HealthRX.com · Printable medication review sheet
Autoimmune condition and Zepbound: specialist coordination record
Bring this to the specialist who treats your autoimmune condition before the first Zepbound injection. Record how stable the disease is by their own measure, every immune medicine by route, which ones need drug levels, and who you will call if new stomach or bowel symptoms start.
The condition today
Diagnosis and year diagnosed
Activity measure your specialist uses, latest score and datefor example DAS28, PASI, SLEDAI or fecal calprotectin
Last flare: when, and how it was treated
Specialist's name and best way to reach the clinic
Immune and other regular medicines
Mark every medicine taken by mouth. The Zepbound label's absorption caution is about oral medicines.
| Medicine | Pill, injection or infusion | Dose and schedule | Drug level or blood test monitored? | Last result and date |
|---|---|---|---|---|
From the Zepbound label and the psoriatic disease studies
- The label's contraindications are a personal or family history of medullary thyroid cancer or MEN 2, and a known serious allergy to tirzepatide or any ingredient in Zepbound. Autoimmune disease is not among them.[1]
- Zepbound slows stomach emptying and may change how pills taken alongside it are absorbed. The label asks for monitoring of oral medicines that depend on a threshold level or have a narrow therapeutic index.[1]
- TOGETHER-PsO: at week 36, 27.1% on ixekizumab plus tirzepatide reached PASI 100 with at least 10% weight loss, against 5.8% on ixekizumab alone.[2]
- In the same trial, stomach and bowel side effects were more common with the combination.[2]
Agreed before the first injection
- The specialist has confirmed the disease is stable, using their usual activity measure
- Every oral medicine is listed, with any that need drug levels marked
- A baseline level is drawn if you take tacrolimus or cyclosporine
- A baseline TSH is drawn if you take levothyroxine
- Baseline kidney tests are done if the condition affects your kidneys
- You know who to call first if diarrhea, stomach pain or vomiting starts
- Check-in dates are set around each dose increase
Act on these without waiting for a check-in
- Swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or a very fast heartbeat: stop Zepbound and get medical help right away.[1]
- Severe stomach pain that will not go away, with or without nausea or vomiting: stop Zepbound and call your healthcare provider right away.[1]
- Nausea, vomiting or diarrhea that does not go away: tell your healthcare provider right away.[1]
For the rheumatologist, gastroenterologist or neurologist
- Is my condition stable enough by your measure to start now?
- Which of my medicines should have a level or blood test after each Zepbound dose increase?
- If I get diarrhea or stomach pain, how will we tell a flare from a side effect?
- Does anything about my biologic or infusion schedule need to change?
- Who adjusts my other medicines if I lose a lot of weight?
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
- Lebwohl M, Blauvelt A, Kartman CE, et al. Ixekizumab With or Without Tirzepatide in Adults With Psoriasis and Overweight or Obesity: A Phase 3b Randomized Clinical Trial. JAMA Dermatol 2026. PMID 42139049. https://pubmed.ncbi.nlm.nih.gov/42139049/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.