Zepbound in South Dakota.

James Simmons, MD · Medical Director, board-certified in emergency medicine

Get startedIt takes about 2 minutes. A doctor reviews your information at no cost. You pay only if you choose medication.

Zepbound^®(tirzepatide)

Self-administered weekly injections
Single-dose vial or KwikPen
Unlimited messaging and video visits with your doctor
No minimum, cancel any time

FDA-approved

Brand-name

Doctor's care$28/mo

Medicine at LillyDirect

You buy it yourself, from Lilly's own direct-to-patient service.

Dose	Price
2.5 mg/wk	$299/mo
5 mg/wk	$399/mo
7.5–15 mg/wk	$449†/mo
Supply kit	Price
Needles and syringes (pen needles for KwikPen)	$5/mo

†When you refill within 45 days. The price is higher after that.

Medicine prices are the makers' self-pay prices as of October 19, 2026, and can change.

Questions & answers

What to know about Zepbound

Getting it

Does Gentle Health prescribe Zepbound online in South Dakota?

Yes. A doctor licensed in South Dakota reviews your online intake and, if Zepbound is right for you, prescribes it.

Step 1Fill in the intakeTell us about your health and goals
Step 2Request careAn online request, a message or a video visit
Step 3Doctor reviewa doctor licensed in South Dakota decides whether it’s right for you
Step 4SubscribeIf prescribed, start your doctor’s care at $28/mo and we send your prescription
Step 5Get your medicineYou buy it from LillyDirect, which ships it to your door

What South Dakota rules require

South Dakota requires a live video examination wherever the same care in person would need a face-to-face encounter, so your doctor may ask you to book a video visit.

Official Licensing across state lines — HHS Telehealth

Our data How our clinic works

Getting it

How can I request Zepbound from Gentle Health in South Dakota?

Three ways, all online: send a request for review, message a doctor, or book a video visit.

FastestOnline requestSend it for review, no appointment
Message a doctorAsk anything and weigh your options in writing
Video visitTalk it through live and decide together

Getting it

Which doctor prescribes Zepbound in South Dakota?

James Simmons, MD, a board-certified physician licensed in South Dakota (license 18947).

James Simmons, MDRead his profile

License 18947Check it with the South Dakota Board of Medical and Osteopathic Examiners
NPI 1215498332Check it in the national registry

Getting it

Which pharmacy fills Zepbound in South Dakota?

LillyDirect, Lilly’s own direct-to-patient service. Your doctor sends it your prescription, and you buy Zepbound there; it ships to your door.

LillyDirectdispenses it for your prescription; it is Eli Lilly's own brand-name medicine

Our data Zepbound’s price at LillyDirect, by dose

What it costs

What does Zepbound cost through Gentle Health in South Dakota?

$28 a month for your doctor. You pay LillyDirect for the medicine, at its self-pay price for your dose unless it takes your insurance for the KwikPen; its checkout adds the supply kit.

2.5 mg$299 medicine 5 mg$399 medicine 7.5–15 mg$449 medicine

At 2.5 mg:

Gentle Healthdoctor + medicine + supplies

$332/mo

Romembership + medicine

$448/mo

At 5 mg:

Gentle Healthdoctor + medicine + supplies

$432/mo

Romembership + medicine

$548/mo

At 7.5–15 mg:

Gentle Healthdoctor + medicine + supplies

$482/mo

up to $732

Romembership + medicine

$598/mo

up to $848

What each price is made of

Gentle Health: Your doctor’s care, $28 a month: reviews, dose decisions, messaging and video visits. Plus LillyDirect’s self-pay price for Zepbound, which you pay LillyDirect. Plus LillyDirect’s supply kit, $5 a month: needles and syringes (pen needles for KwikPen).
Ro: The maker’s price for Zepbound, plus Ro’s membership: $39 the first month, then $149 a month.
Striped: The price if you don’t reorder within 45 days.

Our data Our pricing and the makers’ self-pay prices, checked October 2026

Manufacturer Zepbound self-pay prices — LillyDirect

Competitor Weight loss program pricing — Ro

What it costs

Can I use insurance to pay for Zepbound through Gentle Health?

No, we don’t bill insurance or file prior authorizations. You pay $28 a month for the doctor, by card or with an HSA or FSA card. LillyDirect takes some insurance for the KwikPen, but a plan that needs a prior authorization won’t cover it through us; otherwise you pay its self-pay price.

Our data Does insurance cover Zepbound, and what if it doesn’t?

Manufacturer Zepbound self-pay prices — LillyDirect

Next step

Is Zepbound right for me?

