HealthRX.com · Printable restart record
Zepbound restart call record
Fill this in before you call about restarting after a gap: your last real injection, why you stopped, how you feel now, and the plan you agree. It keeps the label's timing rules and urgent warning signs on the same page.
Your last actual treatment
Use injection dates, not the date you picked up a prescription. Mark any date you are estimating.
Last injection dateestimated? yes / no
Dose at that injection (mg)
Weekly doses missed since then
Weeks on that dose before stopping
Device and strength you have nowsingle-dose pen, vial or KwikPen
Symptoms on that dose before the gap
Why the gap happened
- Pharmacy, supply or cost problem
- Side effects (describe below)
- Illness, vomiting or diarrhea
- Surgery or a procedure
- Pregnancy, or planning pregnancy
- Something else (describe below)
- The reason has now resolved
How you are today
Nausea, vomiting or stomach pain now
Eating and drinking normally?
Current medicinessay if you use insulin or a sulfonylurea
Label timing rules to check against
- One missed dose: inject it within 4 days (96 hours); after that, skip it and wait for your regular day.[1]
- Never take 2 doses within 3 days (72 hours) of each other, including when you change your injection day.[1]
- 2.5 mg is for starting treatment and is not a maintenance dose.[1]
- If you become pregnant, stop Zepbound and tell your prescriber.[1]
Get help now rather than waiting for a restart call
- Severe stomach pain that will not go away, sometimes spreading to your back, with or without vomiting (possible pancreatitis).[1]
- Swelling of your face, lips, tongue or throat, or trouble breathing or swallowing (possible serious allergic reaction).[1]
- Vomiting or diarrhea that stops you keeping fluids down: dehydration can cause kidney problems.[1]
The plan you agree
Next dose (mg)
Date of next injection
Pen, vial or KwikPen to use
When to check in before increasing
Who to call with problems
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
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.