# Jabwise > Free GLP-1 tracker for iPhone: log jabs or tablets, weight, side effects, food noise and mood, see progress by dose, rotate injection areas and share a PDF with your doctor. No account. Jabwise is a free GLP-1 journal for iPhone and iPad by Under Cntrl. Keep doses, weight and how you feel in one calm journal, then see your progress beside every dose change. No account. Logging stays free. ## Key facts - Price: free to download; logging, reminders, every chart, Apple Health, backups and importing your history stay free. - Jabwise Pro (optional): Appointment Report and Widgets. - Platforms: iPhone and iPad (iOS). No Android app. - Account: none. The journal stays on the device; there is no Jabwise server. - Injections: Mounjaro, Ozempic, Wegovy, Saxenda, Trulicity. - Tablets: Rybelsus, Wegovy tablets, Foundayo. - Medicines: semaglutide, tirzepatide, liraglutide, dulaglutide, orforglipron. - Download: coming soon to the App Store. - Not medical advice: Jabwise records what you log; follow your prescriber. ## Features - **Progress by dose**: Weight drawn across each dose, so you see what every dose change is doing. - **Medication level**: An estimate of how each dose rises and eases through the week. - **Injection areas**: A body map that suggests where to inject next and rotates areas. - **Dose changes**: Record a new strength and the day you started; charts and reminders follow. - **Import your history**: Bring doses and weigh-ins over from another app, a spreadsheet or a shared link, checking the columns before anything is added. - **Last 4 weeks**: Your latest four weeks of weight beside the four before them. - **A typical week**: What you lost in a typical week on each dose. - **Check-ins**: Mood, food noise and energy on three sliders, morning, afternoon and evening. - **Side effects**: Log side effects with each check-in and see which come and go over 7, 30 or 90 days. - **Other factors**: Sleep, stress, alcohol, workouts and more, recorded with each check-in. - **Mood trends**: See how you feel over time and which part of the day you feel best. - **Patterns**: Your first 4 weeks of check-ins beside your latest, and the day after a jab that stands out, named only once it holds most weeks. - **Reminders**: Dose, weigh-in, check-in and reorder reminders that never name your medicine on the Lock Screen. - **Diary**: Today's plan at a glance, with what is coming up next. - **Apple Health**: Optional weight, water and steps from Apple Health. - **BMI by dose**: BMI drawn beside every dose. - **Supply**: A nudge before your next order is due. - **Water and steps**: Daily goals and streaks. - **Take a break**: Pause reminders without anything counting as missed, then resume. - **Backups**: Encrypted backups made automatically and kept wherever you choose, ready to restore on a new iPhone or iPad. - **18 languages**: English (UK), English (US), Español, Français, Deutsch, Italiano, Nederlands, Português (Brasil), Svenska, Polski, Čeština, Hrvatski, Türkçe, 日本語, 한국어, 简体中文, 繁體中文, العربية - **Appointment Report** (Pro): A clear PDF of doses, weight and check-ins for your GP or doctor, or a CSV spreadsheet. - **Widgets** (Pro): Home Screen and Lock Screen widgets for your next dose, weight and water. ## Questions ### Can I start before my first dose, or partway through? Either. Add the medicine and dose your prescriber gave you, choose your schedule and reminders, and start from your next dose. You do not need to fill in past entries first. ### Can I bring my history from another app? Yes. Export a CSV or JSON file from your old app or spreadsheet and choose it in Jabwise, or paste a shared Google Sheets, Dropbox or GitHub link. Jabwise matches the columns, shows you what it found before adding anything, and leaves alone any day you have already logged. Your earlier doses fill in your dose history too, so Progress draws every dose. ### Which medicines does it support? GLP-1 injections and tablets, taken daily or weekly, in the strengths they are prescribed in: Mounjaro, Ozempic, Wegovy, Saxenda and Trulicity jabs, and Rybelsus, Wegovy and Foundayo tablets, among others (semaglutide, tirzepatide, liraglutide, dulaglutide and orforglipron). Jabwise records what you log and does not give medical advice; follow your prescriber's guidance. ### Is Jabwise free? Yes. Jabwise is free to download, and everything you log and see stays free: doses, weigh‑ins, check‑ins, side effects, reminders, every Progress chart, Apple Health, backups and importing your history. Jabwise Pro adds Home Screen and Lock Screen widgets and sharing your journal as a PDF for your doctor or a spreadsheet. ### Who can see my journal? Only you. There is no account and no server, so your entries never reach us. Backups are encrypted on your device and only go where you put them, so a new iPhone or iPad can restore the whole journal. ## Guides ### [Your first weeks on a GLP-1](https://jabwise.app/guides/your-first-weeks) Every leaflet and label here starts on a low dose for about a month before the first step up. Mounjaro’s says feeling sick, diarrhoea and being sick are most common when first starting, and decrease over time in most patients. Wegovy’s and Ozempic’s say learn the pen from your doctor or nurse first. Markdown: https://jabwise.app/guides/your-first-weeks/index.md Starting doses Each source’s first dose, quoted as written. Rybelsus’s older tablets start on 3mg and its newer ones on 1.5mg, each for one month before the first step up. - **Mounjaro**: Starts on: "The starting dose is 2.5 mg once a week for four weeks." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Starts on: "The recommended starting dosage is 2.5 mg injected subcutaneously once weekly for 4 weeks." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Starts on: "When you first start using wegovy®, the starting dose is 0.25 mg once weekly." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Starts on: "The starting dose is 0.25 mg once a week for four weeks." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Rybelsus**: Starts on: "The starting dose is one 3 mg tablet once a day for one month." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) # Early on - **Stomach side effects**: Mounjaro’s leaflet says feeling sick, diarrhoea and being sick are most common at first, then ease in most patients. - **Fluids**: When starting Mounjaro, its leaflet says, some people lose fluids; it says drink plenty of fluids to avoid dehydration. - **Dizziness**: Wegovy’s leaflet says some people feel dizzy, mainly in the first 3 months, and not to drive until they feel better. - **Contraception**: On tirzepatide, the NHS says use extra barrier contraception, like condoms, for 4 weeks after starting and each increase. ## Before the first jab - **Learning the pen**: Wegovy’s and Ozempic’s leaflets say your doctor or nurse will show you, or to ask them. - **What to raise first**: The leaflets list things to tell your doctor first, such as pancreatitis or a slow-emptying stomach. - **The same day each week**: Mounjaro, Wegovy and Ozempic ask for the same day each week, where you can. - **New pens in the fridge**: Mounjaro’s, Wegovy’s and Ozempic’s leaflets say keep new pens in the fridge, at 2 to 8°C, never frozen. **Will the side effects last?** Mounjaro’s leaflet says feeling sick, diarrhoea and being sick decrease over time in most patients, and Ozempic’s says feeling sick and diarrhoea usually go away. None gives a timescale. **How long until the level settles?** Mounjaro’s product information says after 4 weeks of weekly doses, and Ozempic’s says 4 to 5. Our guide to how a weekly jab builds up shows it. **What if I miss a dose?** Mounjaro’s leaflet and Zepbound’s label say use it within 4 days, Wegovy’s and Ozempic’s within 5, and otherwise skip it. None covers a missed first dose; your prescriber can advise. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [Rybelsus 1.5, 4 and 9mg patient leaflet](https://www.medicines.org.uk/emc/product/101229/pil), [Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc), [Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Missed a dose?](https://jabwise.app/guides/missed-a-dose) It depends on the medicine and how late you are. For Mounjaro and Zepbound, which are tirzepatide, the leaflet and label say use it if it’s been 4 days or less, and skip it after that. For Wegovy and Ozempic, which are semaglutide, the line is 5 days. All four then say keep to your usual day. Markdown: https://jabwise.app/guides/missed-a-dose/index.md In their own words Each leaflet’s missed-dose rule, quoted as written. Leaflets are updated from time to time, so the one that came with your own pen is the most recent. - **Mounjaro**: Still use it: "it has been 4 days or less since you should have used Mounjaro, use it as soon as you remember." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Skip it: "If it has been more than 4 days since you should have used Mounjaro, skip the missed dose." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Still use it: "take the missed dose as soon as possible within 4 days (96 hours) after the missed dose." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Skip it: "If more than 4 days have passed, skip the missed dose and take your next dose on the regularly scheduled day." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Still use it: "it is 5 days or less since you should have used wegovy®, use it as soon as you remember." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Skip it: "it is more than 5 days since you should have used wegovy®, skip the missed dose." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Still use it: "it is 5 days or less since you should have used Ozempic®, use it as soon as you remember." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Skip it: "it is more than 5 days since you should have used Ozempic®, skip the missed dose." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # Whichever you take - **Next dose, usual day**: After using or skipping a missed dose, every leaflet and label here says go back to your usual injection day. - **Never two at once**: Mounjaro, Wegovy and Ozempic say never take a double dose; Zepbound’s label, never 2 doses within 3 days. - **Three days apart**: The leaflets say you can change your weekly injection day if it’s been at least 3 days since your last dose. **What if I’ve missed more than one dose?** None of the leaflets cover it. The NHS semaglutide page says that if you miss more than one injection, contact your doctor for advice. **Can I change the day I inject?** Yes, the leaflets say, as long as it has been at least 3 days since your last injection. Mounjaro, Wegovy and Ozempic then say to continue with once-a-week dosing. **Is it the same for semaglutide tablets?** No. The NHS says that if you forget your semaglutide tablet, skip the dose you missed and take your next dose at the usual time. **Why 4 days for some and 5 for others?** The leaflets don’t say why. Mounjaro and Zepbound contain tirzepatide and give 4 days; Wegovy and Ozempic contain semaglutide and give 5. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Where to inject, and how to rotate](https://jabwise.app/guides/injection-sites) The NHS, the Mounjaro, Wegovy and Ozempic leaflets and Zepbound’s label all name the stomach, the thigh and the upper arm; for tirzepatide, the back of the arm, with help. On rotating, the NHS and the Mounjaro and Wegovy leaflets say the same area each week is fine, as long as it isn’t the exact same spot. Markdown: https://jabwise.app/guides/injection-sites/index.md Try a rotation Count each side on its own and there are six places, not three. The map starts with six weeks already logged, one jab in each. Tap wherever this week’s went and the dashed ring jumps to the one you’ve left alone longest, which is exactly how the app picks its suggestion. It only keeps track; it can’t tell you which spot suits you. # The three areas - **Stomach**: Also called the abdomen. Wegovy’s leaflet asks you to stay 5cm away from your belly button when you inject. - **Thigh**: The upper leg, which every medicine on this page lists. Ozempic’s leaflet says to use the front of your thigh. - **Upper arm**: All four list it. For the back of it, Mounjaro says someone should help; Zepbound, someone else should inject. ## In their own words What each medicine’s information says about rotating, quoted as written. Ozempic’s leaflet doesn’t cover it, so its row quotes the NHS semaglutide page. - **Mounjaro**: Areas: Stomach, thigh, back of upper arm; On rotating: "If you want to do so, you can use the same area of your body each week. But be sure to choose a different injection site within that area." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Areas: Abdomen, thigh, back of upper arm; On rotating: "Rotate injection sites with each dose." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Areas: Upper arms, stomach, upper legs; On rotating: "You may inject in the same body area, but make sure it is not in the same spot as used the last time." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Areas: Front of thighs, front of waist, upper arm; On rotating: "you can use the same area but do not use the exact same spot" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) ### What they ask on jab day - **A new spot each time**: The same area is fine, says the NHS, just not the exact same spot. - **Under the skin only**: Never into a vein or a muscle, as the Wegovy and Ozempic leaflets both put it. - **Insulin somewhere else**: If you inject insulin as well, the NHS asks for a different place. - **If you’re unsure**: The NHS says to ask a pharmacist or doctor if you’re unsure how to use your pen. **Can I inject in the same area every week?** The NHS and the Mounjaro and Wegovy leaflets say yes, as long as you move to a fresh spot within it each time. If your prescriber has said something different, that applies to you. **Does it matter which side I use?** None of the leaflets prefers one side. Jabwise counts left and right separately only to give you more places to note down, which is why it shows six areas instead of three. **Are Mounjaro and Zepbound injected in the same places?