HealthRX.com · Printable titration log
Young adult Zepbound check-in log: contraception, other medicines and how each step went
A one-page log for the first months on Zepbound in your late teens to twenties: which birth control backup is in place at each dose step, which other medicines need a word with the prescriber, and how stomach symptoms, pulse and mood went between visits.
Starting point
Start date and first dose
Contraception used nowpill, patch, ring, implant, IUD, condoms, none
Other regular medicinesADHD stimulant, antidepressant, acne treatment, others
Usual alcohol intake per week
Resting pulse and blood pressure before starting
Label and trial points to keep in view
- On birth control pills: use a non-oral method or add a barrier method for 4 weeks after starting and for 4 weeks after every dose increase.[1]
- Hormonal methods that are not taken by mouth should not be affected.[1]
- If a pregnancy is recognized, Zepbound is stopped.[1]
- In the pooled weight trials, pulse rose by a mean of 1 to 3 beats per minute on Zepbound and did not rise on placebo.[1]
- In SURMOUNT-1, side effects led 4.3%, 7.1% and 6.2% of people on 5, 10 and 15 mg to stop, against 2.6% on placebo.[2]
One row per dose step or visit
| Date | Dose (mg) | Pill backup in place until | Weight | Pulse / blood pressure | Days with nausea or vomiting | Mood and eating notes |
|---|---|---|---|---|---|---|
Call the prescriber the same day, or get urgent care
- Vomiting or diarrhea that stops you holding down fluids: fluid loss can harm the kidneys.[1]
- Belly pain that is severe or will not settle, sometimes reaching the back, with or without vomiting.[1]
- A positive pregnancy test: stop injecting and call.[1]
Questions for the next visit
- Which contraception makes most sense for me while the dose is still going up?
- Do my stimulant, antidepressant or acne treatment need any extra checks?
- How should I approach alcohol during dose increases?
- Which tests, if any, do you want now and later, and what is each one for?
- If I want to become pregnant later, how will we plan stopping?
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
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022. PMID 35658024. https://pubmed.ncbi.nlm.nih.gov/35658024/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.