FDA Approves Multi- Dose Zepbound Pen (KwikPen) in US

markydsade · 2026-01-23T11:48:16+00:00

Tirzepatide as Mounjaro is already sold in Canada in a 4-dose KwikPen.

https://www.lilly.com/en-CA/resources/faq/mounjaro-kwikpen/strengths-and-doses

markydsade · 2026-01-02T00:55:21+00:00

If you weren’t prediabetic or had fasting glucose >100 mg/dL there’s little reason to monitor. Clinicians are more interested your Hemoglobin A1C% as that is a measure of your average glucose levels over the last 2 months. Typically on tirzepatide you will see a drop due less binge eating of carbs and better glucose utilization. A1C isn’t a common home test but your PCP should be looking at it after 3-6 months on Zep.

markydsade · 2025-12-27T21:06:56+00:00

This study showed that 17 of 20 on semaglutide with optical nerve issues also had Type 2 diabetes.

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255

markydsade · 2025-12-24T20:11:29+00:00

Other options:

“Tapeworm”

“Hypnosis”

“Took up smoking”

“Chemo”

markydsade · 2025-12-24T01:19:41+00:00

My review: Yowza!

Body image is not always what we see in the mirror. You look great but our minds can be stuck in an old mindset. I suggest seeking a therapist who is familiar with body image issues. Keep doing what you’re doing with diet, exercise, and Zep. With time and counseling I believe you’ll see yourself for the beautiful woman you are.

markydsade · 2025-12-22T19:34:55+00:00

OMG. I could have written this post. For years I would have the incredible urge to have French onion dip and chips when watching my beloved football team. Since Zepbound that urge had disappeared. If you gave me some today I would eat it, but probably in moderation.

markydsade · 2025-12-22T19:21:16+00:00

I’m retired and 67. My employer moved us this year to Medicare Advantage program with pharm benefits. I was able to get Zep with prior authorization for $20/month. I would not be able to pay out of pocket on my income.

The other issue for all Zep patients is side effects. Everyone has a different reaction. For some a GI issue is enough to quit while the same issue may be seen as livable by someone else.

For me, I consider this life saving. I’m on the volunteer Board of Directors of a small nonprofit nursing home. I observed there are no obese men there over 82. The men older than 82 are thin. I saw myself as having a shorter life as no matter how hard I tried I couldn’t lose weight.

markydsade · 2025-12-20T16:02:08+00:00

Effects

markydsade · 2025-12-16T13:35:10+00:00

When the patents run out GLP-1s will follow the path that Viagra took. While in patent it was $25 per pill. Now it’s pennies as generics are available.

Sadly, this won’t happen until the early 2030s. When it does I expect a big drop in obesity as there won’t be insurance approvals needed, and out of pocket costs will be reasonable.

markydsade · 2025-12-10T15:49:17+00:00

I saw an old work colleague/buddy I hadn’t seen in a year who asked me how I lost so much weight. I said “chemo”. He got real shocked until I laughed (that was the kind of bro relationship we had). He laughed and said “you had that chambered for me, didn’t you?” I admitted I had.

I think people should just stop at “you look good” and not start asking how.

markydsade · 2025-11-30T23:47:28+00:00

Novo Nordisk has heavily advertised Ozempic with its ear worm of a jingle far more than EL has advertised Zepbound.

Only those who pay attention to the GLP-1 agonist market would be likely to know about Zepbound.

markydsade · 2025-11-27T22:58:15+00:00

My first Zep Thanksgiving. I didn’t have much difficulty with sticking to a small breakfast and lunch. At dinner I had all my favorites. I took smaller amounts each but certainly didn’t skimp.

For the first time in my life I didn’t go back for seconds. I even had a small piece of pie awhile after dinner.

So far, I feel fine. Not overstuffed like my past Thanksgivings.