** Yes. Both are tirzepatide, made by Lilly, and Zepbound is the name it’s sold under for weight loss in the US. The UK Mounjaro leaflet and the Zepbound label list the same three places (stomach, thigh, back of the upper arm) and both involve someone else for the arm: Mounjaro’s leaflet says someone should help, and Zepbound’s label says another person should inject. **What if I inject insulin too?** The NHS pages for semaglutide and tirzepatide both say to inject into a different place if you inject insulin as well, and the Mounjaro leaflet says the same. Your diabetes team can tell you what suits you. **What if the skin is itchy or red afterwards?** The NHS lists itchy or red skin where you inject as a common side effect. If it bothers you or doesn’t go away, it says to speak to a pharmacist or doctor. Sources: [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil). ### [Red, itchy or sore where you inject](https://jabwise.app/guides/reactions-where-you-inject) The NHS lists itchy or red skin where you inject as a common side effect, and Mounjaro’s and Wegovy’s leaflets call injection site reactions common, up to 1 in 10 people. The NHS lists an allergic reaction as serious, with symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing. Markdown: https://jabwise.app/guides/reactions-where-you-inject/index.md In their own words What each source lists as injection site reactions, and how often it says they happen. - **Mounjaro**: What it lists: "Injection site reactions (e.g. itching or redness)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); How often: "Common (may affect up to 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: What it lists: "injection site reactions" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); How often: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: What it lists: "such as bruising, pain, irritation, itching and rash" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); How often: "Uncommon (may affect up to 1 in 100 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **NHS**: What it lists: "itchy or red skin where you inject" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); How often: Common for both # Worth knowing - **A new spot each week**: The NHS says change the place you inject each week; the same area is fine, just not the exact same spot each time. - **On darker skin**: The NHS lists itchy or red skin where you inject, and notes redness may be harder to see on brown or black skin. - **A little blood**: If blood appears where you injected, Wegovy’s and Ozempic’s patient leaflets say press lightly on the spot. - **Pain where you inject**: Mounjaro’s leaflet lists injection site pain as an uncommon side effect, which may affect up to 1 in 100 people. **Is a red, itchy patch normal?** The NHS lists itchy or red skin where you inject among the common side effects, and says speak to a pharmacist or doctor if a side effect bothers you or does not go away. **When is it something more serious?** The NHS lists an allergic reaction among the serious side effects, with symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing. The NHS says call 111 if you think you might be having serious side effects. **Does moving the spot help?** The sources don’t say it prevents reactions. They do say to change the spot each time: the NHS each week, Mounjaro’s leaflet, if you use the same area, a different spot within it, and Wegovy’s not the same spot as last time. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Common side effects, and when to get help](https://jabwise.app/guides/common-side-effects) Feeling or being sick, constipation, diarrhoea, tiredness, hair loss and itchy or red skin where you inject are on the NHS lists for semaglutide and tirzepatide. Its advice is short: speak to a pharmacist or doctor if one bothers you or doesn’t go away, and keep taking your medicine unless you’re advised to stop. Markdown: https://jabwise.app/guides/common-side-effects/index.md The common ones Semaglutide is the medicine in Wegovy and Ozempic; tirzepatide is the one in Mounjaro and Zepbound. Each cell quotes the NHS page for that medicine. - **Feeling or being sick**: Semaglutide: "feeling sick (nausea) and being sick (vomiting)" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "feeling sick (nausea) or being sick (vomiting)" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Constipation**: Semaglutide: "constipation" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "constipation or diarrhoea" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Diarrhoea**: Semaglutide: "diarrhoea" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "constipation or diarrhoea" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Stomach pain**: Semaglutide: Not on the list; Tirzepatide: "stomach pain" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Tiredness**: Semaglutide: "feeling tired" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "feeling tired" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Skin where you inject**: Semaglutide: "itchy or red skin where you inject" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "itchy or red skin where you inject" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Hair loss**: Semaglutide: "hair loss" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Tirzepatide: "hair loss" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) # What the NHS says to do - **If one bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. - **On stopping**: Unless you’re advised to stop, the NHS says keep taking it. If you want to stop, talk to your doctor; don’t stop suddenly. - **Alcohol**: The NHS says it’s best not to drink alcohol, because it can increase side effects like feeling sick or being sick. - **Dizzy, or vision problems**: If you feel dizzy or have vision problems, the NHS says don’t drive, ride a bike or use machinery until they’ve gone. ## Rarer, and serious The NHS says most are rare, and to call 111 if you think you’re having one. - **Allergic reaction (anaphylaxis)**: As the NHS describes it: "symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Listed for: Both - **An inflamed pancreas**: As the NHS describes it: "severe pain in your stomach or back, which does not go away" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Listed for: Both - **Low blood sugar**: As the NHS describes it: "more likely if used with other diabetes medicines" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Listed for: Both - **Gallstones or a swollen gallbladder**: As the NHS describes it: "severe tummy pain" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Listed for: Tirzepatide - **Eye changes**: As the NHS describes it: "sudden loss of vision, usually in one eye at a time" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)); Listed for: Semaglutide **Are these all the side effects?** No. The NHS says these are not all of them, and points you to the leaflet that comes with your medicine for the full list. **Should I stop if I get side effects?** The NHS says to keep taking your medicine unless you’re advised to stop, and to talk to your doctor if you want to stop rather than stopping suddenly. **How do I report a side effect?** In the UK, on the Yellow Card website, which both NHS pages link to. Anyone can report, not only doctors. In the US, the FDA’s MedWatch takes reports from the public. Sources: [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [Yellow Card (UK)](https://yellowcard.mhra.gov.uk/), [MedWatch (US)](https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program). ### [Stomach pain: when it’s serious](https://jabwise.app/guides/serious-stomach-pain) Stomach pain is a listed side effect, but the NHS lists an inflamed pancreas, with severe pain in your stomach or back that does not go away, among the serious ones. Mounjaro’s, Wegovy’s and Ozempic’s leaflets say stop the medicine and seek urgent medical help for severe, persistent stomach pain. Markdown: https://jabwise.app/guides/serious-stomach-pain/index.md In their own words What each leaflet and label says to do about severe stomach pain, quoted as written. - **Mounjaro**: Severe stomach pain: "Stop using this medicine and seek urgent medical help if you experience: Severe, persistent pain in the stomach area (abdomen), with or without nausea and vomiting." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Severe stomach pain: "Stop using ZEPBOUND and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without nausea or vomiting." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Severe stomach pain: "Stop using this medicine and seek urgent medical help if you experience: Severe, persistent pain in the stomach area (abdomen), with or without nausea and vomiting." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Severe stomach pain: "Stop using this medicine and seek urgent medical help if you experience: Severe, persistent pain in the stomach area (abdomen), with or without nausea and vomiting." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Rybelsus**: Severe stomach pain: "Stop using this medicine and seek urgent medical help if you experience: Severe, persistent pain in the stomach area (abdomen), with or without nausea and vomiting." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) # What the NHS lists The serious side effects on the NHS pages that can cause stomach pain, in its words. - **An inflamed pancreas**: As the NHS describes it: "an inflamed pancreas (acute pancreatitis), which can cause severe pain in your stomach or back, which does not go away" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Listed for: Semaglutide and tirzepatide - **Gallstones or gallbladder**: As the NHS describes it: "gallstones or swelling of the gallbladder (cholecystitis), which can cause severe tummy pain" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Listed for: Tirzepatide ## Also in the sources - **Gallbladder signs**: Zepbound’s label lists signs to tell your provider about: upper stomach pain, fever, yellow skin or eyes, clay-colored stools. - **Bowel obstruction**: Wegovy, Ozempic and Rybelsus list bowel obstruction: a severe form of constipation, with stomach ache, bloating or vomiting. - **Everyday stomach pain**: Stomach pain is common with tirzepatide, the NHS says. Severe pain that does not go away is different: see above. - **Had pancreatitis before?**: The leaflets ask you to tell your doctor if you’ve had pancreatitis; Zepbound’s label asks about pancreas problems. **Is stomach pain normal on these medicines?** Stomach pain is on the NHS’s common list for tirzepatide, and the Mounjaro, Wegovy, Ozempic and Rybelsus leaflets list it too. The NHS says speak to a pharmacist or doctor if a side effect bothers you; severe pain that won’t go away is the urgent case below. **When is it urgent?** Mounjaro’s, Wegovy’s, Ozempic’s and Rybelsus’s leaflets say stop the medicine and seek urgent medical help for severe, persistent stomach pain. The NHS says call 111 if you think you might be having serious side effects. **Can the pain go through to the back?** Yes, the sources say. The NHS describes severe pain in your stomach or back, and Zepbound’s label says sometimes you may feel the pain from your abdomen to your back. Sources: [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil). ### [Low blood sugar on a GLP-1](https://jabwise.app/guides/low-blood-sugar) Mostly with diabetes and a sulfonylurea or insulin: the Mounjaro, Wegovy and Ozempic leaflets and Zepbound’s label each say that raises the risk, and your doctor may lower those doses. Signs listed include headache, sweating, hunger, confusion and a fast heartbeat. Wegovy’s and Ozempic’s say they may come on suddenly. Markdown: https://jabwise.app/guides/low-blood-sugar/index.md Who it’s most likely for From each leaflet and Zepbound’s label, quoted as written. All four name the same two medicines that raise the risk: a sulfonylurea and insulin. - **Mounjaro**: Who’s at risk: "you are using a sulphonylurea (another diabetes medicine) or insulin for your diabetes, as low blood sugar (hypoglycaemia) can occur." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); What may change: "Your doctor may need to change your dose of these other medicines to reduce this risk." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Who’s at risk: "Your risk for getting low blood sugar may be higher if you use ZEPBOUND with medicines that can cause low blood sugar, such as an insulin or sulfonylurea." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); What may change: "Reducing dose of insulin or insulin secretagogue may be necessary." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Who’s at risk: "If you have diabetes and are taking a sulfonylurea or an insulin with wegovy® the risk of getting low blood sugar levels (hypoglycaemia) might increase." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); What may change: "Your doctor may reduce your dose of these medicines before you start using this medicine." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Who’s at risk: "Combining a sulfonylurea or an insulin with this medicine might increase the risk of getting low blood sugar levels (hypoglycaemia)." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); What may change: "Your doctor may reduce your dose of these medicines before you start using this medicine." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # The warning signs Each source’s own list, quoted as written. Wegovy’s and Ozempic’s leaflets use the same words, and the two NHS pages list different signs. - **Mounjaro**: Signs it lists: "Symptoms of low blood sugar may include headache, drowsiness, weakness, dizziness, feeling hungry, confusion, irritability, fast heartbeat and sweating." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Signs it lists: "Signs and symptoms of low blood sugar may include: dizziness or light-headedness; sweating; confusion or drowsiness; headache; blurred vision; slurred speech; shakiness; fast heartbeat; anxiety, irritability, or mood changes; hunger; weakness; feeling jittery" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Signs it lists: "The warning signs of low blood sugar may come on suddenly. They can include: cold sweat, cool pale skin, headache, fast heartbeat, feeling sick (nausea) or very hungry, changes in vision, feeling sleepy or weak, feeling nervous, anxious or confused, difficulty concentrating or shaking." