By the ZIVOLABS Medical Team · Updated April 2026 · 5 min read

One of the most common practical questions patients ask before starting is: what happens after the first month? Do I have to consult again? Do I order manually every month? What if I want to pause? This article walks through exactly how the monthly refill process works at ZIVOLABS — so there are no surprises.

Why monthly refills require a doctor's involvement

Semaglutide is a Schedule H drug. Under Indian drug regulations, every dispensing of a Schedule H drug requires a valid prescription from a registered doctor. This is not a ZIVOLABS policy — it is a legal requirement.

This means that unlike a supplement subscription you set and forget, each month's medication is associated with a clinical review. Your doctor is not simply approving a repeat order — they are confirming that your treatment is progressing appropriately, your dose is correct, and that continuing is medically appropriate.

This structure is also clinically valuable. GLP-1 treatment involves dose escalation over the first 3–4 months. Your monthly check-in is when your doctor assesses whether to move you to the next dose level, hold at your current dose, or adjust based on side effects or progress. This personalisation is what makes the treatment work well — and the monthly model is how it is built into the process.

The monthly cycle: how it works

Week 1–2 of the month: Your current month's medication arrives or is in use. Your refill window opens — you will receive a notification prompting you to complete a brief monthly progress update.

The monthly progress update: This is a short questionnaire — typically 5–10 minutes — that captures:

• Your current weight (weigh yourself at home)

• Any side effects experienced since your last check-in

• How you are finding appetite control and fullness

• Any new medications, diagnoses, or health changes

• Questions you have for your doctor

This update is reviewed by your ZIVOLABS doctor before your monthly check-in call.

The monthly check-in call: A 10–15 minute video or audio call with your doctor. They review your progress update, assess how you are responding to your current dose, and confirm or adjust your prescription for the next month.

Common decisions made at the monthly check-in:

• Confirm continuation at the current dose — for patients well-tolerated and progressing

• Escalate to the next dose — when the current dose is well-tolerated and weight loss is plateauing

• Slow the escalation — for patients experiencing significant side effects

• Hold at the current dose — for patients in a period of rapid weight loss where stabilisation is appropriate

• Order bloodwork — when clinical monitoring requires updated kidney function, HbA1c, or other markers

Prescription issued: Following the check-in, your doctor issues the prescription for the next month's supply at the confirmed dose.

Medication dispatched: Your next month's semaglutide is packed in cold-chain packaging and dispatched to arrive before your current supply runs out. Metro city deliveries arrive within 2–3 days. Tier 2 and Tier 3 cities within 3–5 days.

What the monthly refill costs

The monthly fee of ₹4,999 is all-inclusive — it covers the check-in consultation, the prescription, the medication (Semasize or Semanat at your prescribed dose), and the cold-chain home delivery. There are no separate charges for the consultation or the delivery.

If your doctor requests bloodwork as part of monitoring, the diagnostic lab costs are separate (typically ₹800–₹2,000 at any diagnostic lab for the relevant panel). This is not part of the monthly fee — it is the cost of the external lab test.

What if you want to pause?

Life happens. Travel, a family event, a financial constraint in a particular month, an illness. ZIVOLABS does not lock patients into a fixed commitment.

To pause for one month: Contact ZIVOLABS support before your refill is processed. Your subscription is paused and no charge or dispatch occurs for that month.

Clinical considerations for pausing: Your doctor will advise that pausing semaglutide for more than 2–3 weeks may lead to some return of appetite and partial weight regain. If a pause extends beyond 4 weeks, re-starting may require a brief re-titration — beginning at a lower dose before returning to your maintenance dose. Your ZIVOLABS doctor will advise on the appropriate restart protocol.

To pause for longer: Contact ZIVOLABS and your subscription is placed on hold. Your clinical record is maintained, so when you restart, your doctor has full context of your previous treatment history and progress.

What if you want to stop?

You can discontinue at any time. There is no clinical risk in stopping semaglutide — it simply stops working as the medication clears your system over the following 5–7 weeks. Most patients experience a gradual return of appetite over this period.

If you are stopping because of side effects, talk to your doctor before stopping — in many cases, slowing the escalation or temporarily reducing the dose resolves side effect issues without stopping treatment entirely.

If you are stopping because you have reached your goal, your ZIVOLABS doctor will discuss what happens next — whether a maintenance approach makes sense, and what to expect in terms of weight management after stopping.

What if your dose changes?

When your doctor escalates your dose — from 0.25 mg to 0.5 mg, or from 0.5 mg to 1 mg — the next month's delivery reflects the new dose. The cost remains the same across all standard doses. You do not need to take any action — the prescription and dispatch are updated automatically following your check-in.

What happens to unused medication?

If you have leftover pens from the previous month — because your appetite was significantly reduced and you used less than expected, or because a dose was missed — carry them forward. They remain valid until their expiry date, within proper storage conditions. Contact ZIVOLABS if you have significantly more supply than needed — your next refill quantity can be adjusted accordingly.

Frequently asked questions

Do I have to do the monthly check-in by video, or can it be audio only? Either works. Video is preferred as it allows the doctor to observe general health indicators, but audio-only is available if video is not convenient.

What if I miss my monthly check-in? Contact ZIVOLABS to reschedule. Your refill will not be dispatched until the check-in has occurred and your doctor has issued the updated prescription. This is a regulatory requirement, not a choice — a Schedule H prescription requires a doctor's review.

Can I get two months' supply at once? This is subject to your doctor's clinical judgment. In most cases, monthly dispensing is the standard — it aligns with the regulatory prescription cycle and ensures regular clinical monitoring. In specific circumstances — extended travel, for example — your doctor may be able to accommodate a different approach.

Can someone else collect my delivery if I am not home? Yes. You can specify delivery instructions and an alternate recipient. Ensure the alternate person knows to refrigerate the medication immediately on receipt.

My refill arrived earlier than expected and I still have half a month of supply left. What do I do? Store the new pens in the refrigerator alongside your current supply, within their expiry date. There is no problem with having buffer supply — it ensures you are never without medication.

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This article is for informational purposes only. Monthly refill processes are subject to clinical and regulatory requirements that may evolve. Contact ZIVOLABS for the most current information on your specific plan.