Timing of Last Zepbound Dose Before Colonoscopy

Critical Background on GLP-1 Receptor Agonists

Zepbound is a GIP/GLP-1 receptor agonist that significantly delays gastric emptying, which can interfere with bowel preparation quality and increase aspiration risk during sedation 1
GLP-1 receptor agonists substantially affect gastric motility and must be held before colonoscopy, unlike DPP-4 inhibitors 1

The American College of Gastroenterology recommends stopping Zepbound 7 days before the scheduled colonoscopy procedure to minimize the risk of inadequate bowel preparation due to delayed gastric emptying 1
Stopping Zepbound 7 days before colonoscopy allows for clearance of the medication's gastric emptying effects, adequate bowel preparation efficacy, and reduced aspiration risk during procedural sedation 2

For split-dose regimen, begin the second portion of bowel preparation 4-6 hours before colonoscopy, and complete the preparation at least 2 hours before the procedure start, as recommended by the American Gastroenterological Association 3, 4
Each additional hour between last purgative dose and colonoscopy decreases the likelihood of good preparation by 10%, according to the American Society of Gastrointestinal Endoscopy 3

The American Society of Anesthesiologists recommends clear liquids up to 2 hours before sedation, assuming normal gastric emptying, but this may not apply to patients taking GLP-1 receptor agonists like Zepbound 3, 2
Delayed gastric emptying from GLP-1 agonists can compromise both bowel preparation quality and increase retained gastric contents, as noted by the American College of Gastroenterology 2
The American Diabetes Association recommends checking glucose levels more frequently during the period when Zepbound is discontinued, as glycemic control may be affected 5

Resume Zepbound after the colonoscopy once normal eating has been established, and ensure adequate hydration before restarting the medication, as recommended by the American College of Gastroenterology 1