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Signs it lists: "The warning signs of low blood sugar may come on suddenly. They can include: cold sweat, cool pale skin, headache, fast heartbeat, feeling sick (nausea) or very hungry, changes in vision, feeling sleepy or weak, feeling nervous, anxious or confused, difficulty concentrating or shaking." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **NHS (tirzepatide)**: Signs it lists: "low blood sugar (more likely if used with other diabetes medicines), which can cause headaches, vision problems, feeling dizzy, weak or confused, a fast heartbeat or sweating" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **NHS (semaglutide)**: Signs it lists: "low blood sugar, which can cause sweating, shaking, heart palpitations and feeling dizzy (this is more likely if used with other diabetes medicines)" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) ## What they say to do - **Treatment plan**: Mounjaro’s leaflet says your doctor should tell you how to treat low blood sugar; Wegovy’s and Ozempic’s say they will. - **Testing**: On a sulfonylurea or insulin, Mounjaro says test as your doctor instructs; Wegovy and Ozempic say they may ask you to. - **Driving**: With any signs of low blood sugar, Mounjaro’s leaflet says avoid driving; Wegovy’s and Ozempic’s say do not drive. - **Telling your doctor**: On insulin or a sulfonylurea, Zepbound’s label says report any signs of low blood sugar to your healthcare provider. **Can it happen without diabetes?** Wegovy’s leaflet lists low blood sugar in patients without diabetes as uncommon, affecting up to 1 in 100 people. Zepbound’s label says it has also been associated with Zepbound in adults without type 2 diabetes. **How common is it with diabetes medicines?** Mounjaro’s and Ozempic’s leaflets list it as very common, more than 1 in 10 people, with a sulfonylurea or insulin, and common with some other diabetes medicines. Wegovy’s lists it as common, up to 1 in 10, in patients with diabetes. **What should I do if I get the signs?** Wegovy’s and Ozempic’s leaflets say your doctor will tell you how to treat low blood sugar and what to do if you notice the signs. If you think you’re having serious side effects, the NHS says call 111. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Eyesight changes on a GLP-1](https://jabwise.app/guides/eyesight-changes) Wegovy’s and Ozempic’s leaflets say urgently contact your doctor if you notice a sudden loss of vision or rapidly worsening eyesight, which may be NAION, a very rare side effect. Wegovy’s leaflet and Zepbound’s label say fast improvements in blood sugar can temporarily worsen diabetic eye disease. Markdown: https://jabwise.app/guides/eyesight-changes/index.md If you have diabetic eye disease What each says about diabetic eye disease, quoted as written. Mounjaro’s lists it among things to tell your doctor before you start. - **Mounjaro**: What it says: "you have a problem with your eyes (diabetic retinopathy or macular oedema)." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: What it says: "Temporary worsening of diabetic retinopathy has been reported with rapid improvement in glucose control." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: What it says: "Fast improvements in blood sugar control may lead to a temporary worsening of diabetic eye disease. If you have diabetic eye disease and experience eye problems while taking this medicine, talk to your doctor." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: What it says: "Tell your doctor if you have diabetic eye disease or if you experience eye problems during treatment with this medicine." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # Sudden changes to your eyesight - **Sudden loss of vision**: Wegovy’s and Ozempic’s leaflets say urgently contact your doctor about sudden vision loss or rapidly worsening eyesight. - **NAION, very rare**: The same leaflets list NAION, an eye condition that may cause loss of vision without any pain, as up to 1 in 10,000. - **An eye examination**: If it may be NAION, they say your doctor will refer you for an eye examination, and you may have to stop treatment. - **Driving**: The NHS says if you have vision problems after using it, don’t drive, ride a bike or use machinery until they’ve gone. **Can Ozempic affect your eyes?** Ozempic’s leaflet lists complications of diabetic eye disease as common, up to 1 in 10 people, and NAION as very rare, up to 1 in 10,000. **Does Mounjaro cause NAION?** Mounjaro’s leaflet and Zepbound’s label don’t list it. Mounjaro’s asks you to tell your doctor before you start if you have diabetic retinopathy or macular oedema. **What does the NHS say?** The NHS semaglutide page lists sudden loss of vision, usually in one eye at a time, among serious side effects, and says call 111 if you think you’re having one. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Allergic reactions on a GLP-1](https://jabwise.app/guides/allergic-reactions) Both NHS pages list an allergic reaction (anaphylaxis) as a possible serious side effect, with a swollen throat or tongue, a raised, itchy rash or difficulty breathing. Mounjaro’s, Wegovy’s and Ozempic’s leaflets call severe allergic reactions rare, up to 1 in 1,000 people, and say get immediate medical help. Markdown: https://jabwise.app/guides/allergic-reactions/index.md How common it is Each leaflet’s own words for how common allergic and severe allergic reactions are, quoted as written. Wegovy’s lists only the severe kind. - **Mounjaro**: Allergic reactions: "Common (may affect up to 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Severe reactions: "Rare (may affect up to 1 in 1 000 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Allergic reactions: 5% at each dose, against 3% on placebo; Severe reactions: "Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported postmarketing with tirzepatide." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Allergic reactions: Not listed; Severe reactions: "Rare: may affect up to 1 in 1,000 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Allergic reactions: "Uncommon (may affect up to 1 in 100 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Severe reactions: "Rare (may affect up to 1 in 1 000 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **Immediate help**: The leaflets say get immediate medical help for breathing problems, or swelling of the lips, tongue or throat. - **Zepbound’s signs**: Zepbound’s label also lists severe rash or itching, fainting or feeling dizzy, and a very rapid heartbeat among the signs. - **Reacted before?**: The NHS says it may not be suitable if you’ve had an allergic reaction to semaglutide, tirzepatide or another GLP-1 agonist. - **In the KwikPen**: Mounjaro’s KwikPen leaflet says each 0.6ml dose contains 5.4mg of benzyl alcohol, which may cause allergic reactions. **Is a rash a side effect of Mounjaro?** Mounjaro’s leaflet lists allergic reactions such as rash, itching and eczema as common, up to 1 in 10 people. Severe allergic reactions are rare, up to 1 in 1,000. **Is a red, itchy patch where I inject an allergy?** Both NHS pages list itchy or red skin where you inject among common side effects, separately from a serious allergic reaction. **What should I do if I think I’m reacting?** Mounjaro’s, Wegovy’s and Ozempic’s leaflets say get immediate medical help and tell your doctor. Zepbound’s label says stop using it and get medical help right away. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Headaches and dizziness](https://jabwise.app/guides/headaches-and-dizziness) Wegovy’s leaflet lists headache as very common and feeling dizzy as common; Ozempic’s lists both as common. Mounjaro’s lists dizziness as common for weight management. In two Zepbound trials, 4% to 5% reported dizziness, against 2% on placebo. Mounjaro’s lists both as signs of low blood sugar. Markdown: https://jabwise.app/guides/headaches-and-dizziness/index.md How common it is Each leaflet’s own words for how common each is, quoted as written. Zepbound’s figures are the share of people in its two weight trials. - **Mounjaro**: Headache: Listed only as a sign of low blood sugar; Dizziness: "Dizziness observed in patients treated for weight management" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Headache: Not in its table of common side effects; Dizziness: 4% to 5%, against 2% on placebo - **Wegovy**: Headache: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Dizziness: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Headache: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Dizziness: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **Mainly at the start**: Wegovy’s leaflet says some people may feel dizzy when taking it, mainly during the first 3 months of treatment. - **Driving**: The NHS says if you feel dizzy after using it, don’t drive, ride a bike or use machinery until it has gone away. - **Low blood sugar**: Mounjaro’s leaflet lists headache and dizziness among signs of low blood sugar, likelier with insulin or a sulphonylurea. - **On standing up**: Wegovy’s leaflet lists feeling dizzy or lightheaded on standing or sitting up, from a drop in blood pressure, as uncommon. **Does Wegovy cause headaches?** Wegovy’s leaflet lists headache as very common, more than 1 in 10 people, and says its very common side effects usually go away over time. **Does Mounjaro cause dizziness?** Mounjaro’s leaflet lists dizziness as common in people treated for weight management, up to 1 in 10. It also lists dizziness as a possible sign of low blood sugar. **When should I get help?** The NHS says speak to a pharmacist or doctor if a side effect bothers you or doesn’t go away, and call 111 if you think you’re having a serious one. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Taste changes on a GLP-1](https://jabwise.app/guides/taste-changes) Wegovy’s leaflet lists a change in the way food or drink tastes as common, up to 1 in 10 people. Ozempic’s and Mounjaro’s list it as uncommon, up to 1 in 100. In two Zepbound trials, 0.4% reported it, against none on placebo. Wegovy’s also lists changed skin sensation, and says it usually goes away over time. Markdown: https://jabwise.app/guides/taste-changes/index.md Where it’s listed From each leaflet and Zepbound’s label, quoted as written. Neither NHS page lists a change in taste among the common side effects it names for these medicines. - **Mounjaro**: What it says: "Changed sense of taste" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); How common: "Uncommon (may affect up to 1 in 100 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: What it says: "In a pool of Study 1 and 2, dysgeusia was reported by 0.4% of ZEPBOUND-treated patients and no placebo-treated patients." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); How common: 0.4%, against none on placebo - **Wegovy**: What it says: "change in the way food or drink tastes" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); How common: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: What it says: "Change in the way food or drink tastes" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); How common: "Uncommon (may affect up to 1 in 100 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # Changed skin sensation - **Wegovy**: Wegovy’s leaflet lists changed skin sensation as common, says it usually goes away, and may happen more often at 7.2mg. - **Mounjaro and Ozempic**: Mounjaro’s leaflet lists a change in skin sensation as uncommon; Ozempic’s lists it, but says its frequency is not known. - **Zepbound’s trials**: Zepbound’s label says dysesthesia, a changed skin sensation, was reported by 0.2% to 0.4% on it, against 0.1% on placebo. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. **Does Ozempic change your taste?** Ozempic’s leaflet lists a change in the way food or drink tastes as uncommon, up to 1 in 100 people. Wegovy’s, also semaglutide, lists it as common. **Does Mounjaro change your taste?** Mounjaro’s leaflet lists a changed sense of taste as uncommon, up to 1 in 100 people. In two Zepbound trials, 0.4% reported it. **Does it go away?** None of the sources says whether a change in taste goes away. Wegovy’s leaflet says changed skin sensation usually goes away over time. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Hair loss on a GLP-1](https://jabwise.app/guides/hair-loss) Mounjaro’s and Wegovy’s leaflets list it as common, up to 1 in 10 people, and both NHS pages name it. Mounjaro’s lists it for people treated for weight management, and Wegovy’s says it may happen more often at 7.2mg. Zepbound’s label says hair loss in its trials was associated with weight reduction. Markdown: https://jabwise.app/guides/hair-loss/index.md Where it’s listed From each leaflet and Zepbound’s label, quoted as written. Ozempic’s leaflet doesn’t list hair loss, though the NHS semaglutide page does. - **Mounjaro**: What it says: "Hair loss observed in patients treated for weight management" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); How common: "Common (may affect up to 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: What it says: "Hair loss adverse reactions in ZEPBOUND-treated patients were associated with weight reduction." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); How common: "The most common adverse reactions, reported in ≥5% of patients treated with ZEPBOUND" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: What it says: "hair loss – may occur more frequently with semaglutide 7.2 mg" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); How common: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: What it says: Not listed; How common: Not listed # What else they say - **More often in women**: In two Zepbound weight trials, one with type 2 diabetes, 7.1% of women on it reported hair loss, against 0.5% of men. - **None stopped for it**: In those trials, the label says, nobody on Zepbound stopped treatment due to hair loss; one person on placebo did. