece covers where Mounjaro supply actually sits, which strengths are tight, and what Eli Lilly’s $25 billion manufacturing expansion means for the next 12 months.

At TrimRx, we believe that understanding your options is the first step toward a more manageable health journey. You can take the free assessment quiz if you’re ready to see whether a personalized program is a fit for you.

Is Mounjaro Still on Shortage in 2026?

Not according to the FDA Drug Shortage Database. Mounjaro and Zepbound (same molecule, different indications) both came off the shortage list on December 19, 2024, after Eli Lilly’s manufacturing capacity expansion came online. That federal declaration ended the legal basis for outsourcing facilities to compound brand-equivalent tirzepatide under section 503B.

Quick Answer: Mounjaro was removed from the FDA shortage list in December 2024

Pharmacy-level supply is uneven. The 2.5 mg starter and 5 mg titration doses are widely available. The 7.5 mg and 10 mg doses see periodic delays of 3 to 10 days. The 12.5 mg and 15 mg high-dose pens are the bottleneck, with intermittent regional gaps lasting 1 to 4 weeks in some markets.

IQVIA dispensing data shows that the Mountain West and Southeast U.S. regions see the longest delays in 2026, likely due to lower wholesaler density. Major metros like New York, Chicago, and Los Angeles have steadier supply.

Why Is Mounjaro Still Hard to Get If the Shortage Is Over?

Three reasons. First, drug substance manufacturing for tirzepatide is complex. It’s a 39-amino-acid peptide that requires solid-phase synthesis followed by purification at industrial scale. Global capacity for that chemistry is finite, and Lilly competes with itself between Mounjaro and Zepbound.

Second, autoinjector device production is the actual bottleneck in 2026, not the drug substance itself. The KwikPen requires a multi-component assembly with sterile fill-finish in specialized lines. Lilly is in-sourcing more of the component supply chain through 2026, but that ramp takes quarters.

Third, demand keeps growing. ADA 2025 Standards of Care recommend GLP-1 or GIP/GLP-1 agonists as preferred for type 2 diabetes patients with established cardiovascular or chronic kidney disease, which expanded the eligible population.

Which Mounjaro Strengths Are Easiest to Find?

The 2.5 mg and 5 mg doses are widely stocked at major chains, independents, and mail-order pharmacies in 2026. New patient starts rarely have trouble getting through the first 8 weeks of titration. Lilly explicitly prioritizes these strengths to keep onboarding flowing.

The 7.5 mg dose, where many patients hit a clinically useful A1C target, sees occasional 3 to 7 day delays. The 10 mg, 12.5 mg, and 15 mg high-dose pens are where patients lose time. If your prescriber has you at 12.5 mg or 15 mg, plan refills 2 to 3 weeks ahead of your actual run-out date.

Vials are a different supply chain than pens. Lilly’s vial fill-finish capacity grew faster than autoinjector capacity, so when pens are out, vials can sometimes be ordered through specialty pharmacies. Vials require self-drawing into syringes, which not every patient is comfortable with.

What Does Eli Lilly Say About Mounjaro Supply?

Lilly’s Q4 2025 earnings call reported tirzepatide manufacturing capacity at approximately 4.2 million pen-equivalents per month for the U.S. market, up from 1 million in mid-2023. CEO David Ricks publicly committed to supporting 100 million U.S. patients on tirzepatide by 2030, which requires another roughly tenfold capacity expansion.

The Lebanon, Indiana facility (announced 2022, $1.6 billion investment) reached commercial production for injectable tirzepatide in late 2025. The Concord, North Carolina expansion came online in early 2025 for fill-finish. A new Mount Vernon, Indiana site (announced 2024) is targeting 2027 for first commercial output.

Lilly’s investor day in 2026 projected that maintenance-dose Mounjaro supply gaps would narrow through Q3 2026 and largely close by Q4 2026 absent demand surges from new indication approvals.

What Happens If My Pharmacy Can’t Fill My Mounjaro Prescription?

Ask the pharmacy for the wholesaler’s expected restock date. They have access to that data through their ordering system. If it’s under 7 days, wait. If it’s longer, transfer the prescription.

Try a different pharmacy. Independent pharmacies often have access to wholesaler inventory that chain corporate allocations don’t. Call before you transfer. Ask: “Do you have Mounjaro 10 mg in stock right now, and how many pens?”

Try a different channel. Insurance-tied mail-order pharmacies (Express Scripts, OptumRx, CVS Caremark Mail) generally have steadier supply than retail. A 90-day mail-order fill is usually more reliable than monthly retail.

If supply remains out for more than 2 weeks, talk to your prescriber about a bridge prescription for Trulicity®, Ozempic®, or a non-GLP-1 diabetes drug. Don’t go without therapy.

Key Takeaway: SURPASS-2 (Frias et al. 2021 NEJM) showed 2.30 percentage point A1C reduction at 15 mg tirzepatide

Can I Switch to Zepbound While Mounjaro Is Short?

