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GLP-1 Guide

What to Expect with Zepbound Guide

As you begin the program, we wanted to share some useful information on what to expect when starting your GLP-1 medication (glucagon-like peptide-1s).

How the medication works 

GLP-1s are powerful, naturally-occurring hormones in your body that send signals to your brain to improve your metabolic function and regulate your appetite and digestion. The GLP-1 medications that Calibrate doctors prescribe work on the same receptors as the natural GLP-1 hormones.

The GLP-1s you’ll be taking through Calibrate will help your body to fight the natural increases in appetite and hunger that occur as you begin to lose weight. GLP-1s are different from older classes of weight loss medications (like phentermine) because they work on key underlying metabolic pathways to support sustained weight loss and are not a quick fix.

How to take it 

We prescribe injectables because clinical studies show they’re more effective than pills for weight loss. You’ll administer your GLP-1 medication yourself through an injection pen in your thigh, abdomen, or upper arm. 

While this may sound scary, most members actually report it being painless, quick, and easy. The needle is extremely small and thin—significantly smaller than those used for shots at the doctor’s office—and also because you’re injecting it directly under the skin instead of into muscle, which is also different from the shots you’re probably used to. For further information, please watch the instructions for administering Zepbound.

As for high-level things to keep in mind, you can take the medication with or without food and at any time during the day. Also, store your pen in the fridge until you’re ready to use it. If you aren’t able to refrigerate your pen, Zepbound can be stored at room temperature for up to 21 days. Discard the pen without using it if you haven’t used it after 21 days at room temperature.

There are 6 doses for Zepbound: 2.5 mg, 5.0 mg, 7.5 mg, 10.0 mg, 12.5 mg, and the maximum dose is 15 mg weekly.

Zepbound comes in six different pen formulations, and each dose is labeled with a different color.

What to expect

1st pen (gray label): 4 doses at 2.5 mg (weeks 1-4)
2nd pen (purple label): 4 doses at 5 mg (weeks 5-8)
3rd pen (green label): 4 doses at 7.5 mg (weeks 9-12)
4th pen (pink label): 4 doses at 10 mg (weeks 13-16)

To help minimize side effects, you’ll start at the lowest dose — that’s 2.5 mg weekly. After four weeks, increase to 5 mg weekly. You will increase your dose every four weeks after that until you reach the 10 mg dose. 

After reaching the 10 mg dose, the Calibrate Medical Team will determine if an increase to a higher dose is recommended. If a higher dose is recommended, the dose increase schedule continues as noted below:

5th pen (blue label): 4 doses at 12.5 mg for 4 weeks

6th pen (orange label): 4 doses at 15 mg and continue this dose

To show you exactly how to use the pen and perform your injections, read this page and watch this video. The step-by-step instructions have been compiled by the makers of Zepbound, the medication you will be taking. If you have any further questions about how to take your medication, send a message to your Calibrate Medical Team through the Calibrate app and they’ll walk you through the process.

If you experience intolerable side effects after a dose increase, contact your Calibrate Medical Team via the Support Center in the app to discuss possibly going back to your previous dose. With our guidance you’ll most likely stay on the lower dose for a couple of extra weeks before you increase the dose again.

The most common side effects include nausea, constipation, diarrhea, and stomach discomfort. The good news is that they typically go away within three weeks, so try to stick with it. In case of an emergency (such as severe abdominal pain, which is very uncommon) please call 911 or go to your nearest emergency room. If you were to have a medical emergency, when you are able to do so please also notify your Calibrate Medical Team via the Support Center in the app.

How do GLP-1s work?

GLP-1 (glucagon-like peptide 1) is a hormone naturally produced by your small intestine. The GLP-1 medications work on the same receptors as your natural GLP-1 hormone to control feelings of hunger and fullness and regulate blood sugar.  Mechanistically, GLP-1s address biology in a way that helps lower your weight set point.

Why use an injectable?

Injectable GLP-1s are preferred since they’ve been around for years and their use is supported by many clinical trials. They are more effective than oral GLP-1s for weight loss in clinical studies. An injectable also offers a lot of flexibility, as it can be done with or without food at any time of day.  

Is it painful?

While an injectable seems scary and sounds painful to many individuals, it’s actually easy to use, and your Calibrate Medical Team will walk you through all the steps. After starting, most patients report that it’s easier than taking a pill, and it doesn’t hurt. The needle is extremely small and hidden in the pen so you can barely see it when injecting.

How do I inject?

Zepbound comes in a pen that’s simple to use. We recommend changing the site each week to minimize the potential of a skin reaction. The videos below will walk you through injecting Zepbound step-by-step. We’re also happy to answer any questions you have if needed. Message your Calibrate Medical Team through the Calibrate app with any questions.

What are common side effects? 

Many individuals don’t have any side effects with this medication. However, for those who do, nausea is the most common. Usually nausea resolves after a few weeks as your body adapts to medication, but we encourage you to reach out to the Medical Team to discuss dosage modifications and for side effect management. Do not increase the dose faster than recommended, since the dosing schedule was designed to minimize side effects. Things that help reduce nausea are eating blander foods, eating smaller meals, and staying active.

You may also have changes in bowel movements (constipation being the most common). If this happens, you can take a fiber supplement (such as Metamucil or Benefiber) or increase your intake of vegetables and fruits. 

If you’re worried about any side effects, you can also always message the Medical Team via the Support Center in the Calibrate app.

Will I develop any redness around the injection site?

Redness around the injection site is common and will go away. We recommend rotating the injection site and never using the same needle twice in a row.  If you choose to inject in the same area (e.g.,. abdomen), always use a different spot. If the area becomes painful and/or swollen, let us know right away by messaging your Medical Team in the Calibrate app. 

What if I forgot to take it on the day I’m supposed to or I want to change the day I inject?

If you miss a dose of Zepbound, take the missed dose as soon as possible within five days after you missed the dose. If more than five days have passed, skip the missed dose and take it again on your regularly scheduled day.

The day of weekly administration can be changed if necessary, as long as the time between the two doses is at least 3 days (72 hours).

If you experience a lapse in Zepbound for more than 2 weeks, please send the medical team a message for guidance on restarting your medication as dosage adjustments might be needed.

Where do I store the pens?

Keep your unopened Zepbound pens in the refrigerator.

  • Make sure the temperature is between 36°F to 46°F (2°C to 8°C).
  • Do not freeze the Zepbound pen(s)
  • If you are going on a trip or once you start using a pen, Zepbound can last unrefrigerated (at room temperature) for 21 days. Just make sure the temperature does not get any higher than 86°F (30°C).

What do I do with the needles after the pen is used up?

You can place the entire pen in any large empty container (i.e. detergent, milk, or water container) and drop it off at the pharmacy when full.

How do I travel with the medication?

You can travel with unopened pens in your suitcase. Put them in the fridge when you get to your destination. See the Tracking, Medications, and More for Travel Guide for more information on traveling while doing Calibrate.

How long does it take for the medication to work?

It usually takes a couple of weeks of titrating up on the medication before you start losing weight, but you may notice that you feel full longer within the first week. 

Is there a risk of developing thyroid cancer?

We do not recommend GLP-1s if you have a personal or family history of medullary thyroid cancer or MEN syndrome. But for everyone else, there are no human studies that show an increased risk of thyroid cancer.