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. - **On stopping**: The NHS says keep taking your medicine unless you’re advised to stop, and talk to your doctor if you want to stop. **Does Ozempic cause hair loss?** Ozempic’s leaflet doesn’t list it. The NHS semaglutide page, which covers Ozempic and Wegovy, lists hair loss among semaglutide’s common side effects. **Is it linked to losing weight?** Zepbound’s label says hair loss in its trials was associated with weight reduction. Mounjaro’s leaflet lists it for people treated for weight management. **Will my hair grow back?** None of these sources says how long hair loss lasts. If it bothers you or doesn’t go away, the NHS says speak to a pharmacist or doctor. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Feeling sick on a GLP-1](https://jabwise.app/guides/feeling-sick) Mounjaro’s, Wegovy’s and Ozempic’s leaflets list feeling sick as very common, more than 1 in 10 people, and both NHS pages list it. In two Zepbound trials, 25% to 29% reported nausea, against 8% on placebo. Mounjaro’s leaflet says it’s most common when first starting, and decreases over time in most patients. Markdown: https://jabwise.app/guides/feeling-sick/index.md How common it is Each leaflet’s own words for how common it is, quoted as written. Zepbound’s figures are the share of people in its two weight trials who reported it. - **Mounjaro**: Feeling sick: "Very common (may affect more than 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Being sick: Very common for weight management; common in adults treated for type 2 diabetes - **Zepbound**: Feeling sick: 25% to 29%, against 8% on placebo; Being sick: 8% to 13%, against 2% on placebo - **Wegovy**: Feeling sick: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Being sick: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Feeling sick: "Very common (may affect more than 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Being sick: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **Most common at the start**: Mounjaro’s leaflet says feeling sick is usually not severe, most common at first, and decreases over time in most patients. - **While the dose goes up**: Zepbound’s label says most nausea, vomiting and diarrhoea in its trials came while the dose was going up, then decreased. - **Fluids**: Wegovy’s and Ozempic’s leaflets say being sick can cause dehydration, and that drinking fluids is important to prevent it. - **Stopping for gut side effects**: In two Zepbound trials, 1.9% to 4.3% stopped treatment due to stomach and gut side effects, against 0.5% on placebo. **Is nausea a side effect of Mounjaro?** Yes. Mounjaro’s leaflet lists feeling sick as very common, more than 1 in 10 people, and says it’s usually not severe and decreases over time in most patients. **Does alcohol make it worse?** Both NHS pages say alcohol can increase side effects like feeling or being sick. The semaglutide page says it’s best not to drink it; the tirzepatide page, best to avoid it. **When is it serious?** Mounjaro’s, Wegovy’s and Ozempic’s leaflets say stop using it and seek urgent medical help for severe, persistent stomach pain, with or without nausea and vomiting, as it could be pancreatitis. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Diarrhoea on a GLP-1](https://jabwise.app/guides/diarrhoea) Mounjaro’s, Wegovy’s and Ozempic’s leaflets list diarrhoea as very common, more than 1 in 10 people, and both NHS pages list it. In two Zepbound trials, 19% to 23% reported it, against 8% on placebo. Wegovy’s and Ozempic’s leaflets say it can cause dehydration, and that drinking fluids is important to prevent it. Markdown: https://jabwise.app/guides/diarrhoea/index.md How common it is Each leaflet’s own words for how common diarrhoea is, quoted as written. Zepbound’s label counts it among its most common side effects. - **Mounjaro**: How common: "Very common (may affect more than 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: How common: "The most common adverse reactions, reported in ≥5% of patients treated with ZEPBOUND are: nausea, diarrhea" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: How common: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: How common: "Very common (may affect more than 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **It usually eases**: Wegovy’s and Ozempic’s leaflets say diarrhoea usually goes away over time; Mounjaro’s says it decreases in most patients. - **By dose in the trials**: In Zepbound’s trials, diarrhoea was reported by 19% on 5mg, 21% on 10mg and 23% on 15mg, against 8% on placebo. - **Losing fluids**: Mounjaro’s leaflet says losing fluids at the start may reduce kidney function, and to avoid dehydration with plenty of fluids. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. **Is diarrhoea a side effect of Mounjaro?** Yes. Mounjaro’s leaflet lists it as very common, more than 1 in 10 people, and says it’s usually not severe and decreases over time in most patients. **How long does it last?** None of the sources gives a timescale. Wegovy’s and Ozempic’s leaflets say it usually goes away over time; Zepbound’s label says most cases in its trials came while the dose was going up. **When should I get help?** The NHS says call 111 if you think you’re having a serious side effect. Zepbound’s label asks you to tell your healthcare provider right away if diarrhoea doesn’t go away. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Constipation on a GLP-1](https://jabwise.app/guides/constipation) All four list it, and so do both NHS pages. Wegovy’s leaflet calls it very common, as does Mounjaro’s for weight management; Ozempic’s calls it common. In two Zepbound trials, 11% to 17% reported it, against 5% on placebo. Wegovy’s and Ozempic’s list bowel obstruction; Zepbound’s, intestinal obstruction. Markdown: https://jabwise.app/guides/constipation/index.md How common it is Each source’s own words for how common constipation is, quoted as written. Zepbound’s label counts it among its most common side effects. - **Mounjaro**: How common: "Constipation is very common in patients treated for weight management, and in the type 2 diabetes cardiovascular disease study but common in patients treated for type 2 diabetes." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: How common: "The most common adverse reactions, reported in ≥5% of patients treated with ZEPBOUND" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: How common: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: How common: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **It often eases**: Wegovy’s leaflet lists constipation with its very common side effects, and says these usually go away over time. - **By dose in the trials**: In Zepbound’s trials, constipation was reported by 17% on 5mg, 14% on 10mg and 11% on 15mg, against 5% on placebo. - **A severe form**: Wegovy and Ozempic list bowel obstruction, a severe form. Zepbound’s label lists intestinal obstruction after approval. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. **Is constipation a side effect of Mounjaro?** Yes. Mounjaro’s leaflet says it’s very common in people treated for weight management and in a heart study of people with type 2 diabetes, and common in people treated for type 2 diabetes. **Does it go away?** Wegovy’s leaflet says its very common side effects, constipation among them, usually go away over time. The other leaflets don’t say so for constipation. **When is it serious?** Wegovy’s and Ozempic’s leaflets list bowel obstruction, a severe form of constipation with stomach ache, bloating or vomiting. Zepbound’s label lists intestinal obstruction and severe constipation reported after approval. If you think you’re having a serious side effect, the NHS says call 111. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Heartburn, burping and indigestion](https://jabwise.app/guides/heartburn-and-burping) All four list them. Mounjaro’s, Wegovy’s and Ozempic’s leaflets each call indigestion, burping and reflux or heartburn common, up to 1 in 10 people. In two Zepbound trials, indigestion was reported by 9% to 10% of people on it, against 4% on placebo, and reflux and burping by 4% to 5%. Markdown: https://jabwise.app/guides/heartburn-and-burping/index.md In their own words Each source’s own name for them, quoted as written. Mounjaro’s, Wegovy’s and Ozempic’s leaflets list all three as common side effects. - **Mounjaro**: Indigestion: "Indigestion (dyspepsia)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Burping: "Burping (eructation)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Reflux or heartburn: "Reflux or heartburn (also called gastroesophageal reflux disease – GORD)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Indigestion: "indigestion" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Burping: "belching" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Reflux or heartburn: "heartburn" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Indigestion: "upset stomach or indigestion" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Burping: "burping" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Reflux or heartburn: "reflux or heartburn – also called ‘gastro-oesophageal reflux disease’" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Indigestion: "Indigestion" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Burping: "Burping" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Reflux or heartburn: "Reflux or heartburn – also called ‘gastro-esophageal reflux disease’ (GERD)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **What reflux is**: Mounjaro’s leaflet says reflux is caused by stomach acid coming up into the tube from your stomach to your mouth. - **An inflamed stomach**: Wegovy and Ozempic also list gastritis, an inflamed stomach, with signs like stomach ache, feeling sick or being sick. - **In Zepbound’s trials**: Indigestion was reported by 9% to 10% on Zepbound, against 4% on placebo; burping by 4% to 5%, against 1%. - **If one bothers you**: Zepbound’s label says talk to your healthcare provider if you have any side effect that bothers you or does not go away. **Does Mounjaro cause heartburn?** Its leaflet lists reflux or heartburn as common, up to 1 in 10 people, along with indigestion and burping. **Is burping a side effect of Ozempic?** Yes. Ozempic’s leaflet lists burping as common, up to 1 in 10 people. Mounjaro’s and Wegovy’s leaflets list it too, and Zepbound’s label calls it belching. **What helps?** None of these leaflets suggests a remedy. The NHS says speak to a pharmacist or doctor if a side effect bothers you or doesn’t go away; they may be able to give advice. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Bloating and wind](https://jabwise.app/guides/bloating-and-wind) Mounjaro’s, Wegovy’s and Ozempic’s leaflets list bloating of the stomach and gas (flatulence) as common, up to 1 in 10 people. In two Zepbound trials, 3% to 4% reported each, against 2% on placebo. Wegovy’s and Ozempic’s list bloating among the signs of bowel obstruction, a severe form of constipation. Markdown: https://jabwise.app/guides/bloating-and-wind/index.md How common it is Each leaflet’s own words for how common each is, quoted as written. Zepbound’s figures are the share of people in its two weight trials. - **Mounjaro**: Bloating: "Common (may affect up to 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Wind: "Common (may affect up to 1 in 10 people)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Bloating: 3% to 4%, against 2% on placebo; Wind: 3% to 4%, against 2% on placebo - **Wegovy**: Bloating: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Wind: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Bloating: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Wind: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **By dose in the trials**: In Zepbound’s trials, wind was reported by 3% on 5mg and 10mg and 4% on 15mg, against 2% on placebo; bloating the same. - **Listed alongside it**: Mounjaro’s, Wegovy’s and Ozempic’s leaflets also list burping, indigestion and reflux or heartburn as common side effects. - **A severe form**: Wegovy and Ozempic list bowel obstruction: a severe form of constipation, with stomach ache, bloating or vomiting. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. **Is bloating a side effect of Mounjaro?** Yes. Mounjaro’s leaflet lists bloating of the stomach and gas (flatulence) as common, up to 1 in 10 people. **Do the NHS pages list it?** Not among their common side effects. Both say those aren’t all the side effects, and point to the leaflet that comes with your medicine for a full list. **When is it serious?** Wegovy’s and Ozempic’s leaflets list bowel obstruction, a severe form of constipation with stomach ache, bloating or vomiting. If you think you’re having a serious side effect, the NHS says call 111. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Gallstones and the gallbladder](https://jabwise.app/guides/gallstones) Wegovy’s and Ozempic’s leaflets list gallstones as common, up to 1 in 10, and Mounjaro’s says they were common when used for weight management. The NHS tirzepatide page lists gallstones or a swollen gallbladder as serious. Zepbound’s label says gallbladder events in its trials were associated with weight reduction. Markdown: https://jabwise.app/guides/gallstones/index.md How common it is Each leaflet’s own words for how common gallstones are, quoted as written. Zepbound’s figure is the share of people in its two weight trials. - **Mounjaro**: How common: "Increased gallstones were common in the cardiovascular disease study and when used for weight management but uncommon when used in adults for type 2 diabetes." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: How common: 1.1%, against 1% on placebo - **Wegovy**: How common: "Common: may affect up to 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: How common: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **Linked to weight loss**: Zepbound’s label says acute gallbladder events in its two weight trials were associated with weight reduction. - **A swollen gallbladder**: In those trials, cholecystitis (swelling of the gallbladder) was reported by 0.7% on Zepbound, against 0.2% on placebo. - **The NHS on tirzepatide**: The NHS tirzepatide page lists gallstones or swelling of the gallbladder, which can cause severe tummy pain, as serious. - **Gallbladder signs**: Zepbound’s label lists signs to tell your provider about: upper stomach pain, fever, yellow skin or eyes, clay-colored stools. **Can Mounjaro cause gallstones?