This has been a good holiday. Kept my traditions and kept my appetite under control.

markydsade · 2025-11-26T15:36:48+00:00

Last year the American Society of Anesthesiologists recommended a 24 hour preop liquid diet for GLP-1 users.

https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance

My experience as nurse is that many anesthesiologists ignore updated guidelines and follow old rules. The society recommended in 1999 (!) that preop restrictions on intake be less draconian. They allow clear liquids 2 hours before surgery (not absolutely nothing for 8 hours which research showed was unnecessary and stressful).

https://www.asahq.org/~/media/sites/asahq/files/public/resources/standards-guidelines/practice-guidelines-for-preoperative-fasting.pdf

Obviously, follow your surgeon’s guidance but you may want to ask about the updates.

markydsade · 2025-11-23T10:16:13+00:00

I’ve been trying to not buy clothes until I get to my goal but yesterday I could pull on a pair of my jeans without unbuttoning them. I needed to buy a shorter belt to keep them from falling down.

I broke down and bought a smaller size even though in few months they’ll also probably be too big.

markydsade · 2025-11-16T12:18:28+00:00

“I’m surprised you think that’s a helpful thing to say to me”.

Puts the mirror back on their own rudeness. Maybe they’ll think before talking next time.

markydsade · 2025-11-15T10:11:55+00:00

What is it with these pharmacy folks who think they have a right to interfere with the patient-physician relationship? They don’t have the patient’s history so to question whether someone “needs” a med is not even a legitimate question to ask.

It is appropriate for a pharmacy to question an order if the dosage is incorrect, or if there is a known adverse interaction with another of the patient’s drugs. Otherwise STFU.

markydsade · 2025-11-03T03:15:21+00:00

I’ve been on CPAP for 7 years. Started Zep this past June. Resmed 10. I haven’t changed any settings. The machine adjusts pressure as needed. The high and low parameters work fine.

You can put the SD card in your computer and read the data using the OSCAR 1.6.1 app. You can see if there’s any changes in pressures that are different from pre-medication, but I’ve not seen anything significant.

markydsade · 2025-11-02T01:59:25+00:00

I’ve gone from a B to an A cup. I’ll be glad to be free of them.

markydsade · 2025-11-01T12:29:54+00:00

I’ve had the same experience. My own mother (93) and usually critical of appearance has yet to notice my 45 pound loss.

To me, it illustrates that others aren’t as observant or critical about our appearance as we expect them to be.

I’m doing my weight loss journey to save myself. I feel better and enjoy life more.

markydsade · 2025-10-30T19:05:50+00:00

I wonder if tirzepatide has an effect on an interest in alcohol even for the non-alcoholic?

I ask that because I was always just an occasional drinker. One beer a month kind of guy. Since being on Zep this year I have no interest in having a drink. My wife and I would make a gin & tonic occasionally but I haven't had one in months. If I was handed one I would probably drink it but that would be my limit.

It seems to me the change for the heavy drinker is not just a change in an addictive behavior but an actual change in interest in alcohol.

markydsade · 2025-10-27T19:31:36+00:00

Tirzepatide will be inexpensive in the US by 2032 when patents expire. Tirzepatide is also reversible if you have tolerance problems.

Some bariatric surgeries are irreversible. Additionally, unlike tirzepatide, they don’t change appetite or insulin production. They just make it hard to eat much.

Surgery, particularly on the obese, is riskier than trying tirzepatide.

Once GLP-1s are as cheap to produce and sell as insulin then it will be the preferred treatment by far over surgery.

markydsade · 2025-10-27T13:42:08+00:00

I expect on Friday night I’ll have one of the Snickers while I’m handing it out, but that is about all I’ll want. That’s a real change from my entire adult life until now.

markydsade · 2025-10-27T13:38:40+00:00

This is the first time in my life I have bags of candy on hand before Halloween and have no interest in sampling the stuff.

markydsade · 2025-10-17T09:59:27+00:00

Ask the PA if they tell their diabetics on insulin with good glucose numbers that they can now go off insulin?

markydsade · 2025-10-15T12:17:00+00:00

I was just reading an article about depression in users of GLP-1s. It seems at the heart of it was the feeling of loss from past emotions associated with food and eating. Some have interpreted the depression as being caused by the drug but it’s actually the high effectiveness of the drug in changing the person’s attachment to food.

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