A doctor can check whether Zepbound is safe for you and whether you need it in the first place.

Complete the intake

The medicine

Will it work

How much weight will I lose on Zepbound?

15.0% to 20.9% of your body weight on average over 72 weeks, depending on the dose, in people without diabetes; 3.1% on placebo. 12.8% to 14.7% of your body weight on average over 72 weeks, depending on the dose, in people with type 2 diabetes; 3.2% on placebo.

No diabetes Type 2 diabetes

Without diabetes:

5 mga week

−15.0%

10 mga week

−19.5%

15 mga week

−20.9%

Placebo

−3.1%

How this was studied · SURMOUNT-1 trial · 2,539 people · 72 weeks · vs placebo

Who took part: Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people: 630 on 5 mg, 636 on 10 mg, 630 on 15 mg and 643 on placebo
How long: 72 weeks, including up to 20 weeks of stepping up the dose
What they got: Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at a fixed 5, 10 or 15 mg, reached by rising 2.5 mg every 4 weeks. Everyone had counseling toward eating 500 fewer calories a day and at least 150 minutes of activity a week.
Compared with: Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured: Average change in body weight after 72 weeks, and the share of people who lost at least 5%, the trial’s two main results (primary endpoints).
Who was counted: Everyone randomized, as the Zepbound label reports it; missing week-72 weights were estimated (imputed).
Who paid for it: Eli Lilly, the maker of Zepbound and Mounjaro
Published as: Jastreboff et al., NEJM 2022
Registered as: SURMOUNT-1 on ClinicalTrials.gov

With type 2 diabetes:

10 mga week

−12.8%

15 mga week

−14.7%

Placebo

−3.2%

How this was studied · SURMOUNT-2 trial · 938 people · 72 weeks · vs placebo

Who took part: Adults with type 2 diabetes and a BMI of 27 or more, with an HbA1c of 7% to 10%, managed by diet and exercise or by diabetes pills other than DPP-4 inhibitors or GLP-1 pills. People on insulin or injected GLP-1 medicines were excluded.
How many people: 312 on 10 mg, 311 on 15 mg and 315 on placebo
How long: 72 weeks, including up to 20 weeks of stepping up the dose
What they got: Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at a fixed 10 or 15 mg, reached by rising 2.5 mg every 4 weeks. Everyone had counseling toward eating 500 fewer calories a day and at least 150 minutes of activity a week.
Compared with: Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured: Average change in body weight after 72 weeks, and the share of people who lost at least 5%, the trial’s two main results (primary endpoints).
Who was counted: Everyone randomized, as the Zepbound label reports it; missing week-72 weights were estimated (imputed).
Who paid for it: Eli Lilly, the maker of Zepbound and Mounjaro
Published as: Study 2 in the Zepbound FDA-approved label, Table 2
Registered as: SURMOUNT-2 on ClinicalTrials.gov

FDA Weight reduction studies, Zepbound FDA-approved label — DailyMed

Peer-reviewed SURMOUNT-1 · Jastreboff et al., NEJM 2022

How it feels

Will Zepbound make me feel sick?

Possibly. On the top dose, 15 mg, 31% of people had nausea at some point, mostly mild to moderate and mostly while the dose was still going up.

Nausea

31%

on placebo 9.5%

Diarrhea

23%

on placebo 7.3%

Vomiting

12.2%

on placebo 1.7%

Constipation

11.7%

on placebo 5.8%

On Zepbound 15 mg On placebo

How this was studied · SURMOUNT-1 trial · 1,273 people · 72 weeks · vs placebo

Who took part: Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people: 630 on 15 mg and 643 on placebo. The trial also tested 5 mg and 10 mg in 1,266 more people.
How long: 72 weeks: up to 20 weeks of stepping up the dose, then 15 mg for the rest
What they got: Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, starting at 2.5 mg and rising by 2.5 mg every 4 weeks to 15 mg, plus diet and activity counseling
Compared with: Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured: Whether each person had a side effect at any point during treatment
Stopped because of side effects: 6.2% on 15 mg, against 2.6% on placebo
Who paid for it: Eli Lilly, the maker of Zepbound and Mounjaro
Published as: Jastreboff et al., NEJM 2022
Registered as: SURMOUNT-1 on ClinicalTrials.gov

Peer-reviewed SURMOUNT-1 · Jastreboff et al., NEJM 2022

Is it safe

Who cannot take Zepbound?

Anyone with medullary thyroid cancer in themselves or their family, MEN2, or a serious allergy to tirzepatide or another ingredient in Zepbound.