** Mounjaro’s leaflet says gallstones were common when it was used for weight management, up to 1 in 10 people, and uncommon in adults treated for type 2 diabetes. **Does Wegovy cause gallstones?** Wegovy’s and Ozempic’s leaflets both list gallstones as common, up to 1 in 10 people. The NHS semaglutide page doesn’t list them. **What does the NHS say?** The NHS tirzepatide page lists gallstones or swelling of the gallbladder among serious side effects, and says call 111 if you think you’re having one. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Feeling tired on a GLP-1](https://jabwise.app/guides/feeling-tired) All four list it, and both NHS pages name feeling tired among common side effects. Wegovy’s leaflet calls feeling weak or tired very common, and says it usually goes away over time; Ozempic’s calls tiredness common. In two Zepbound trials, 5% to 7% reported fatigue, against 3% on placebo. Markdown: https://jabwise.app/guides/feeling-tired/index.md How common it is From each leaflet and Zepbound’s label, quoted as written. Mounjaro’s gives a different answer for its heart study of people with type 2 diabetes. - **Mounjaro**: Listed as: "Feeling tired (fatigue)" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); How common: "Fatigue was very common in the type 2 diabetes cardiovascular disease study and common in patients treated for weight management, and type 2 diabetes." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Listed as: "feeling tired" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); How common: "The most common adverse reactions, reported in ≥5% of patients treated with ZEPBOUND" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Listed as: "feeling weak or tired" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); How common: "Very common: may affect more than 1 in 10 people" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Listed as: "Tiredness" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); How common: "Common (may affect up to 1 in 10 people)" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **It often eases**: Wegovy’s leaflet lists feeling weak or tired with its very common side effects, and says these usually go away over time. - **In Zepbound’s trials**: Fatigue, counting weakness and lethargy, was reported by 5% to 7% of people on Zepbound, against 3% on placebo. - **Low blood sugar signs**: Mounjaro’s leaflet lists drowsiness and weakness among signs of low blood sugar, likelier with insulin or a sulphonylurea. - **If it bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. **Does Mounjaro make you tired?** Its leaflet lists feeling tired (fatigue): very common in a heart study of people with type 2 diabetes, and common in people treated for weight management or type 2 diabetes. **Does the tiredness go away?** Wegovy’s leaflet says its very common side effects, feeling weak or tired among them, usually go away over time. The other leaflets don’t say so for tiredness. **Could it be low blood sugar?** Mounjaro’s leaflet lists drowsiness and weakness among the symptoms of low blood sugar, and Wegovy’s lists feeling sleepy or weak, for people with diabetes. Mounjaro’s says your doctor should tell you how to treat it. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [Surgery, sedation and the dentist](https://jabwise.app/guides/surgery-and-sedation) Mounjaro’s, Wegovy’s and Ozempic’s leaflets ask you to tell your doctor if you’re due surgery under anaesthesia. The NHS says tell the healthcare professional about a general anaesthetic or sedative, at the dentist too. Zepbound’s label says tell all your providers before planned procedures. Markdown: https://jabwise.app/guides/surgery-and-sedation/index.md In their own words Each source’s own line, quoted as written. The three UK leaflets use near-identical words, each naming its own medicine, as do the two NHS pages. - **Mounjaro**: What it says: "If you know that you are due to have surgery where you will be under anaesthesia (sleeping), please tell your doctor that you are using Mounjaro." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: What it says: "If you know that you are due to have surgery where you will be under anaesthesia (sleeping), please tell your doctor that you are taking wegovy®." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: What it says: "If you know that you are due to have surgery where you will be under anaesthesia (sleeping), please tell your doctor that you are taking Ozempic®." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Zepbound**: What it says: "Tell all your healthcare providers that you are taking ZEPBOUND before you are scheduled to have surgery or other procedures." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **NHS (semaglutide)**: What it says: "a general anaesthetic (which puts you to sleep) or a sedative (which relaxes you) for an operation or dental procedure – tell the healthcare professional that you're using semaglutide" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) - **NHS (tirzepatide)**: What it says: "a general anaesthetic (which puts you to sleep) or a sedative (which relaxes you) for an operation or dental procedure – tell the healthcare professional that you're using tirzepatide" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) # Why they ask - **Food in the lungs**: Zepbound’s label lists food or liquid getting into the lungs in surgery or procedures that use anaesthesia or deep sedation. - **A slower stomach**: Zepbound’s label says it slows stomach emptying, and may raise the chance of food getting into your lungs in surgery. - **Rare, despite fasting**: Zepbound’s label cites rare reports of aspiration on GLP-1s under anaesthesia or deep sedation, despite reported fasting. - **At the dentist too**: The NHS includes dental work: before a sedative or general anaesthetic, tell the healthcare professional you use it. **Should I stop before surgery?** None of these sources tells you to stop before a procedure. They say tell your doctor, or the healthcare professional, that you use it. The NHS says talk to your doctor if you want to stop. **Does it count for the dentist?** Yes, for a general anaesthetic or a sedative. The NHS names dental procedures, and says tell the healthcare professional that you’re using it. **Why does it matter?** Zepbound’s label says it delays stomach emptying, and there have been rare reports, in people on GLP-1 medicines, of food getting into the lungs under general anaesthesia or deep sedation during planned procedures. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Taking it with other medicines](https://jabwise.app/guides/other-medicines) Tell your doctor, pharmacist or nurse about other medicines, Mounjaro’s, Wegovy’s and Ozempic’s leaflets say. The NHS names warfarin, insulin, other diabetes medicines and, for semaglutide, levothyroxine. Wegovy’s and Ozempic’s add that warfarin may mean more blood tests, and Zepbound’s that it may affect tablets. Markdown: https://jabwise.app/guides/other-medicines/index.md Medicines they name Each in the words of a source that names it, quoted as written. None of these lists is complete, and the sources ask you to mention any other medicines you take. - **Warfarin**: What they say: "Warfarin or other similar medicines taken by mouth to reduce blood clotting (oral anti-coagulants). You may need frequent blood tests to check how quickly your blood clots." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Insulin**: What they say: "insulin – your doctor or specialist nurse may need to adjust your dose" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Diabetes medicines**: What they say: "other diabetes medicines, such as gliclazide, glimepiride, metformin and tolbutamide" ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Levothyroxine**: What they say: "levothyroxine, for an underactive thyroid" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) - **The pill**: What they say: "Birth control pills by mouth may not work as well while using ZEPBOUND." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Other tablets**: What they say: "ZEPBOUND delays gastric emptying and thereby has the potential to impact the absorption of concomitantly administered oral medications." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) # What they ask - **Everything you take**: Ozempic’s leaflet includes herbal medicines and ones bought without a prescription; the NHS adds vitamins and supplements. - **On insulin**: Ozempic’s leaflet says your doctor will tell you how to reduce the dose, and recommend checking your blood sugar more often. - **Contraception**: The NHS says use extra barrier contraception, like condoms, for 4 weeks after starting tirzepatide and each increase. - **Rybelsus tablets**: Both Rybelsus leaflets say wait at least 30 minutes after it before eating, drinking or taking other oral medicines. **Can I take it with metformin?** The NHS names metformin among other diabetes medicines that may not mix well with tirzepatide or semaglutide. The NHS says tell your doctor or a pharmacist before you use it. **Does Mounjaro affect the pill?** Mounjaro’s leaflet says women with obesity or overweight on oral contraceptives should consider also using a barrier method, or switching to a non-oral one, for 4 weeks after starting and after each increase. **Who should I tell?** Your doctor, pharmacist or nurse, say the Mounjaro, Wegovy and Ozempic leaflets (Rybelsus’s: doctor or pharmacist), about any medicine you use, have recently used or might use. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [Rybelsus 1.5, 4 and 9mg patient leaflet](https://www.medicines.org.uk/emc/product/101229/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Do side effects ease over time?](https://jabwise.app/guides/do-side-effects-ease) Usually, the leaflets say, for the stomach ones. Mounjaro’s says feeling sick, diarrhoea and being sick decrease over time in most patients. Ozempic’s and Rybelsus’s say feeling sick and diarrhoea usually go away over time, and Wegovy’s says so of its very common side effects. None gives a timescale. Markdown: https://jabwise.app/guides/do-side-effects-ease/index.md In their own words Which side effects each leaflet says usually ease, in its own words. - **Mounjaro**: Side effects: Feeling sick, diarrhoea, being sick; What it says: "They are most common when first starting tirzepatide but decrease over time in most patients." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: Side effects: Headache, feeling or being sick, diarrhoea, constipation, stomach pain, feeling weak or tired; What it says: "These usually go away over time." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Side effects: Feeling sick, diarrhoea; What it says: "this usually goes away over time" ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Rybelsus**: Side effects: Feeling sick, diarrhoea; What it says: "this usually goes away over time" ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) # Meanwhile - **On stopping**: The NHS says keep taking your medicine unless you’re advised to stop, and talk to your doctor if you want to stop. - **If one bothers you**: If a side effect bothers you or doesn’t go away, the NHS says a pharmacist or doctor may give advice on how to reduce it. - **Usually not severe**: Mounjaro’s leaflet says feeling sick, diarrhoea and being sick are usually not severe, and decrease over time for most. - **Fluids**: The Mounjaro, Wegovy, Ozempic and Rybelsus leaflets say these can dehydrate you, so drink fluids to prevent it. **How long until they ease?** The leaflets don’t say. Mounjaro’s says they are most common when first starting; the others say they usually go away over time. **What if one doesn’t go away?** The NHS says speak to a pharmacist or doctor if you have any side effects that bother you or do not go away. **Which ones need help straight away?** The NHS lists serious ones, such as an inflamed pancreas, which can cause severe pain in your stomach or back that does not go away, and says call 111 if you think you might be having one. Our side effects guide has the list. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [How long does a pen last?](https://jabwise.app/guides/how-long-a-pen-lasts) Usually 4 weeks. A Mounjaro KwikPen, a Wegovy FlexTouch and a Zepbound KwikPen each hold 4 doses, and US single-dose Zepbound pens come 4 to a box, so your fifth weekly jab needs a new pen. Wegovy 7.2mg is the exception: three 2.4mg injections a dose. How long a started pen keeps differs by brand. Markdown: https://jabwise.app/guides/how-long-a-pen-lasts/index.md Work out your dates Pick your pen and its first dose day for the four dose days, when the next is due and the label’s limit. It counts dates; it doesn’t change your prescriber’s advice. # How long a pen keeps Each label’s own limit, quoted as written. - **Mounjaro KwikPen**: In the box: One pen, four doses; The label’s limit: "can be stored unrefrigerated not above 30 ºC for up to 30 days after first use and then the pen must be discarded" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy FlexTouch**: In the box: One pen, four doses; at 7.2mg, three make one dose; The label’s limit: "You can keep the pen for 6 weeks when stored at a temperature below 30°C or in a refrigerator (2°C to 8°C)" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Zepbound KwikPen**: In the box: One pen, four doses; The label’s limit: "after a total of 30 days at room temperature, 30 days after first use, or after taking 4 weekly doses" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Zepbound single-dose pens**: In the box: Four pens, one dose each; The label’s limit: "can be stored unrefrigerated at temperatures not to exceed 30°C (86°F) for up to a total of 21 days" ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) ## Before the first dose, and after the last - **Before you start**: Fridge, 2 to 8°C, say Mounjaro, Wegovy and Ozempic; Zepbound’s label also allows limited room temperature. - **If it froze**: The Mounjaro, Wegovy and Ozempic leaflets are all clear that a pen that has been frozen must not be used. - **After dose 4**: There may be a little medicine left in your pen after dose 4. Mounjaro’s leaflet says not to try to use it. **How many doses are in a Mounjaro pen?