What to expect once you start your GLP-1 medication.
This guide is for PropPilot patients who have already completed their consultation and been approved for treatment. It covers what to expect in the first few weeks, common side effects, when to reach your prescriber, and how to keep doses on track so the medication can do its job.
After your consult
What to expect after your consult
What happens after your consult is approved
Once your board-certified physician completes your consult and approves you for therapy, a care coordinator finalises your prescription and sends it to the dispensing pharmacy. You will receive a confirmation message with your dose, your pharmacy details, and your first scheduled check-in. Most patients hear back within one business day of their consult.
When to expect your first shipment
Your medication ships from a licensed U.S. pharmacy, typically within 2–5 business days of your prescription being finalised. Tracking information is sent to the email on file as soon as it is available. If your physician has flagged pharmacy prior-authorisation requirements, expect an extra 1–3 business days while your insurer or pharmacy benefit manager reviews the prescription.
How titration works
You will not start at the highest dose. Your physician will prescribe a low starting dose and step it up gradually over the first 4–8 weeks (called titration). This lets your body adjust to the medication and significantly lowers the risk and severity of GI side effects. Your dosing schedule is sent in the confirmation message, and each new dose is prescribed only after your check-in.
How follow-ups are scheduled
Routine follow-ups happen at roughly 4, 8, and 12 weeks during titration, and quarterly once a maintenance dose is reached. Your prescriber uses these check-ins to titrate, monitor side effects, and adjust the plan if needed. You can request an additional check-in at any time through the patient portal — see the /track page for the portal link.
Side effects
Common side effects — and when to call your prescriber
Most GLP-1 side effects are mild, expected, and fade as your body adjusts to the medication during titration. The list below covers what is normal and self-limiting. The Call-Your-Prescriber-Immediately block that follows lists symptoms that are not normal and should not be managed at home.
Common gastrointestinal effects
Nausea, bloating, early satiety (feeling full quickly), mild stomach cramping, and occasional vomiting or diarrhoea are the most frequently reported side effects, especially during the first 2–4 weeks of a new dose. They usually ease with smaller portions, slower meals, and avoiding rich or high-fat foods. If symptoms prevent you from eating or drinking for more than 24 hours, contact your prescriber through the patient portal.
Injection-site reactions
Mild redness, itching, or a small bruise around the injection site is normal and usually fades within a day or two. Rotate injection sites (abdomen, thigh, upper arm) and avoid injecting into skin that is tender, bruised, or scarred. If you notice hardened lumps, spreading redness, drainage, or persistent pain at the site, contact your prescriber — these are uncommon and should be checked.
Hypoglycaemia signs (especially if you also take insulin or sulfonylureas)
GLP-1 medications alone rarely cause low blood sugar, but the risk goes up if you also take insulin or a sulfonylurea. Watch for shakiness, sweating, sudden hunger, confusion, pounding heart, or dizziness. Treat mild episodes with a fast-acting carb (juice, glucose tablets) and let your prescriber know at the next check-in. If you have type-1 diabetes or take insulin, your prescriber may adjust those doses at titration.
Call your prescriber immediately
Red-flag symptoms — do not wait for the next scheduled check-in.
The symptoms below are uncommon but serious. Stop the medication and reach out through the patient portal — or call 911 or your local emergency number if any of these are severe.
- Severe abdominal pain that does not go away, especially if it radiates to your back, may be accompanied by vomiting, or starts after a recent dose increase. These can be signs of pancreatitis.
- Persistent vomiting or the inability to keep fluids down for more than 24 hours, particularly if you cannot stay hydrated.
- A lump or swelling in your neck, hoarseness, or trouble swallowing can occasionally indicate thyroid C-cell concerns. If you or your family have a history of medullary thyroid carcinoma or MEN 2, your prescriber will have already discussed this and may have steered you to a different medication.
- Signs of a serious allergic reaction: swelling of the face, lips, tongue, or throat, hives, difficulty breathing, or a rapid heartbeat after a dose.
- New, severe abdominal pain combined with yellowing of the skin or eyes, dark urine, or clay-coloured stools — these can signal gallbladder disease, which is more common with rapid weight loss.
Adherence
Adherence basics — keep your medication working for you
Weekly dosing cadence
GLP-1 medications like semaglutide and tirzepatide are once-weekly injections. Pick a day that fits your routine (a Sunday evening, a Wednesday morning — anything consistent) and stick with it. If you miss a dose and it has been less than 48 hours since your scheduled time, take it as soon as you remember; if it has been more than 48 hours, skip the missed dose and resume your normal schedule.
Missed-dose rule
Never double a dose to make up for a missed one. Doubling up raises the risk of severe nausea and other GI effects without adding any therapeutic benefit. If you miss two doses in a row, contact your prescriber before resuming — you may need to step back down to a lower dose for two weeks before returning to your scheduled dose.
Storage
Unopened pens are stored in the refrigerator (36°F–46°F / 2°C–8°C). Once in use, most pens can stay at room temperature (below 86°F / 30°C) for up to 28–56 days depending on the brand — your pharmacy will print the exact window on the packaging. Do not freeze the medication and do not use it if it has been frozen.
Traveling with your medication
Keep the pen in its original box with the pharmacy label when flying. For domestic flights in the U.S., GLP-1 medications do not require a special declaration; for international travel, carry a copy of your prescription and your portal message confirming the dose. Use an insulated travel sleeve — do not leave the pen in checked luggage or in a hot car.
Pair your injection with consistent meal timing
The medication works by reducing post-meal blood-sugar spikes and slowing stomach emptying. You will get the best day-to-day symptom control and the best appetite response if you eat your meals at roughly the same times each day, keep portions small, and protein-forward.
Contact
When to reach out to your prescriber
A routine question about titration timing, a missed dose, or a small side-effect change
Send a portal message at any time. Your care team replies within one business day. There is no need to wait for a scheduled check-in for these.
A side effect is keeping you from eating, drinking, or working for more than a day
Send a portal message marked urgent. Your prescriber or covering physician will respond same-day, and may move your next check-in forward or adjust your dose.
Any of the red-flag symptoms listed in the Side Effects section
Call your prescriber and follow up with a portal message, OR go to urgent care / call 911 if symptoms are severe. Do not wait for a portal reply for severe abdominal pain, allergic reaction, or trouble breathing.
You want to pause, restart, or change the medication plan
Send a portal message describing the change you want to make. Do not adjust your dose, stop, or restart on your own without a portal message from your prescriber.
A pharmacy or insurance issue (denial, prior-authorisation delay, lost shipment)
Send a portal message and our care coordination team will work directly with the pharmacy on your behalf.
Back to your patient portal
Track your consultation request, send a portal message to your prescriber, or review your dosing schedule.
Open the patient portal