HealthRX.com · Printable medication review sheet
Kidney disease and Zepbound: medicine list and sick-day record
Bring this to the prescriber or nephrologist: your latest kidney results, the medicines on your list that interact with fluid loss or slower stomach emptying, and a day-by-day record of any vomiting or diarrhea once you start or step up the dose.
Your kidney details
Most recent eGFR and its date
Urine albumin (UACR), if measured
On dialysis?type and schedule
Kidney transplant?date and transplant team contact
Nephrologist or kidney clinic contact
Medicines to go over with the prescriber
Tick what you take. The page above explains why each one matters with Zepbound.
- Diuretic (water pill)
- ACE inhibitor or ARB
- SGLT2 inhibitor
- Insulin or a sulfonylurea
- Tacrolimus or cyclosporine
- Warfarin
- Phosphate binder
What the label and the kidney study say
- The label recommends no dose adjustment for kidney impairment.[1]
- It asks prescribers to check kidney function when side effects could cause fluid loss, especially when starting or stepping up.[1]
- Acute kidney injury: 0.5% on Zepbound versus 0.2% on placebo in the pooled weight trials.[1]
- After a single 5 mg dose, levels were similar across kidney groups; total exposure was 25% to 29% higher in moderate impairment.[2]
Sick-day record
| Date | Vomiting or diarrhea (times) | Fluids kept down? | Passing less urine? | Zepbound dose taken or held | Who you told |
|---|---|---|---|---|---|
Call the prescriber the same day
- Vomiting or diarrhea that keeps going: fluid loss can injure the kidneys.[1]
- Severe stomach pain that will not settle, sometimes spreading to the back.[1]
Questions to ask
- Should any of my medicines be paused on a day I cannot keep fluids down?
- When will my kidney function be rechecked after I start or step up?
- If I am on dialysis, who adjusts my fluid targets as my weight falls?
- Which symptoms mean urgent care rather than a call?
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
- Urva S, Quinlan T, Landry J, et al. Effects of Renal Impairment on the Pharmacokinetics of the Dual GIP and GLP-1 Receptor Agonist Tirzepatide. Clin Pharmacokinet 2021. PMID 33778934. https://pubmed.ncbi.nlm.nih.gov/33778934/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.