** Four. The UK leaflet says each KwikPen contains 4 doses, in whichever strength you’re prescribed. Taken once a week, that’s 4 weeks. **How long does a Wegovy pen last once it’s open?** The Wegovy FlexTouch leaflet says you can keep the pen for 6 weeks when stored below 30°C, or in the fridge. It holds four doses, so on a weekly schedule you’ll finish it well inside that. **Does a Wegovy pen last 4 weeks at 7.2mg?** No. The leaflet gives the 7.2mg dose as three 2.4mg injections on the same day, says you may need to use multiple pens, and asks you to make sure you have enough to complete the dose before you start. Your pharmacist can help you plan supply. **Is there medicine left after the last dose?** There can be. Mounjaro’s leaflet says not to try to use any remaining medicine, and that the pen must be properly discarded after the last dose. **What if my pen has been frozen?** The Mounjaro, Wegovy and Ozempic leaflets all say not to use a pen that has been frozen. Your pharmacist can tell you what to do next. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil). ### [Storing your pen](https://jabwise.app/guides/storing-your-pen) In the fridge, at 2 to 8°C, say the Mounjaro, Wegovy and Ozempic leaflets; Zepbound’s label also allows its KwikPen at room temperature, up to 30°C, for up to 30 days. All four say never freeze it, or use a pen that has been frozen. Wegovy and Ozempic add keep it from the cooling element, with the cap on. Markdown: https://jabwise.app/guides/storing-your-pen/index.md In their own words Where to keep each pen before it’s started, and what each says about freezing, quoted as written. How long a started one keeps is in how long a pen lasts. - **Mounjaro**: Where to keep it: In a refrigerator, 2 to 8°C; Freezing: "Do not freeze. If the pen has been frozen, DO NOT USE." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound KwikPen**: Where to keep it: "Store multi-dose vial or single-patient-use KwikPen in the refrigerator between 36°F to 46°F (2°C to 8°C) or at room temperature [up to 86°F (30°C)]. Throw away the multi-dose vial or single-patient-use KwikPen after a total of 30 days at room temperature, 30 days after first use, or after taking 4 weekly doses, even if it still has medicine in it." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Freezing: "Do not freeze ZEPBOUND. Do not use ZEPBOUND if frozen." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Zepbound single-dose pen**: Where to keep it: "Store single-dose pen and single-dose vial in the refrigerator between 36°F to 46°F (2°C to 8°C). If needed, each single-dose pen or single-dose vial can be stored at room temperature up to 86°F (30°C) for up to a total of 21 days." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Freezing: "Do not freeze ZEPBOUND. Do not use ZEPBOUND if frozen." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Where to keep it: "Store in a refrigerator (2°C to 8°C). Keep away from the cooling element." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Freezing: "Do not freeze wegovy® and do not use it if it has been frozen." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Where to keep it: "Store in a refrigerator (2 °C–8 °C)." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Freezing: "Do not freeze Ozempic® and do not use it if it has been frozen." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # Also in the leaflets - **Not by the cooling element**: Before first use, Wegovy and Ozempic say keep pens in the fridge, away from the cooling element, and never frozen. - **Cap on**: Wegovy’s and Ozempic’s leaflets both say keep the pen cap on, in order to protect the medicine inside from light. - **Cloudy or discoloured**: Before use, Mounjaro’s leaflet says don’t use it if the medicine is cloudy, discoloured or has any particles in it. - **Not in the bin**: Not down the sink or in household waste: the UK leaflets say ask your pharmacist how to throw away medicines. **What if my pen was frozen?** All four say don’t use it. Zepbound’s label adds, for its single-dose pen, throw the pen away and use a new pen. **Can a pen be out of the fridge once I’ve started it?** Yes, within each brand’s limit. Wegovy and Ozempic say up to 6 weeks below 30°C or in the fridge; Mounjaro says unrefrigerated, not above 30°C, for up to 30 days after first use; Zepbound’s KwikPen, a total of 30 days at room temperature, 30 days after first use, or 4 weekly doses, whichever comes first. **Do I need to warm it up before injecting?** Zepbound’s label says, for its single-dose pen, it is not necessary to warm the pen to room temperature. The other leaflets don’t say. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil). ### [How the doses step up](https://jabwise.app/guides/how-the-doses-step-up) Slowly, each starting on a low dose for 4 weeks. Mounjaro and Zepbound start at 2.5mg a week for 4 weeks, then 5mg, and may go up in 2.5mg steps, at least 4 weeks on each, to as much as 15mg. Wegovy starts at 0.25mg and rises every 4 weeks to 2.4mg from week 17. Your prescriber decides each step. Markdown: https://jabwise.app/guides/how-the-doses-step-up/index.md In their own words Each leaflet’s start and the steps after it, quoted as written. - **Mounjaro**: Starts on: "The starting dose is 2.5 mg once a week for four weeks." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Then: "After four weeks your doctor will increase your dose to 5 mg once a week." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Starts on: "The recommended starting dosage is 2.5 mg injected subcutaneously once weekly for 4 weeks." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Then: "Increase the dosage in 2.5 mg increments after at least 4 weeks until recommended maintenance dosage is achieved." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Starts on: "When you first start using wegovy®, the starting dose is 0.25 mg once weekly." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Then: "Your doctor will instruct you to gradually increase your dose every 4 weeks until you reach the dose of 2.4 mg once weekly." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Starts on: "The starting dose is 0.25 mg once a week for four weeks." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Then: "After four weeks your doctor will increase your dose to 0.5 mg once a week." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # Wegovy, week by week The table in Wegovy’s leaflet for weight management. 7.2mg is for adults with obesity, if needed, and is three 2.4mg injections on the same day. - **Weeks 1 to 4**: Weekly dose: 0.25mg - **Weeks 5 to 8**: Weekly dose: 0.5mg - **Weeks 9 to 12**: Weekly dose: 1mg - **Weeks 13 to 16**: Weekly dose: 1.7mg - **From week 17**: Weekly dose: 2.4mg - **From week 21**: Weekly dose: 7.2mg, if needed ## Worth knowing - **At least 4 weeks a step**: Mounjaro’s leaflet and Zepbound’s label both say at least 4 weeks on one dose before moving to a higher one. - **Not every step**: Your doctor may go higher if needed, Mounjaro’s says. Zepbound’s weight maintenance doses: 5, 10 or 15mg. - **Your doctor’s call**: Mounjaro’s and Ozempic’s leaflets say not to change your dose unless your doctor has told you to do so. **Do I have to go up to the top dose?** Mounjaro’s leaflet says your doctor may increase your dose if you need it, and Zepbound’s label lists 5mg, 10mg or 15mg as maintenance doses for weight reduction. Wegovy’s leaflet steps up to 2.4mg, with 7.2mg only if needed. Your prescriber decides. **Can I go up faster?** Mounjaro and Zepbound say at least 4 weeks on each dose, and Wegovy steps up every 4 weeks. Mounjaro’s and Ozempic’s leaflets say not to change your dose unless your doctor has told you to do so. **What is Wegovy 7.2mg?** A higher dose in Wegovy’s leaflet for adults with obesity, if needed, after at least 4 weeks on 2.4mg. The leaflet says it is three 2.4mg injections, one after another on the same day. **How does Ozempic step up?** From 0.25mg for four weeks to 0.5mg. Its leaflet says your doctor may go to 1mg, then 2mg, if your blood sugar is not controlled well enough on the dose before. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil). ### [Wegovy 7.2mg: three injections](https://jabwise.app/guides/wegovy-7-2mg) It’s Wegovy’s highest dose, for adults with obesity if needed, after at least 4 weeks on 2.4mg. The leaflet says it is three 2.4mg injections, one after another on the same day: in the same body area if you like, but at least 5cm apart, with a new needle each time and enough pens to finish before you start. Markdown: https://jabwise.app/guides/wegovy-7-2mg/index.md In the leaflet’s words Wegovy’s leaflet on the 7.2mg dose, line by line, quoted as written. - **The dose**: Wegovy’s leaflet: "For the wegovy® 7.2 mg weight management dose you will need to inject three doses of 2.4 mg, one after each other on the same day." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Where**: Wegovy’s leaflet: "the injections can be given in the same body area but should be at least 5 cm apart." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Needles**: Wegovy’s leaflet: "you must change the needle between each dose." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Pens**: Wegovy’s leaflet: "you may need to use multiple pens. Do not discard the pen until it is empty. Partially used pens must be stored in the fridge with the needle removed." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Supply**: Wegovy’s leaflet: "make sure you have a sufficient supply of pens to complete your dose before you start injecting." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) # Worth knowing - **Only if needed**: If it’s needed, the Wegovy leaflet says, a step up to 7.2mg can be made after a minimum of 4 weeks on 2.4mg. - **Adults with obesity**: Wegovy 7.2mg is for adults with obesity. For adolescents, the leaflet says doses above 2.4mg are not recommended. - **Side effects at 7.2mg**: The Wegovy leaflet says hair loss and changed skin sensation may happen more frequently with the 7.2mg dose. - **Pens run out sooner**: A 2.4mg pen holds 4 doses, and a 7.2mg dose is three injections on one day, so a pen no longer lasts 4 weeks. **Can all three go in the same area?** Yes, the leaflet says, as long as each injection is at least 5cm from the others. **Do I need a new needle each time?** Yes. The leaflet says always use a new needle for each injection, including between the three injections for 7.2mg. **What if a pen runs out partway through the three?** The leaflet says you may need more than one pen, not to throw a pen away until it’s empty, and to keep a partly used pen in the fridge with the needle removed. If the dose counter stops before your full dose, it says there isn’t enough left: dispose of the pen and use a new one. Sources: [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil). ### [Changing your injection day](https://jabwise.app/guides/changing-your-injection-day) Yes, as long as it’s been at least 3 days since your last injection. Mounjaro’s, Wegovy’s and Ozempic’s leaflets all say so, Zepbound’s label puts it as at least 3 days (72 hours) between two doses, and the NHS agrees. After the change, the UK leaflets say carry on once a week on the new day. Markdown: https://jabwise.app/guides/changing-your-injection-day/index.md Count the days Pick your last jab day and the day you’d like, and it counts the days until the new day comes round. Under 3, a pharmacist or your prescriber can say how to move it. # In their own words Each leaflet’s rule for a new day, quoted as written. - **Mounjaro**: Changing the day: "If necessary, you can change the day of your weekly Mounjaro injection, as long as it has been at least 3 days since your last injection." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Changing the day: "You may change the day of the week you use ZEPBOUND as long as the time between the 2 doses is at least 3 days (72 hours)." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Changing the day: "If necessary, you can change the day of your weekly injection of this medicine as long as it has been at least 3 days since your last injection." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Changing the day: "If necessary you can change the day of your weekly injection of this medicine as long as it has been at least 3 days since your last injection of it." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) ## Staying on track - **Same day each week**: Mounjaro’s, Wegovy’s and Ozempic’s leaflets each ask you to use it on the same day every week, where you can. - **Any time of day**: The Mounjaro, Wegovy and Ozempic leaflets and Zepbound’s label all say any time of day, with or without food. - **Noting the day**: Ozempic’s leaflet suggests noting your chosen weekday on the carton, and writing down the date each time you inject. - **Never two close together**: Zepbound’s label says 2 doses must be at least 3 days (72 hours) apart, even when you’re changing your day. **What if my new day is less than 3 days away?** The leaflets only set the minimum of 3 days. A pharmacist or your prescriber can say how to move to the day you want. **Is it 3 days or 72 hours?** Mounjaro, Wegovy and Ozempic say 3 days. Zepbound’s label puts it as at least 3 days (72 hours) between the two doses. **Does the time of day matter?** Each says you can inject at any time of day, with or without food. What matters is the gap: at least 3 days, or 72 hours on Zepbound’s label. