HealthRX.com · Printable medication review sheet
Benzodiazepine and Zepbound medication review
Bring this to the prescriber or pharmacist before the first Zepbound dose and at each increase: which benzodiazepine you take and why, your falls, sleep apnea and opioid history, and a short log of how fast each dose works and how drowsy you feel.
The benzodiazepine
Name and strengthalprazolam, lorazepam, clonazepam, diazepam or other
Every day, or only when needed
What it is foranxiety, panic, sleep, seizures, muscle spasm
Usual time of day
History to share
- Falls or near-falls in the past year
- Obstructive sleep apnea or a CPAP machine
- An opioid painkiller, buprenorphine or methadone
- Regular alcohol
- Liver disease
- Older adult, or living alone
Dose log after starting or increasing Zepbound
Write the time of each dose and when you first felt it. If it seems late, wait and call; do not take another.
| Date | Zepbound dose (mg) | Benzodiazepine dose and time | Time it began to work | Drowsy or dizzy (none, mild, strong) | Second dose taken? Why |
|---|---|---|---|---|---|
From the labels
- Alprazolam (Xanax) reaches its peak blood level 1 to 2 hours after a dose.[1]
- Clonazepam (Klonopin) reaches its peak within 1 to 4 hours.[2]
- Zepbound slows stomach emptying and can change how medicines taken by mouth are absorbed.[3]
- A benzodiazepine taken with an opioid can cause profound sedation, slowed breathing, coma and death.[1]
- Older people may be especially sensitive to benzodiazepines; the Xanax label starts them at 0.25 mg two or three times a day.[1]
- Stopping a benzodiazepine suddenly can cause serious withdrawal reactions, including seizures.[1]
Get help right away for
- Severe drowsiness or breathing problems, especially with an opioid, alcohol or another sedating medicine.[1]
- Marked confusion, slurred speech or unsteadiness after a dose, which can mean too much benzodiazepine.[1]
Questions for the prescriber or pharmacist
- If a dose seems slow after a Zepbound increase, what should I do instead of taking another?
- Could my benzodiazepine dose be lowered or tapered, given my age, sleep apnea or falls?
- If I take it for seizures, do I need closer follow-up or a blood level while Zepbound is increased?
- Is it safe for me to drive in the weeks after a Zepbound dose increase?
Sources for the facts on this sheet
- Viatris Specialty LLC, via DailyMed. Xanax (alprazolam) tablets: prescribing information and Medication Guide. Effective 2024-04-15. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bb5cf72e-3a41-41a8-9a38-80f974eca33f
- H2-Pharma, LLC, via DailyMed. Klonopin (clonazepam) tablets: prescribing information and Medication Guide. Effective 2025-12-01. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cfa0d79a-843c-4b88-95a1-e9511d649ca1
- 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
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.