PREventClinic

GLP-1 Receptor Agonist Therapy

Patient Enrollment & Education Guide

What Are GLP-1 RA Medications?

GLP-1 receptor agonist (GLP-1 RA) medications are a class of injectable drugs that work by mimicking a natural hormone your body already makes called GLP-1 (glucagon-like peptide-1). After you eat, your gut releases this hormone to help your body manage blood sugar and appetite. Think of GLP-1 as one of your body’s built-in signals that tells your brain, “I’m full,” while also helping your pancreas release the right amount of insulin.

These medications are lab-engineered versions of that same peptide, designed to last much longer in your body than the natural hormone (which breaks down in just a few minutes). By activating the same GLP-1 receptors throughout your body, these medications reduce appetite, slow stomach emptying so you feel satisfied longer, and improve how your body processes sugar and fat. Semaglutide (brand names: Wegovy® and Ozempic®, made by Novo Nordisk) works on the GLP-1 receptor alone. Tirzepatide (brand names: Zepbound® and Mounjaro®, made by Eli Lilly) works on two receptors—both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide)—which may offer additional metabolic benefits.

These medications have been rigorously studied in large clinical trials and are FDA-approved for chronic weight management and/or type 2 diabetes. They are prescribed as part of a comprehensive plan that includes healthy nutrition, regular physical activity, and ongoing medical supervision.

Understanding Potential Side Effects

Most side effects of GLP-1 RA medications involve the gastrointestinal (GI) system. This makes sense because the medication slows your digestion and changes how your gut communicates with your brain. Most GI side effects are mild to moderate and tend to improve over time as your body adjusts, especially during the slow dose-escalation process. However, not all side effects produce symptoms you can feel—some can only be detected through blood tests, which is why regular lab monitoring is essential.

Common Side Effects (Mild to Moderate)

• Nausea — The most frequently reported side effect, especially during dose increases; usually improves with time
• Diarrhea — Often occurs early in treatment and may come and go during titration
• Constipation — Results from slowed gut motility; adequate hydration and fiber intake can help
• Vomiting — More common during dose escalation; eating smaller, more frequent meals may reduce episodes
• Abdominal pain or discomfort — Cramping or bloating, particularly after meals; usually transient

Serious Side Effects (Require Immediate Medical Attention)

• Pancreatitis — Inflammation of the pancreas causing severe, persistent abdominal pain that may radiate to the back, often with nausea and vomiting. Seek emergency care immediately.
• Gallbladder disease — Includes gallstones (cholelithiasis) and gallbladder inflammation (cholecystitis), which may cause sudden, intense pain in the upper right abdomen, especially after eating.
• Thyroid tumors (including medullary thyroid carcinoma) — Observed in animal studies. Report any lump or swelling in the neck, hoarseness, difficulty swallowing, or persistent shortness of breath. These medications are contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

⚠  IMPORTANT: Silent Side EffectsSome adverse effects of GLP-1 RA medications do not produce noticeable symptoms and can only be detected through laboratory testing. These may include changes in kidney function, liver enzymes, lipase/amylase levels, and blood glucose. This is why blood work at your follow-up visits is not optional—it is a critical safety requirement of this program.

Required Monthly Follow-Up Visits

All patients enrolled in PREventClinic’s GLP-1 RA therapy program are required to attend monthly follow-up appointments. These visits are conducted by our Nurse Practitioners and are mandatory prior to any dose increase. This ensures your body is safely tolerating the medication before moving to a higher dose.

The first three to four visits must be conducted in-office because we perform blood testing at each visit to monitor for side effects that may not have any symptoms. After this initial in-office period, subsequent visits may be conducted via telehealth at the discretion of your provider, provided you are tolerating your medication well and your lab work is stable.

Visit	Format	Labs Required	Purpose
Month 1	In-Office	Yes	Baseline labs, injection training, side effect review
Month 2	In-Office	Yes	Lab check, dose escalation assessment
Month 3	In-Office	Yes	Lab check, dose escalation assessment
Month 4	In-Office	Yes	Lab check, final escalation clearance
Month 5-12+	In-Office or Telehealth	As clinically indicated	Ongoing monitoring, dose maintenance

Missing or skipping appointments may result in a delay in dose escalation or a hold on your prescription until a proper evaluation can be completed. Your safety is our top priority.

Dose Escalation Schedules

Both semaglutide and tirzepatide follow a gradual dose-escalation approach over several months. Starting at a low dose and increasing slowly helps your body adjust to the medication and significantly reduces the severity of gastrointestinal side effects. The timelines below represent the typical 12-month course for most patients. Your provider may adjust the pace of escalation based on your individual tolerance and response.

Semaglutide (Wegovy® / Ozempic® — Novo Nordisk)

Month	Dose	Phase	Notes
1	0.25 mg	Titration	Starting dose; not therapeutic
2	0.5 mg	Titration	First dose increase
3	1.0 mg	Titration	Continued escalation
4	1.7 mg	Titration	Approaching target dose
5-12+	2.4 mg	Maintenance	Target maintenance dose

12-Month Visual Timeline (dose in mg)

0.25	0.5	1.0	1.7	2.4	2.4	2.4	2.4	2.4	2.4	2.4	2.4
Mo 1	Mo 2	Mo 3	Mo 4	Mo 5	Mo 6	Mo 7	Mo 8	Mo 9	Mo 10	Mo 11	Mo 12
TITRATION PHASE	MAINTENANCE PHASE

Tirzepatide (Zepbound® / Mounjaro® — Eli Lilly)

Month	Dose	Phase	Notes
1	2.5 mg	Titration	Starting dose; not therapeutic
2	5.0 mg	Titration	First dose increase
3	7.5 mg	Titration	Continued escalation
4	10 mg	Titration	Continued escalation
5	12.5 mg	Titration	Optional; based on response
6-12+	15 mg	Maintenance	Maximum maintenance dose

12-Month Visual Timeline (dose in mg)

2.5	5.0	7.5	10	12.5	15	15	15	15	15	15	15
Mo 1	Mo 2	Mo 3	Mo 4	Mo 5	Mo 6	Mo 7	Mo 8	Mo 9	Mo 10	Mo 11	Mo 12
TITRATION PHASE	MAINTENANCE PHASE

Note on TimelinesThese schedules represent a typical course and are not set in stone. Your provider may slow the titration if you experience significant side effects, or may find that you respond well to a dose below the maximum. The goal is to find the lowest effective dose for you with the fewest side effects.