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [How to take Rybelsus tablets](https://jabwise.app/guides/taking-rybelsus-tablets) As soon as you wake up, the NHS says. The Rybelsus leaflets say on an empty stomach after at least 8 hours’ fasting, swallowed whole with a sip of water, up to 120ml, then wait at least 30 minutes before eating, drinking or other medicines by mouth. One tablet a day, and they say skip a missed one. Markdown: https://jabwise.app/guides/taking-rybelsus-tablets/index.md In their own words The leaflet and the NHS on each part of the morning, quoted as written. The NHS adds when to take them: as soon as you wake up, after at least 8 hours without food. - **Before**: Rybelsus leaflet: "Take your Rybelsus® tablet on an empty stomach after a recommended fasting period of at least 8 hours." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)); NHS: "do not eat anything for at least 8 hours before you take semaglutide" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) - **Taking it**: Rybelsus leaflet: "Swallow your Rybelsus® tablet whole with a sip of water (up to 120 mL)." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)); NHS: "swallow tablets whole with half a glass of water (up to 120ml)" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) - **After**: Rybelsus leaflet: "After taking your Rybelsus® tablet wait at least 30 minutes before eating, drinking or taking other oral medicines." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)); NHS: "wait at least 30 minutes before eating, drinking or taking other medicines" ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) # Two sets of strengths Rybelsus comes as 1.5, 4 and 9mg round tablets, or 3, 7 and 14mg oval ones, each set with its own leaflet. Both start on the lowest strength for a month. - **1.5, 4 and 9mg**: Starts on: "The starting dose is one 1.5 mg tablet once a day for one month." ([Rybelsus 1.5, 4 and 9mg patient leaflet](https://www.medicines.org.uk/emc/product/101229/pil)); Then: "After one month, your doctor will increase your dose to one 4 mg tablet once a day." ([Rybelsus 1.5, 4 and 9mg patient leaflet](https://www.medicines.org.uk/emc/product/101229/pil)) - **3, 7 and 14mg**: Starts on: "The starting dose is one 3 mg tablet once a day for one month." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)); Then: "After one month, your doctor will increase your dose to one 7 mg tablet once a day." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) ## Also in the leaflets - **One a day**: Always just one tablet a day, the Rybelsus leaflets say: never take two tablets to get the effect of a higher dose. - **Whole**: The Rybelsus leaflets say swallow it whole and don’t split, crush or chew it, as it isn’t known if that affects absorption. - **Why the wait**: The leaflets say waiting less than 30 minutes before eating or drinking lowers the absorption of semaglutide. - **On levothyroxine?**: If you also take levothyroxine for your thyroid, the leaflets say your doctor may need to check your thyroid levels. **What if I forget a tablet?** The leaflets say skip the missed dose and just take your normal dose the next day. The NHS says don’t take 2 doses at the same time to make up for a missed one. **Can I take it with coffee?** The leaflets say swallow it with a sip of water, up to 120ml, then wait at least 30 minutes before eating, drinking or taking other medicines by mouth. **Are the round and oval tablets the same?** Both are Rybelsus, but the strengths differ: 1.5, 4 and 9mg round tablets, or 3, 7 and 14mg oval ones. The leaflets say your doctor will prescribe the strength that is right for you. Sources: [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [Rybelsus 1.5, 4 and 9mg patient leaflet](https://www.medicines.org.uk/emc/product/101229/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [How a weekly jab builds up](https://jabwise.app/guides/how-a-weekly-jab-builds-up) Over about a month. Mounjaro’s product information says its level settles after 4 weeks of weekly doses, and Ozempic’s says 4 to 5. Both peak within a few days of each jab, then fade slowly, so the next lands before the last has gone and the level climbs in steps. Ozempic’s stays about 5 weeks after a last dose. Markdown: https://jabwise.app/guides/how-a-weekly-jab-builds-up/index.md See it build Drawn from the published models Jabwise uses, for the same dose on time every week. It shows the shape of a build-up, not your own level: bodies and doses differ. # In their own words From each medicine’s product information, written for prescribers. - **Mounjaro**: Peak after a dose: "reached 8 to 72 hours post dose" ([Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc)); Half-life: "elimination half-life of approximately 5 days" ([Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc)); Settled after: "4 weeks of once weekly administration" ([Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc)) - **Ozempic**: Peak after a dose: "reached 1 to 3 days post dose" ([Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc)); Half-life: "elimination half-life of approximately 1 week" ([Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc)); Settled after: "4–5 weeks of once weekly administration" ([Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc)) - **Wegovy**: Peak after a dose: Not stated; Half-life: "prolonged half-life of around 1 week" ([Wegovy product information (SmPC)](https://www.medicines.org.uk/emc/product/102093/smpc)); Settled after: Not stated ## What the numbers say - **A few days to peak**: 8 to 72 hours after a Mounjaro dose, and 1 to 3 days after an Ozempic dose, their product information says. - **A month to settle**: Mounjaro settles after 4 weeks of weekly doses, and Ozempic after 4 to 5, their product information says. - **Weeks to leave**: Their product information says about 5 weeks after a last Ozempic dose, 7 after a last 2.4mg Wegovy dose. **Why does a weekly jab build up?** Each dose fades slowly. Tirzepatide’s half-life is approximately 5 days and semaglutide’s about 1 week, so some of last week’s dose is still there when the next one goes in. **How long does it stay after a last dose?** Ozempic’s product information says semaglutide will be present for about 5 weeks after the last dose, and Wegovy’s says approximately 7 weeks after the last 2.4mg dose. If you’re thinking of stopping, the NHS says talk to your doctor and don’t stop suddenly. **Is the chart my actual level?** No. It’s an estimate from published models of how these medicines behave on average. Jabwise draws the same estimate from your own logged doses, and labels it as one. Sources: [Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc), [Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc), [Wegovy product information (SmPC)](https://www.medicines.org.uk/emc/product/102093/smpc), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Drinking enough when you feel sick](https://jabwise.app/guides/drinking-enough) Being sick and diarrhoea can dehydrate you, as every leaflet and label here says. Mounjaro’s says drink plenty of fluids; Wegovy’s and Ozempic’s add this is especially important with kidney problems. None gives an amount. Zepbound’s label says tell your healthcare provider right away if it doesn’t go away. Markdown: https://jabwise.app/guides/drinking-enough/index.md In their own words Why each leaflet raises it, and what it asks you to do, quoted as written. - **Mounjaro**: Why: "When starting treatment with Mounjaro, in some cases you may experience loss of fluids/dehydration, e.g. due to vomiting, nausea and/or diarrhoea, which may lead to a decrease in kidney function." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); What to do: "It is important to avoid dehydration by drinking plenty of fluids." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: Why: "Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); What to do: "It is important for you to drink fluids to help reduce your chance of dehydration." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **Wegovy**: Why: "These side effects can cause dehydration (loss of fluids)." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); What to do: "It is important that you drink enough fluids to prevent dehydration." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: Why: "These side effects can cause dehydration (loss of fluids)." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); What to do: "It is important that you drink plenty of fluids to prevent dehydration." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) # What else they say - **Early on**: Mounjaro’s leaflet says that, in some cases, fluids can be lost when you start treatment, through sickness or diarrhoea. - **Kidney problems**: Wegovy and Ozempic say drinking enough fluids to avoid dehydration matters especially if you have kidney problems. - **When it won’t stop**: Zepbound’s label says tell your healthcare provider right away about nausea, vomiting or diarrhoea that does not go away. - **No set amount**: None of the leaflets, nor Zepbound’s label, gives a set number of glasses or litres to drink. A pharmacist can help. **How much should I drink?** The leaflets don’t give an amount. Mounjaro’s and Ozempic’s say plenty of fluids, and Wegovy’s says enough. A pharmacist can help if you’re not sure. **Does it have to be water?** The leaflets say fluids, not water in particular. On alcohol, the NHS says it can increase side effects like feeling or being sick, so it’s best not to drink it. **When should I get help?** The NHS says to speak to a pharmacist or doctor if you have side effects that bother you or do not go away. Zepbound’s label says tell your healthcare provider right away if nausea, vomiting or diarrhoea does not go away. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Food, drink and alcohol](https://jabwise.app/guides/food-drink-and-alcohol) Mounjaro’s and Wegovy’s leaflets say they make you feel less hungry, and pair them with a reduced-calorie diet and more activity. The NHS says you’ll need a healthy, balanced diet, and that it’s best not to drink alcohol, as it can increase feeling or being sick. Markdown: https://jabwise.app/guides/food-drink-and-alcohol/index.md In their own words How each source describes the effect on appetite, and the diet it pairs with. - **Mounjaro**: Appetite: "Mounjaro primarily works by regulating your appetite, giving you a sense of satiety (‘fullness’), making you feel less hungry and experience less food cravings." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Diet alongside: "Mounjaro is also used together with reduced-calorie diet and increased physical activity for weight loss" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: Appetite: "wegovy® works by acting on receptors in the brain that control your appetite, causing you to feel fuller and less hungry and experience less craving for food." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Diet alongside: "wegovy® should be used with a reduced calorie meal plan and increased physical activity." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **NHS**: Appetite: "Tirzepatide works for weight loss by reducing your appetite and helping you feel fuller for longer." ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)); Diet alongside: "You'll need to eat a healthy, balanced diet while using semaglutide." ([NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/)) # Meals and drinks - **With or without food**: Mounjaro, Zepbound, Wegovy and Ozempic can each be injected at any time, with or without food, their leaflets and label say. - **Tablets are different**: Rybelsus’s leaflet says fast at least 8 hours first, then wait at least 30 minutes before food, drink or oral medicines. - **Alcohol**: The NHS says it’s best not to drink alcohol while you use it, as it can increase side effects like feeling or being sick. - **Fluids when you’re sick**: If you’re sick or have diarrhoea, Mounjaro’s, Wegovy’s and Ozempic’s leaflets say drink fluids to prevent dehydration. **Can I drink alcohol on Mounjaro?** The NHS says it’s best to avoid drinking alcohol while using tirzepatide, because it can increase side effects like feeling or being sick. **Why do I feel less hungry?** Mounjaro’s leaflet says it works by regulating your appetite and making you feel less hungry, and Wegovy’s says much the same. **Is there a set diet?** None of the sources sets one. Mounjaro’s and Wegovy’s leaflets pair them with a reduced-calorie diet and more physical activity, and the NHS says you’ll need a healthy, balanced diet. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Driving on a GLP-1](https://jabwise.app/guides/driving-on-a-glp-1) The UK leaflets each say it’s unlikely to affect your driving. If you feel dizzy or have vision problems, the NHS says don’t drive, ride a bike or use machinery until they’ve gone. If you also take a sulfonylurea or insulin, the leaflets say avoid driving, or don’t drive, with any signs of low blood sugar. Markdown: https://jabwise.app/guides/driving-on-a-glp-1/index.md In their own words From each leaflet’s driving section, quoted as written. The low blood sugar line is for people who also take a sulfonylurea or insulin for diabetes. - **Mounjaro**: On driving: "It is unlikely that this medicine will affect your ability to drive and use machines." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); With low blood sugar: "Avoid driving or using machines if you get any signs of low blood sugar, e.g. headache, drowsiness, weakness, dizziness, feeling hungry, confusion, irritability, fast heartbeat and sweating" ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: On driving: "wegovy® is unlikely to affect your ability to drive and use machines. Some patients may feel dizzy when taking wegovy® mainly during the first 3 months of treatment (see section 4). If you feel dizzy you should not drive or operate machines until you feel better." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); With low blood sugar: "Do not drive or use machines if you get any signs of low blood sugar." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: On driving: "Ozempic® is unlikely to affect your ability to drive and use machines." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); With low blood sugar: "Do not drive or use machines if you get any signs of low blood sugar." