HealthRX.com · Printable medication review sheet
Zepbound start-up review for ages 50 to 64: medicines, history and each titration visit
Bring this to the visit where Zepbound is started and to each dose increase. It lists the medicines worth reviewing first in this age group, the history that changes the plan (heart disease, gallstones, hormone therapy), and a running record of symptoms and blood pressure at every step.
History that changes the plan
Heart or blood vessel disease, and when diagnosed
Gallstones or gallbladder surgery
Menopause stage, testosterone status, and any hormone therapy
Latest kidney result and date
Reflux, constipation or slow digestion already present
Medicines to go through before the first injection
- Insulin or a sulfonylurea
- Two or more blood pressure medicines, or a diuretic
- Warfarin or another medicine where small level changes matter
- Levothyroxine
- Oral hormone therapy or birth control pills
- Acid reducers (PPIs), laxatives or iron
- Regular anti-inflammatory pain relievers
From the Zepbound label
- The labeled maintenance doses are 5, 10 or 15 mg weekly; not everyone needs the highest.[1]
- In the weight trials, 4.8%, 6.3% and 6.7% of people on 5, 10 and 15 mg stopped because of side effects, against 3.4% on placebo.[1]
- Gallstones were reported in 1.1% on Zepbound and 1% on placebo; gallbladder inflammation in 0.7% and 0.2%.[1]
- With insulin or a sulfonylurea, the prescriber should consider lowering that medicine's dose when Zepbound starts.[1]
- Oral medicines with a narrow margin, such as warfarin, should be monitored when Zepbound is added.[1]
At each titration visit
| Date | Dose (mg) | Weight and waist | Blood pressure and pulse | Nausea, reflux or constipation | Medicine changes made |
|---|---|---|---|---|---|
Tell the prescriber right away
- Upper belly pain, fever, yellow skin or eyes, or pale clay-colored stools: possible gallbladder trouble.[1]
- Severe or persistent belly pain that may spread to the back, with or without vomiting.[1]
- Light-headedness with ongoing vomiting or diarrhea, especially on blood pressure medicines.[1]
Questions for the prescriber
- Do any of my current medicines need a lower dose when I start?
- What will decide whether I go above 5 mg, and how long will each step last?
- Should a new hormone therapy wait until my Zepbound dose is stable?
- Given my heart history, which checks do you want during treatment?
- Which gallbladder symptoms should make me call straight away?
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.