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HealthRX.com · Printable surgery planning sheet

Zepbound anesthesia handoff card

Fill this in before any procedure with sedation or anesthesia and hand it to each person who asks: the procedure and anesthesia type, your Zepbound dose and last injection, whether it was held on advice, the stomach symptoms the anesthesia team checks for on the day, and the restart plan.

Companion to “Zepbound and Anesthesia: What You Need to Know Before Surgery” · healthrx.com/interactions-v2-zepbound/anesthesia-interaction · Facts checked 2026-10-18

The procedure

Procedure and date
Anesthesia plannedgeneral, deep sedation, moderate sedation
Surgeon or proceduralist
Anesthesia contact and phone

Zepbound details to say out loud

Current weekly dose (mg)
Date and time of the last injection
Held on the team's advice?yes / no / nobody advised
Any dose increase in the last month
Oral medicines taken on the morning of the procedure

Who has been told, and when

  • Surgeon's office, at scheduling
  • Anesthesiologist, at the pre-anesthesia interview
  • Pre-op nurse, on the day
  • Zepbound prescriber
  • Endoscopy team, for a colonoscopy or upper endoscopy

On the morning: symptoms to report

  • Severe nausea, vomiting or retching
  • Bloated abdomen
  • Abdominal pain
  • Feeling full after very little food
  • None of these

What the sources say

  • Zepbound slows stomach emptying. Aspiration has been reported rarely in people on GLP-1 medicines who still had stomach contents despite fasting.[1]
  • Tell your providers before any planned surgery or procedure that you take Zepbound.[1]
  • Under ASA's 2023 guidance, severe nausea, vomiting, bloating or abdominal pain on the day is a reason to consider delaying an elective procedure.[2]
  • Pooled trials found GLP-1 medicines delayed solid-meal half-emptying by about 36 minutes; ASA fasting minimums for solids are 6 to 8 hours.[3]

After the procedure

Bowel function back (date)
Eating and drinking without significant nausea (date)
Restart date agreed with the prescriber
Sources for the facts on this sheet
  1. 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
  2. American Society of Anesthesiologists. American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists. Accessed 2026-10-18. https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative
  3. Hiramoto B, McCarty TR, Lodhia NA, et al. Quantified Metrics of Gastric Emptying Delay by Glucagon-Like Peptide-1 Agonists: A Systematic Review and Meta-Analysis With Insights for Periprocedural Management. Am J Gastroenterol 2024. PMID 38634551. https://pubmed.ncbi.nlm.nih.gov/38634551/

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.