Do not take Medullary thyroid cancer, or MEN2 in you or your family, or MEN2 in you
Do not take A serious allergic reaction to tirzepatide or to another ingredient in Zepbound
Do not take now Pregnant or trying stop when you find out you are pregnant; Gentle Health does not start treatment while you are trying
Do not take now Breastfeeding not an FDA contraindication; Gentle Health does not start treatment while you breastfeed
Not offered here Previous pancreatitis not an FDA contraindication; Gentle Health does not offer treatment
Not offered here Severe gastroparesis FDA: not recommended; Gentle Health does not offer treatment
Not offered here Type 1 diabetes not addressed in the FDA label; Gentle Health does not offer treatment
Do not take now Already taking another GLP-1 medicine do not overlap; your doctor plans the switch
Clinical review Severe mental illness your doctor reviews it with you before prescribing
Clinical review On the birth-control pill it may work less well: switch to a non-pill method, or add condoms, for 4 weeks after starting and after each dose increase

FDA Contraindications and warnings, Zepbound FDA-approved label — DailyMed

Will it work

Is Zepbound approved for sleep apnea?

Yes, for moderate to severe obstructive sleep apnea in adults with obesity. In people not using CPAP, pauses and shallow breaths in sleep fell 50.7% on average over 52 weeks; 3% on placebo.

Pauses and shallow breathsin sleep, change over 52 weeks

−50.7%

on placebo −3%

On Zepbound 10 or 15 mg On placebo

How this was studied · SURMOUNT-OSA trial without CPAP · 234 people · 52 weeks · vs placebo

Who took part: Adults with obesity (a BMI of 30 or more) and moderate to severe obstructive sleep apnea who could not or would not use a breathing machine (PAP, such as CPAP). People with type 2 diabetes were excluded.
How many people: 114 on Zepbound and 120 on placebo
How long: 52 weeks, including up to 20 weeks of stepping up the dose
What they got: Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, raised to 10 or 15 mg, the highest dose each person tolerated, plus diet and activity counseling
Compared with: Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured: How many times an hour breathing stopped or became shallow during sleep (the apnea-hypopnea index) after 52 weeks, the trial’s main result (primary endpoint): down 25.3 an hour on Zepbound, against 5.3 on placebo. The 50.7% is the percent change, a secondary result.
Also found: In a second trial of 235 people who used a breathing machine, measured after a week off it, the drop was 58.7%, against 2.5% on placebo.
Who paid for it: Eli Lilly, the maker of Zepbound and Mounjaro
Published as: Study 5 in the Zepbound FDA-approved label, Table 9

FDA Sleep apnea studies, Zepbound FDA-approved label — DailyMed

How it feels

What if I miss a Zepbound dose?

Take it if 4 days (96 hours) or less have passed since it was due; after that, skip it and take the next dose on your usual day.

FDA Missed doses, Zepbound FDA-approved label — DailyMed

Is it safe

What is the thyroid warning on Zepbound about?

A possible thyroid cancer risk. Tirzepatide, the medicine in Zepbound, caused thyroid C-cell tumors in rats; nobody knows yet whether it does in people.

1Do not take it with a personal or family history of medullary thyroid cancer, or MEN2.
2Tell your doctor about a neck lump, lasting hoarseness, trouble swallowing, or shortness of breath.

FDA Boxed warning: thyroid C-cell tumors in rats — Zepbound FDA-approved label

What is it

How is Zepbound different from Mounjaro and compounded tirzepatide?

All three are weekly tirzepatide shots, and all are legal. Only Mounjaro and Zepbound are FDA-approved: Mounjaro for type 2 diabetes, Zepbound for weight loss and sleep apnea.

Mounjaro Zepbound Compounded Active ingredient tirzepatide tirzepatide tirzepatide Legal Yes Yes Yes Tested in people Yes Yes No FDA-approved for Type 2 diabetes Weight loss and sleep apnea – not FDA-approved

Our data Tirzepatide itself: how it works, results and safety

FDA Mounjaro FDA-approved label — DailyMed

FDA Zepbound FDA-approved label — DailyMed

FDA FDA’s concerns with unapproved GLP-1 drugs used for weight loss — U.S. Food and Drug Administration

FDA Section 503A of the FD&C Act — U.S. Food and Drug Administration

Educational only, not medical advice: talk to a doctor about your own history before starting or stopping anything.

Zepbound® is a registered trademark of Eli Lilly and Company. Gentle Health is not affiliated with, or endorsed by, Eli Lilly.

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