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Rybelsus**: On driving: "Rybelsus® is unlikely to affect your ability to drive and use machines. Some patients may feel dizzy when taking Rybelsus®. If you feel dizzy, be extra careful while driving or using machines." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)); With low blood sugar: "Do not drive or use machines if you get any signs of low blood sugar." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) # What the NHS adds - **Dizzy or vision problems**: If you feel dizzy or have vision problems, the NHS says don’t drive, ride a bike or use machinery until they’ve gone. - **Low blood sugar signs**: The NHS tirzepatide page lists headaches, vision problems, feeling dizzy, weak or confused, a fast heartbeat or sweating. - **Other diabetes medicines**: The NHS semaglutide and tirzepatide pages both say low blood sugar is more likely with other diabetes medicines. - **Taken too much?**: If you’ve taken too much and are told to go to A&E, the NHS says don’t drive: ask someone to drive you, or call 999. **Can I drive after my injection?** Mounjaro’s, Wegovy’s and Ozempic’s leaflets say they are unlikely to affect your ability to drive. The NHS says don’t drive if you feel dizzy or have vision problems, until they’ve gone. **When is dizziness most likely?** Wegovy’s leaflet says mainly during the first 3 months of treatment. The other leaflets don’t say. **What are the signs of low blood sugar?** Mounjaro’s leaflet lists headache, drowsiness, weakness, dizziness, feeling hungry, confusion, irritability, fast heartbeat and sweating. The leaflet’s driving advice applies if you also take a sulfonylurea or insulin. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Contraception and pregnancy](https://jabwise.app/guides/contraception-and-pregnancy) Only Mounjaro and Zepbound mention the pill. For women with obesity or overweight, Mounjaro’s suggests a barrier method or a switch for 4 weeks after starting and after each increase; Zepbound’s label, the same 4 weeks. Planning a baby? Wegovy and Ozempic say stop 2 months before; the NHS, 4 weeks for tirzepatide. Markdown: https://jabwise.app/guides/contraception-and-pregnancy/index.md Tirzepatide and the pill Mounjaro and Zepbound are tirzepatide. Each source in its own words. - **Mounjaro**: What it says: "If you are a woman with obesity or overweight and are using oral contraceptives, you should consider also using a barrier method of contraception (e.g., a condom) or switching to a non-oral contraceptive method for 4 weeks after starting Mounjaro and for 4 weeks after each increase in dose." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Zepbound**: What it says: "If you take birth control pills by mouth, your healthcare provider may recommend another type of birth control for 4 weeks after you start ZEPBOUND and for 4 weeks after each increase in your dose of ZEPBOUND." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)) - **NHS**: What it says: "It’s important to use an additional barrier contraception, such as condoms, a diaphragm or cap for 4 weeks after starting tirzepatide, and for 4 weeks after each dose increase." ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) # How the weeks add up If a dose goes up every 4 weeks, the windows run into each other. In the picture, 2.5mg from week 1 and 5mg from week 5 cover weeks 1 to 8. They end 4 weeks after the last increase. That’s counting on the leaflet’s wording, an example rather than your own dates. A pharmacist or your prescriber can tell you which method suits you. ## Pregnancy Each medicine’s words on when to stop before trying for a baby. - **Mounjaro**: During pregnancy: "This medicine should not be used during pregnancy as the effects of this medicine on an unborn child are not known." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Planning a baby: "If you want to become pregnant, you should stop using tirzepatide at least 4 weeks before you start trying." ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Zepbound**: During pregnancy: "ZEPBOUND may harm your unborn baby." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Planning a baby: "If you want to become pregnant, you should stop using tirzepatide at least 4 weeks before you start trying." ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Wegovy**: During pregnancy: "This medicine should not be used during pregnancy, as it is not known if it may affect your unborn child." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Planning a baby: "If you wish to become pregnant, you should stop using this medicine at least two months in advance." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: During pregnancy: "This medicine should not be used during pregnancy, as it is not known if it affects an unborn baby." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Planning a baby: "If you wish to become pregnant, discuss how to change your treatment with your doctor as you should stop using this medicine at least 2 months in advance." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) ### Also in the leaflets - **While you use it**: Mounjaro’s, Wegovy’s and Ozempic’s leaflets all recommend using contraception while you use them. - **If you become pregnant**: Wegovy’s and Ozempic’s leaflets say talk to your doctor straight away, as treatment will need to stop or change. - **Breastfeeding**: Wegovy and Ozempic say not to use them while breastfeeding; Mounjaro’s leaflet says talk to your doctor first. **Does semaglutide affect the pill?** Neither the Wegovy nor the Ozempic leaflet mentions the pill. Both recommend contraception while you use them, and the NHS says you’ll need it if there’s a chance you could get pregnant. **What if I don’t take the pill?** Mounjaro’s leaflet and Zepbound’s label tie the 4 weeks to the pill. The NHS tirzepatide page asks for additional barrier contraception for the same weeks without naming the pill. A pharmacist or your prescriber can say which applies to you. **Is it the same for Mounjaro and Zepbound?** Largely. Both give 4 weeks after starting and after each increase for the pill, but Mounjaro’s leaflet says it for women with obesity or overweight. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/). ### [What to tell your doctor](https://jabwise.app/guides/what-to-tell-your-doctor) The leaflets list what to raise before you start: pancreatitis, a stomach that empties slowly, diabetic eye disease, insulin or a sulfonylurea, and any surgery where you’ll be put to sleep. Pregnancy is on every list. During treatment, Wegovy and Ozempic say contact your doctor urgently about a sudden loss of vision. Markdown: https://jabwise.app/guides/what-to-tell-your-doctor/index.md Before you start One leaflet’s words for each, and which of the four list it. - **Pancreatitis**: In a leaflet’s words: "If you have ever had pancreatitis (inflammation of the pancreas) which may cause severe pain in the stomach and back which does not go away" ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)); Listed by: All four - **Slow stomach emptying**: In a leaflet’s words: "If you have slow (delayed) stomach emptying (called gastroparesis), use of Ozempic® may lead to serious or severe gastrointestinal adverse events." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Listed by: All four - **Diabetic eye disease**: In a leaflet’s words: "you have a problem with your eyes (diabetic retinopathy or macular oedema)." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Listed by: All four - **Diabetes medicines**: In a leaflet’s words: "Tell your healthcare provider if you are taking medicines to treat diabetes including an insulin or sulfonylurea." ([Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html)); Listed by: All four - **Surgery**: In a leaflet’s words: "If you know that you are due to have surgery where you will be under anaesthesia (sleeping), please tell your doctor that you are using Mounjaro." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Listed by: All four - **Pregnancy**: In a leaflet’s words: "If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)); Listed by: All four - **Other medicines**: In a leaflet’s words: "Tell your doctor, pharmacist or nurse if you are taking, have recently taken or might take any other medicines, including herbal medicines or other medicines you bought without a prescription." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)); Listed by: All four # During treatment - **A sudden change in sight**: Wegovy and Ozempic say to contact your doctor urgently about a sudden loss of vision or fast-worsening eyesight. - **Surgery or the dentist**: The NHS says to tell the healthcare professional that you’re using it before you have a general anaesthetic or a sedative. - **Lasting stomach trouble**: Zepbound’s label says tell your healthcare provider about stomach problems that are severe or will not go away. - **Too much by mistake**: If you use too much, Mounjaro’s leaflet says talk to your doctor immediately. The NHS says get help from NHS 111. **Do I need to tell the dentist?** The NHS lists a general anaesthetic or a sedative for an operation or dental procedure, and says to tell the healthcare professional that you’re using it. **Why does surgery matter?** Zepbound’s label says it may increase the chance of food getting into your lungs during surgery or other procedures. Mounjaro’s, Wegovy’s and Ozempic’s leaflets ask you to tell your doctor if you’re due to have surgery under anaesthesia. **Is this the full list?** No. It’s the items all four list. The leaflet in your own box has the full list, and a pharmacist can check anything else you take. Sources: [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Zepbound prescribing information](https://uspl.lilly.com/zepbound/zepbound.html), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/). ### [Stopping or taking a break](https://jabwise.app/guides/stopping-or-pausing) Talk to your doctor first, say the NHS and the leaflets. The NHS adds don’t stop suddenly, and your doctor may suggest reducing your dose gradually. Mounjaro’s, Wegovy’s and Ozempic’s leaflets say not to stop without talking to your doctor, and with type 2 diabetes, Mounjaro’s and Ozempic’s say blood sugar can rise. Markdown: https://jabwise.app/guides/stopping-or-pausing/index.md In their own words What each source says about stopping, quoted as written. - **NHS**: On stopping: "Talk to your doctor if you want to stop using tirzepatide, and do not stop suddenly." ([NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/)) - **Mounjaro**: On stopping: "Do not stop using Mounjaro without talking with your doctor. If you stop using Mounjaro, and you have type 2 diabetes, your blood sugar levels can increase." ([Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil)) - **Wegovy**: On stopping: "Do not stop using this medicine without talking to your doctor." ([Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil)) - **Ozempic**: On stopping: "Do not stop using this medicine without talking to your doctor. If you stop using it, your blood sugar levels may increase." ([Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil)) - **Rybelsus**: On stopping: "Do not stop using this medicine without talking to your doctor. If you stop using it, your blood sugar levels may increase." ([Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil)) # After a last dose How long semaglutide stays after a last dose, per its product information. - **Ozempic**: After the last dose: "With an elimination half-life of approximately 1 week, semaglutide will be present in the circulation for about 5 weeks after the last dose." ([Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc)) - **Wegovy**: After the last dose: "With an elimination half-life of approximately 1 week, semaglutide will be present in the circulation for approximately 7 weeks after the last dose of 2.4 mg." ([Wegovy product information (SmPC)](https://www.medicines.org.uk/emc/product/102093/smpc)) ## Worth knowing - **Gradually, perhaps**: If you want to stop, the NHS says talk to your doctor first; they may suggest reducing your dose gradually. - **Blood sugar**: If you have type 2 diabetes, the NHS says stopping could affect your blood sugar. It says don’t stop suddenly. - **Missed more than one jab?**: The NHS semaglutide page says contact your doctor for advice if you miss more than one of your weekly injections. - **Planning a baby**: Wegovy and Ozempic say stop at least 2 months before trying for a baby; the NHS says 4 weeks for tirzepatide. **Can I just stop?** The NHS says talk to your doctor if you want to stop, and do not stop suddenly. Mounjaro’s, Wegovy’s and Ozempic’s leaflets say not to stop without talking to your doctor. **How do I start again after a break?** The patient leaflets don’t cover it. Wegovy’s product information for prescribers says that if more doses are missed, reducing the starting dose for re-initiation should be considered. The NHS semaglutide page says contact your doctor if you miss more than one injection. **Does Mounjaro stay as long?** Its product information gives a half-life of approximately 5 days, against about a week for semaglutide, but doesn’t say how many weeks it stays after a last dose. Sources: [NHS: Semaglutide](https://www.nhs.uk/medicines/semaglutide/), [NHS: Tirzepatide](https://www.nhs.uk/medicines/tirzepatide/), [Mounjaro KwikPen patient leaflet](https://www.medicines.org.uk/emc/product/15481/pil), [Wegovy FlexTouch patient leaflet](https://www.medicines.org.uk/emc/product/13800/pil), [Ozempic patient leaflet](https://www.medicines.org.uk/emc/product/9748/pil), [Rybelsus 3, 7 and 14mg patient leaflet](https://www.medicines.org.uk/emc/product/11507/pil), [Ozempic product information (SmPC)](https://www.medicines.org.uk/emc/product/9750/smpc), [Wegovy product information (SmPC)](https://www.medicines.org.uk/emc/product/102093/smpc), [Mounjaro product information (SmPC)](https://www.medicines.org.uk/emc/product/15481/smpc). ## Pages - [Home](https://jabwise.app/): the product page - [Guides](https://jabwise.app/guides): practical GLP-1 guides, each checked against its sources - [Support](https://jabwise.app/support): help, backups and restoring - [Privacy Policy](https://jabwise.app/privacy) - [Terms of Use](https://jabwise.app/terms)