Your first Zepbound shot is a big moment, and it is normal to be a bit anxious about it. Here is what the prescribing information says, and what the first week tends to look like.
The starting dose
According to the prescribing information, Zepbound starts at 2.5 mg once a week for 4 weeks. After that, your prescriber usually increases it step by step, by 2.5 mg at least every 4 weeks, up to the dose that works for you. The 2.5 mg dose is a starting dose, meant to help your body adjust.
Day by day
Shot day. Take it on the day you picked, at any time, with or without food. Rotate the site: stomach area (at least 2 inches from the belly button), front of the thigh, or back of the upper arm. The pen instructions walk you through it.
Days 1 to 2. Tirzepatide reaches its peak 8 to 72 hours after the injection. If you get side effects, this is when many people notice them. Many others notice nothing much.
Days 3 to 5. The level eases off slowly. Some people notice smaller portions feel like enough.
Days 6 to 7. The level is at its lowest before the next shot. On the first dose, it is also still well below where it will settle after a few weeks.
The side effects the label lists
The most common ones in the Zepbound prescribing information are digestive: nausea, diarrhea, vomiting, constipation, stomach pain and indigestion, plus injection site reactions, tiredness and burping, among others. They are more common while the dose is going up.
Things people commonly find helpful for the digestive ones: smaller meals, stopping when full, eating slowly, and drinking enough fluids.
Get medical help for severe stomach pain that will not go away (with or without vomiting), signs of an allergic reaction, or if you are vomiting and cannot keep fluids down. The label also lists other serious warnings: read the medication guide that came with your pen.
If you take birth control pills
The label says tirzepatide may make oral hormonal birth control less effective. It advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and after each dose increase. Ask your prescriber.
What to track in week 1
- The date, time and site of your shot
- Your weight once, to have a starting point
- How you feel each day in a word or two: nausea, appetite, food noise, energy
It takes a minute a day, and after a month you will see your own pattern instead of guessing.
Sources
- Zepbound prescribing information and medication guide: dosage, pharmacokinetics, adverse reactions, warnings, drug interactions.