GLP-1 Medication Patient Guide
Your provider has prescribed a GLP-1 receptor agonist medication (semaglutide or tirzepatide) as part of your metabolic treatment plan. This guide covers what to expect, how to use your medication, and how to manage the most common side effects. Read it before your first injection.
You may see compounded versions of semaglutide or tirzepatide advertised online or offered by clinics. Compounded versions are not FDA approved. Talk to your medical provider before using one.
What This Medication Does
• Reduces food noise, the constant background preoccupation with food that many people experience.
• Helps you feel full faster and stay satisfied for longer after meals.
• Slows digestion, which reduces post-meal blood sugar spikes.
• In the pancreas: stimulates insulin release only when blood sugar is elevated, not at normal glucose levels. On its own, this medication rarely causes low blood sugar. If you also take insulin or a sulfonylurea such as glipizide or glimepiride, low blood sugar becomes a real risk and your provider may need to change those doses. Ask about this before your first injection.
• In the brain: acts on appetite centers to reduce hunger signals.
How to Inject Your Medication, Step by Step
• Wash your hands thoroughly with soap and water.
• Choose your injection site: abdomen (2 inches from the belly button), outer thigh, or back of upper arm.
• Wipe the site with an alcohol pad and let it dry completely.
• Pinch the skin gently between your thumb and fingers.
• Insert the needle at a 90-degree angle in one smooth motion.
• Push the plunger and keep the needle in the skin until the full dose is delivered. Follow the timing and dose counter or indicator in the Instructions for Use that came with your pen, because this differs between products.
• Remove the needle and dispose of it immediately in a sharps container.
• Rotate your injection site every week; do not inject in the same spot repeatedly.
Storage
• Unopened pens: keep refrigerated at 36 to 46 degrees Fahrenheit. Do not freeze. Do not leave in a hot car.
• Once in use: follow the room-temperature window and temperature range in the Instructions for Use for your specific pen. Semaglutide and tirzepatide differ on both, so use the instructions for the product you were prescribed rather than a general rule.
Managing the Most Common Side Effects
Nausea: Eat slowly and stop before you feel full. Avoid fried, fatty, or spicy foods. Try ginger tea or ginger chews. Cold or room-temperature foods are often better tolerated. If prescribed, take ondansetron as directed.
Constipation: Do not go more than 2 days without a bowel movement before calling your provider. Drink 80 to 100 oz of water daily, take a fiber supplement such as psyllium husk or methylcellulose, and take magnesium citrate 400 mg at bedtime. If no bowel movement after 2 days, contact your provider.
Heartburn or reflux: Eat smaller meals. Stop eating at least 3 hours before bed. Elevate the head of your bed by 4 to 6 inches. Your provider may recommend an antacid for short-term use.
Fatigue: Check that you are meeting the daily intake and protein target your provider set for you, and add electrolytes if you are eating much less than usual. Fatigue can also come from dehydration, low blood sugar if you take insulin or a sulfonylurea, or something unrelated to this medication. Contact your provider if fatigue is new, severe, or persistent.
The Three Things Your Provider Requires Alongside This Medication
1. Protein target: _____ grams per day, minimum _____ grams per meal, set by your provider. Protein comes before the calorie deficit, not after it. Your provider should check your kidney function before setting a protein target above the usual daily requirement.
2. Resistance training: _____ sessions per week. This protects your muscle while you lose fat.
3. Bowel protocol: 80 to 100 oz water daily plus a fiber supplement daily, from day one.
Safety and Referral
1. Before you start, tell your provider if you or a close family member has had medullary thyroid cancer or multiple endocrine neoplasia type 2; if you are pregnant, breastfeeding, or planning a pregnancy; and every other medicine you take, especially insulin or a sulfonylurea. Relative Contraindications; history of pancreatitis, gastroparesis, gallbladder disease, and severe renal impairment eGFR <15.
2. Call your provider if you experience severe or persistent abdominal pain that radiates to your back; no bowel movement for 2 or more days despite the bowel protocol; vomiting that prevents you from keeping fluids down for more than 24 hours; signs of dehydration; shakiness, sweating, confusion, or a fast heartbeat that eases after you eat; or a lump or swelling in your neck or throat.