HealthRX.com · Printable side-effect diary
First four weeks on Zepbound 2.5 mg: injection and symptom diary
One row per week of the starting dose: where you injected, how many days nausea or bowel changes got in the way, whether you kept fluids up, and your weight. Bring it to the week-4 check-in, where the decision about the first increase is made.
Getting started
First injection: date and time of day
Injection day you plan to keep
Strength printed on the pen or vial
Weight on the first day
Other medicinesinsulin, a sulfonylurea, birth control pills, others
Week-by-week diary
| Week | Injection date and site | Days nausea got in the way | Days with vomiting or diarrhea | Constipation? | Drinking enough most days? | Weight | Anything else |
|---|---|---|---|---|---|---|---|
| Week 1 | |||||||
| Week 2 | |||||||
| Week 3 | |||||||
| Week 4 |
Label points for the starting month
- Start at 2.5 mg once weekly for 4 weeks. It is a starting dose, not a maintenance dose.[1]
- The first increase, in a 2.5 mg step, can come after at least 4 weeks on the current dose.[1]
- Blood levels reach a steady state after about 4 weeks of weekly injections.[1]
- Keep single-dose pens and single-dose vials refrigerated at 36°F to 46°F. If needed, one can stay out of the fridge, no warmer than 86°F, for a total of up to 21 days.[1]
- A missed dose can be taken within 4 days (96 hours); after that, skip it and keep your usual day.[1]
Stop the diary and get help for
- A swollen face, lips, tongue or throat, or trouble breathing or swallowing: emergency care.[1]
- Belly pain that is severe or will not ease, sometimes spreading to the back.[1]
- Upper belly pain with fever, yellowing skin or eyes, or pale clay-colored stools.[1]
For the week-4 check-in
- Does my symptom pattern this month support moving up to the next dose now?
- Would staying on 2.5 mg longer make sense for me?
- Which injection sites should I rotate between?
- What should I change about meals on injection day if nausea came back each week?
- Do any of my other medicines need adjusting as the dose rises?
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.