HealthRX.com · Printable titration log
Zepbound dose-step record for adults 65 and older
Keep one row for every dose step: how long you stayed, how eating and drinking went, any dizziness or falls, and what you and the prescriber decided. The first block records the kidney result and medicines that change how a step is judged at this age.
Before the first step
Kidney result (eGFR or creatinine) and date
Blood pressure sitting and standing
Medicines that lower blood sugar or blood pressure
Falls in the past year
Who helps with injections or shopping, if anyone
What the label and the age analysis say
- The label's schedule is the same for every adult: 2.5 mg weekly for 4 weeks, then increases of 2.5 mg no sooner than every 4 weeks.[1]
- The label recommends no dose adjustment for kidney impairment.[1]
- In the label's weight-trial pool, 226 Zepbound-treated patients (9%) were 65 or older and 13 (0.5%) were 75 or older.[1]
- Across the SURMOUNT and SUMMIT trials, side effects led 13.0% of tirzepatide-treated adults aged 65 and older to stop, against 6.8% on placebo. Under 65 the figures were 6.6% and 3.0%.[2]
- Stomach or bowel side effects were the main reason for stopping in 7.0% of tirzepatide-treated adults aged 65 and older, and in 3.6% of those under 65.[2]
- Kidney function should be checked when side effects could cause dehydration, especially when a dose is started or raised.[1]
One row per dose step
| Date started | Dose (mg) | Weeks at this dose | Days with nausea or vomiting | Meals and drinks kept down | Weight | Dizziness, falls or near-falls | Decision: stay, step up or step back |
|---|---|---|---|---|---|---|---|
Call the same day if
- Vomiting or diarrhea means you cannot keep fluids down: losing fluid can damage the kidneys.[1]
- You feel light-headed or faint, which in the trials went along with stomach side effects and dehydration.[1]
- You use insulin or a sulfonylurea and notice dizziness, sweating, confusion, blurred vision or shakiness: these can be low blood sugar.[1]
Questions at each step
- Is there a reason to stay longer on this dose before the next increase?
- Should any blood pressure or diabetes medicine change as my weight falls?
- When should my kidney test be repeated?
- What would make us step back to the previous dose?
- What is my target dose, and is a lower maintenance dose enough for me?
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
- Alfaris N, Kushner RF, Li J, et al. Tirzepatide for Obesity in Adults ≥ 65 Years: A Post Hoc Analysis of the SURMOUNT and SUMMIT Clinical Trials. Diabetes Obes Metab 2026. PMID 42303274. https://pubmed.ncbi.nlm.nih.gov/42303274/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.