HealthRX.com · Printable titration log
Pill and Zepbound dose-change backup calendar
For anyone staying on a birth control pill while starting or raising Zepbound: write the date of each new dose, count 4 weeks forward to the end of that backup window, and tick off whether backup was used, with space for spotting, missed pills and the questions to settle a switch to a method that is not swallowed.
Your contraception now
Pill name and typecombined or progestin-only
Time of day you take it
Backup you will usecondoms or another barrier method
Would you consider an IUD, implant, shot, patch or ring?
Each Zepbound start or dose increase
The backup window ends 4 weeks after the first dose at each new strength.
| First dose at this strength (date) | New dose (mg) | Backup ends on | Backup used every time? | Spotting or bleeding between periods | Missed or late pills |
|---|---|---|---|---|---|
| 2.5 (start) | |||||
From the Zepbound label
- On the pill: switch to a non-oral method or add a barrier method for 4 weeks after starting Zepbound and for 4 weeks after every dose increase.[1]
- Hormonal birth control that is not swallowed should not be affected.[1]
- With a first 5 mg dose, the peak level of the pill's ethinyl estradiol fell by 59%, while total exposure fell by 20%.[1]
- Tell your prescriber if you are pregnant or plan to become pregnant; Zepbound is stopped once a pregnancy is recognized.[1]
From FDA's birth control chart
- Of 100 women using the pill, the patch or the ring for a year, about 7 may become pregnant; with an implant or IUD, fewer than 1.[2]
- Male condoms used on their own: 13 per 100 in a year.[2]
Questions for your prescriber
- Would an IUD, implant, shot, patch or ring suit me better while my Zepbound dose is changing?
- If I stay on the pill, which exact dates do I need backup?
- What should I do if I have spotting or bleeding between periods?
- When should I take a pregnancy test?
- If I want to become pregnant, when should Zepbound stop?
Sources for the facts on this sheet
- 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
- U.S. Food and Drug Administration, Office of Women's Health. Birth Control Guide (chart), May 2024. Accessed 2026-10-18. https://www.fda.gov/media/150299/download
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.