Medication Weaning & Discontinuation

When the time comes to discontinue your GLP-1 RA medication, it is critically important that this be done through a long, slow, supervised taper—not abruptly. These medications work by modifying your body’s hormonal signaling, appetite regulation, and metabolic set points. Stopping suddenly can lead to significant rebound effects.

Risks of Abrupt Discontinuation

• Rapid weight regain — Often exceeding pre-treatment levels due to rebound appetite and hormonal shifts
• Return of elevated blood sugar and insulin resistance
• Rebound increase in appetite and cravings
• Worsening of cardiovascular and metabolic risk markers
• Gastrointestinal disturbances as the body readjusts

Your provider will design a personalized weaning plan that gradually reduces your dose over several months, allowing your body to adjust. Do not stop or reduce your medication on your own without consulting your care team. If you need to stop the medication for any reason (e.g., surgery, pregnancy planning, insurance changes), please contact us immediately so we can plan a safe taper.

Reporting Side Effects

Prompt reporting of any side effects is essential for your safety and for us to properly manage your care. Please report side effects through the following channels:

• Patient Portal / MyChart — Log in and send a message to your care team describing your symptoms. This is the preferred method for non-urgent concerns and creates a documented record in your chart.
• At Your Appointments — Discuss all side effects, even those that have resolved, with your Nurse Practitioner at each monthly visit.
• Phone Call — For urgent or severe symptoms (severe abdominal pain, persistent vomiting, signs of allergic reaction), call our office immediately. If after hours, seek emergency care.

Injection Demonstration Videos

Before administering your first injection at home, please watch the official demonstration video from your medication’s manufacturer. Your Nurse Practitioner will also demonstrate proper injection technique at your first in-office visit.

Semaglutide (Wegovy® / Ozempic®) — Novo Nordisk:

https://www.wegovy.com/taking-wegovy/how-to-use-the-wegovy-pen.html

Tirzepatide (Zepbound®) — Eli Lilly:

https://zepbound.lilly.com/weight/how-to-use

Tirzepatide (Mounjaro®) — Eli Lilly:

https://mounjaro.lilly.com/how-to-use-mounjaro

Patient Acknowledgment & Enrollment

By signing below, I acknowledge that I have read and understand the information in this enrollment guide. I understand the nature of GLP-1 receptor agonist therapy, the potential side effects (including those that may be silent and require blood testing to detect), and the requirement for monthly follow-up visits. I agree to the following:

• I will attend all required monthly follow-up appointments and understand that the first 3–4 visits must be in-office with blood work.
• I understand that dose increases will only be authorized after evaluation by a PREventClinic Nurse Practitioner.
• I will report any side effects promptly through the patient portal/MyChart and at my appointments.
• I will not stop, skip, or change my dose without consulting my care team.
• I understand that discontinuation must be done through a slow, supervised wean and that abrupt withdrawal can cause serious side effects including significant weight regain.
• I have been provided links to the manufacturer’s injection demonstration videos and will review them before my first self-administered injection.

Patient Signature	Date
Patient Printed Name	Date of Birth
Provider Signature	Date

ADDENDUM

Oral GLP-1 RA Therapy (Pill Formulation)

In addition to the injectable formulations described above, oral (pill) versions of GLP-1 receptor agonist medications are available or in development. The most well-established oral option is Rybelsus® (oral semaglutide, 7 mg and 14 mg tablets, Novo Nordisk), which is FDA-approved for type 2 diabetes. A higher-dose oral semaglutide tablet (Wegovy® 25 mg tablet) has also received FDA approval for chronic weight management.

Key Differences & Special Considerations for Oral GLP-1 RA

The oral formulation has specific administration requirements that differ from the injection. The pill must be taken on an empty stomach with no more than 4 ounces of plain water, and you must wait at least 30 minutes before eating, drinking, or taking any other oral medications. This is because the absorption enhancer in the tablet is sensitive to food and fluid volume.

Surveillance Requirements for Oral GLP-1 RA Patients

Patients taking the oral formulation are subject to the same monitoring and follow-up requirements as injection patients. This includes:

• Monthly follow-up appointments with a PREventClinic Nurse Practitioner
• In-office visits with blood work for the first 3–4 months of therapy
• Ongoing laboratory surveillance for kidney function, liver enzymes, pancreatic markers (lipase/amylase), and metabolic panels as clinically indicated
• Dose escalation only after provider evaluation and lab clearance
• Side effect reporting through the patient portal/MyChart and at appointments

Additionally, because oral absorption can be more variable than injection delivery, your provider may order more frequent lab work during the initial titration phase to ensure adequate drug levels and safe metabolic response. Adherence to the strict fasting requirements is essential for the medication to work properly.

Oral Formulation — Same Rules ApplyAll program requirements outlined in the main enrollment guide—including mandatory monthly visits, supervised dose escalation, prompt side effect reporting, and gradual supervised weaning upon discontinuation—apply equally to patients on oral GLP-1 RA therapy.

PREventClinic, Inc.

Sandy Springs, Georgia  |  www.preventclinic.com

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