HealthRX.com · Printable medication review sheet
Zepbound reaction record for a switch conversation
Before anyone suggests Ozempic after a bad reaction to Zepbound, write down exactly what happened, when it happened relative to your doses, how you coped with fluids, and what was done. The prescriber can then sort the reaction into a type before choosing the next step.
The reaction
Zepbound strength and the dates of your last 4 injections
Had the dose just gone up?yes or no, and the date
What happened, and how long after the injection it started
Worst point, and when it eased or stopped
Care you received and any test results
Other medicines, supplements, alcohol, illness or unusual food around that time
Which kind of reaction was it? (tick all that fit)
- Expected stomach or bowel upset: nausea, fullness, diarrhea, constipation, vomiting
- Severe or persistent: repeated vomiting, could not keep fluids down, symptoms lasting beyond a dose step
- Possible complication: severe belly pain, gallbladder symptoms, a big change in glucose, new vision problems
- Allergic: hives, widespread rash, swelling of the face, lips, tongue or throat, trouble breathing
- At the injection site only: redness, itching, pain or swelling
Day by day after the reaction
| Date | Vomiting or diarrhea (times) | Fluids kept down | Urine (normal or less) | Glucose if checked | Notes |
|---|---|---|---|---|---|
What the labels and the head-to-head trials say
- Ozempic label: use caution after angioedema or anaphylaxis with another GLP-1 receptor agonist, because it is unknown whether such patients are predisposed to anaphylaxis with Ozempic.[1]
- Zepbound label: Zepbound must not be used after a known serious hypersensitivity reaction to tirzepatide or its ingredients.[2]
- Both labels: not recommended with severe gastroparesis.[1]
- SURPASS-2 (40 weeks, open-label): nausea in 17 to 22% on tirzepatide and 18% on semaglutide 1 mg; vomiting in 6 to 10% and 8%.[3]
- SURMOUNT-5 (72 weeks, ClinicalTrials.gov results record): non-serious injection-site reactions in 32 of 374 people on tirzepatide and 1 of 376 on semaglutide.[4]
Get help now rather than waiting for the switch appointment
- Swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or a very fast heartbeat: stop the medicine and get medical help right away (both Medication Guides).[2]
- Severe stomach pain that will not go away, with or without vomiting (Ozempic guide: stop and call your provider right away).[1]
- Nausea, vomiting or diarrhea that does not go away (Ozempic guide: tell your provider right away).[1]
For the prescriber
- Which kind of reaction do you think this was, and what makes you think so?
- Is Ozempic approved and covered for the condition I am being treated for?
- Would a slower dose increase or a lower dose of the same medicine be an option?
- If we try Ozempic, what starting dose and timing would you use, and why?
- What should make me stop and call you after the first new dose?
Sources for the facts on this sheet
- Novo Nordisk, via DailyMed. Ozempic (semaglutide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-06-01. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
- Frías JP, Davies MJ, Rosenstock J, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med 2021. PMID 34170647. https://pubmed.ncbi.nlm.nih.gov/34170647/
- U.S. National Library of Medicine, ClinicalTrials.gov (API v2 record). NCT05822830: A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight With Weight Related Comorbidities (SURMOUNT-5), results record. Accessed 2026-10-19. https://clinicaltrials.gov/api/v2/studies/NCT05822830
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.