GLP-1 Medications
Wegovy Injectable Pen
| Dose | Format | Monthly Cost |
|---|---|---|
| 0.25 mg | Weekly pen | $199/mo (first 2 months), then $349/mo |
| 0.5 mg | Weekly pen | $199/mo (first 2 months), then $349/mo |
| 1.7 mg | Weekly pen | $349 / month |
| 2.4 mg | Weekly pen | $349 / month |
Wegovy Pill
| Dose | Format | Monthly Cost |
|---|---|---|
| 1.5 mg | Daily pill | $149 / month |
| 4.0 mg | Daily pill | $199 / month |
| 9.0 mg | Daily pill | $299 / month |
| 25 mg | Daily pill | $299 / month |
Ozempic® (semaglutide)
| Dose | Format | Monthly Cost |
|---|---|---|
| 0.25 mg | Weekly pen | $199/mo (first 2 months), then $349/mo |
| 0.5 mg | Weekly pen | $199/mo (first 2 months), then $349/mo |
| 1 mg | Weekly pen | $349 / month |
| 2 mg | Weekly pen | $349 / month |
| Dose | Format | Monthly Cost |
|---|---|---|
| 7.5 mg | Vial or KwikPen | $449 / month |
| 10 mg | Vial or KwikPen | $449 / month |
| 12.5 mg | Vial or KwikPen | $449 / month |
| 15 mg | Vial or KwikPen | $449 / month |
Do I need labs before starting?
In most cases, yes. Typical baseline labs include HbA1c, a metabolic panel (kidney and liver function), a lipid panel, and a thyroid panel (TSH). Labs completed within the past 12 months may be accepted. All results are reviewed by your prescriber before a prescription is written and can increase the likelihood of insurance coverage.
Do I need a video visit with a prescriber?
Berry Street requires a live video visit to establish care before a GLP-1 can be prescribed. This is both a legal requirement and the standard for safe prescribing. Later follow-ups may be done asynchronously, depending on your state and clinical needs.
What's the starting dose, and how does it change over time?
Every GLP-1 begins at the lowest available dose and increases gradually over time to minimize digestive side effects. Typical starting doses are 0.25 mg weekly for Wegovy and Ozempic, and 2.5 mg weekly for Zepbound and Mounjaro. Dose increases usually happen every four weeks based on how you're tolerating the medication and how much weight you lose.
What should I do if I miss a dose?
For weekly injections: if fewer than 5 days have passed since your scheduled dose, take it as soon as you remember. If more than 5 days have passed, skip that dose and resume your usual weekly schedule. For daily pills, take the missed dose on the same day you remember, then continue your normal schedule.
What if I stop or pause my medication?
If you stop or pause for any reason, you'll need to restart at a low dose and titrate back up — do not resume at your previous dose. Restarting gradually helps avoid severe side effects.
What are the most common side effects?
The most common side effects are digestive and are usually worst in the first few weeks or just after a dose increase. They typically improve as your body adjusts. Rates observed in clinical trials:
Nausea (about 28–44% of people)
Diarrhea (23–30%)
Vomiting (13–24%)
Constipation (11–24%)
Abdominal pain or bloating (10–20%)
Most symptoms are mild to moderate. Fewer than 10% of clinical trial patients stopped treatment because of side effects.
How can I manage the digestive side effects?
Nausea: Eat small meals every 3–4 hours, eat slowly and stop when full, avoid high-fat, greasy, or spicy foods (especially after dose increases), limit carbonated drinks and alcohol, and try ginger or peppermint tea. Don't skip meals — going too long without eating can make nausea worse.
Constipation: Drink 2–3 liters (8–12 cups) of water daily, gradually increase fiber from fruits, vegetables, and whole grains, stay active, and consider over-the-counter options like psyllium (Metamucil), docusate (Colace), or polyethylene glycol (MiraLAX).
Diarrhea: Stay hydrated with water and electrolyte fluids, temporarily avoid high-fat and very high-fiber foods, and contact your doctor if symptoms are severe or persistent.
Heartburn or reflux: Eat smaller portions, don't lie down for 2–3 hours after eating, and limit irritating spices and high-fat foods. Your doctor may suggest an antacid or acid-reducing medication.
Your Berry Street dietitian is your primary resource for managing side effects through food and lifestyle changes. If symptoms are significantly affecting daily life, ask your primary care physician about a short-term anti-nausea prescription.
When should I seek urgent care?
Go to the emergency room right away if you experience:
Severe abdominal pain that doesn't go away (could signal pancreatitis or gallbladder problems)
Persistent nausea or vomiting that prevents you from keeping down fluids
Signs of an allergic reaction (rash, swelling, trouble breathing)
Sudden vision changes
Severe dizziness or fainting
Do GLP-1s interact with other medications?
They can. If you take insulin or sulfonylureas for diabetes, your risk of low blood sugar goes up — your prescriber may adjust those doses before you start. Because GLP-1s slow stomach emptying, they can also affect how oral medications absorb. This matters most for birth control pills if you're on tirzepatide (see below). Your prescriber will do a full interaction review as part of your evaluation.
Will I need to change my birth control on tirzepatide?
Possibly. Tirzepatide can reduce the effectiveness of oral birth control because it slows stomach emptying. If you take the pill, you should either switch to a non-oral form (IUD, implant, or injection), or use a backup barrier method (like condoms) for 4 weeks after starting tirzepatide and for 4 weeks after each dose increase. This is specifically a tirzepatide concern and is less of an issue with semaglutide — but discuss with your doctor either way.
Do I need to stop the medication before surgery?
Tell both your surgeon and anesthesiologist that you are on a GLP-1. These medications slow stomach emptying, which can raise the risk of complications during anesthesia. Your surgical team will advise on when to pause the medication and when it's safe to resume.
What should I eat while taking a GLP-1?
Because these medications reduce your appetite, every bite matters. Your Berry Street dietitian will build a personalized plan for you, but in general you'll focus on fruits, vegetables, whole grains, lean proteins (chicken, fish, eggs, Greek yogurt, cottage cheese, beans), and healthy fats (olive oil, avocado, nuts). You'll want to limit refined carbohydrates, sugary beverages, processed and fried foods, and red or processed meats. Ask your primary care provider whether a daily multivitamin or specific supplements (like vitamin D, calcium, or B12) make sense for you while your appetite is reduced.
Should I exercise while on a GLP-1?
Yes — this is one of the most important things you can do. When you lose weight through any method, up to 25–40% of the loss can come from muscle rather than fat. Regular exercise, especially strength training, can reduce that muscle loss by 50–95% and help preserve bone density. A simple way to build up:
Start with movement. Aim for 150 minutes per week of moderate activity (brisk walking, cycling, swimming) or 75 minutes of vigorous activity.
Add strength training. Shoot for 2–3 sessions per week — weights, resistance bands, bodyweight, or fitness classes all count.
Keep it combined. The best long-term results come from 30–60 minutes of daily aerobic activity plus 2–3 strength sessions per week. Older adults should add balance and mobility work too.
Exercise also independently improves blood sugar, blood pressure, cholesterol, mood, and energy.
Can I drink alcohol?
There's no direct interaction between GLP-1 medications and alcohol, but alcohol can affect blood sugar and may make nausea worse. Talk with your doctor about what level of consumption is right for you.