Zepbound is the same molecule (tirzepatide) as Mounjaro, but it’s FDA-approved for obesity, not diabetes. Insurance plans treat the two prescriptions as separate even though the drug is identical. You generally can’t switch a diabetes patient to Zepbound without going through a new prior authorization for the obesity indication, which requires BMI documentation.

For diabetes patients without a BMI in the obesity range, Zepbound isn’t an option. The clinical benefit is the same molecule, but the labeled indication is different, and insurers enforce that boundary.

If your A1C and weight both qualify you for both indications, ask your prescriber whether dual-indication documentation could keep your therapy continuous when one supply channel runs out.

What Alternatives Work for Type 2 Diabetes If Mounjaro Is Unavailable?

Several. Ozempic (semaglutide) is the most direct alternative, with a long cardiovascular outcomes track record (SUSTAIN-6, Marso et al. 2016 NEJM, showed 26% MACE reduction). Trulicity (dulaglutide) is another weekly GLP-1 agonist with REWIND outcomes data.

For patients who don’t need a GLP-1 mechanism specifically, SGLT2 inhibitors like Jardiance and Farxiga offer cardiovascular and kidney benefits independent of GLP-1 effects. The EMPA-REG and DAPA-HF trials demonstrated those.

Insulin remains the backup for patients with high A1C and limited time. It’s not first-line in most modern algorithms but is reliable, available, and inexpensive in generic forms.

Switching diabetes drugs is a prescriber-led process. Don’t substitute on your own. A1C targets and hypoglycemia risk need monitoring.

Is Compounded Tirzepatide Still Available for Diabetes Patients?

The FDA’s 503B mass-compounding exception ended in December 2024 when Mounjaro and Zepbound came off the shortage list. After that, 503B outsourcing facilities could no longer make compounded tirzepatide.

State-licensed 503A pharmacies can still compound tirzepatide on a patient-specific basis when there’s a documented clinical reason commercial product won’t work, like inactive ingredient allergy or non-standard dosing needs. For a diabetes patient who can find commercial Mounjaro, the clinical justification for compounding is thin and most prescribers won’t write for it.

Compounded tirzepatide is not generally covered by insurance for diabetes use. Most diabetes patients hitting supply gaps should switch brands rather than pursue compounding.

How Can I Plan Refills to Avoid Running Out?

Three habits. First, set your refill reminder 14 days before your actual run-out date, not 5 days. Pharmacy stock takes time to verify and transfer. Second, ask your prescriber for 90-day supply prescriptions with mail-order rather than 30-day retail. Third, ask for multiple authorized refills upfront, so insurance approval doesn’t have to be redone monthly.

If you live somewhere with periodic supply gaps, talk to your prescriber about a contingency. Pre-authorize a Trulicity or Ozempic prescription that you can fill if Mounjaro goes out for more than a week. Pre-approval removes the panic when supply tightens.

Bottom line: Switching from Mounjaro to Trulicity, Ozempic, or insulin requires prescriber-led dose adjustment

FAQ

Is the Mounjaro Shortage Actually Over?

Per FDA, yes, since December 2024. Pharmacy-level supply gaps persist for specific high-dose strengths but no systemic shortage is on the FDA list.

Why Doesn’t Lilly Just Make More?

They are. The $25 billion manufacturing buildout is the largest in pharma history. Capacity comes online in stages, and autoinjector assembly is the bottleneck rather than the drug substance.

Can I Take Mounjaro for Weight Loss?

Mounjaro is FDA-approved for type 2 diabetes only. Zepbound is the same molecule approved for obesity. Off-label use of Mounjaro for weight loss happens but is usually not insurance-covered.

How Does Mounjaro Compare to Ozempic?

SURPASS-2 head-to-head (Frias et al. 2021 NEJM) showed tirzepatide produced larger A1C reductions and more weight loss than semaglutide. Side-effect profiles are similar, with more constipation on tirzepatide and more diarrhea on semaglutide anecdotally.

Will Compounded Tirzepatide Come Back If There’s Another Shortage?

If FDA relisted tirzepatide as in shortage, yes, but that’s not expected in 2026 given Lilly’s capacity ramp.

Does TrimRx Help Diabetes Patients?

TrimRx focuses on weight management. For diabetes-specific care, work with an endocrinologist or primary care prescriber who manages your A1C and broader treatment plan.

What’s the Average Wait Time at Retail Pharmacies for High-dose Mounjaro Right Now?

Roughly 3 to 14 days for 10 mg, 12.5 mg, and 15 mg in 2026, depending on region. Less than 24 hours for 2.5 mg and 5 mg at most chain pharmacies.

Disclaimer: This content is for informational purposes only and does not constitute medical advice. It is not intended to diagnose, treat, cure, or prevent any disease or condition. Individual results may vary. Always consult a qualified healthcare professional before starting any weight loss program or medication.