Tirzepatide Dosage Chart: Zepbound and Mounjaro Doses, Week by Week
Every tirzepatide plan starts at 2.5 mg once a week and steps up by 2.5 mg no sooner than every 4 weeks, to a maximum of 15 mg. Here is the full label schedule, what differs between Zepbound and Mounjaro, and what to do about missed doses and side effects.
The FDA-approved tirzepatide dosage starts at 2.5 mg injected once weekly for 4 weeks, then 5 mg. After that, the dose can go up in 2.5 mg steps (7.5 mg, 10 mg, 12.5 mg, 15 mg), with at least 4 weeks on each dose. The maximum dose is 15 mg once a week. Moving up is not required: your prescriber picks the lowest dose that works for you and that you tolerate.
- Starting dose: 2.5 mg once weekly for 4 weeks. It gets your body used to the drug and is not a maintenance dose for weight loss.
- Steps: 2.5 mg at a time, at least 4 weeks apart.
- Maximum: 15 mg once weekly for adults.
- Zepbound weight-loss maintenance doses: 5 mg, 10 mg or 15 mg. Sleep apnea: 10 mg or 15 mg.
- Missed dose: take it within 4 days (96 hours), otherwise skip it.
- Changing your injection day is fine if doses stay at least 3 days (72 hours) apart.
Tirzepatide dosage chart (week by week)
Both FDA labels for tirzepatide use the same ladder. You inject once a week, under the skin of the belly or thigh (or the back of the upper arm if someone else gives it), on the same day each week, any time of day, with or without food.
The chart below shows the fastest schedule the label allows. Many people move slower, and many stop at a lower step. That is normal and expected.
| Weeks | Weekly dose | Step | What the label says |
|---|---|---|---|
| 1 to 4 | 2.5 mg | Start | Starting dose for everyone. Not a weight-loss maintenance dose. |
| 5 to 8 | 5 mg | Step 1 | First possible maintenance dose (weight loss). |
| 9 to 12 (or later) | 7.5 mg | Step 2 | Optional. Only after at least 4 weeks on 5 mg. |
| 13 to 16 (or later) | 10 mg | Step 3 | Optional. A maintenance dose for weight loss and sleep apnea. |
| 17 to 20 (or later) | 12.5 mg | Step 4 | Optional. Only after at least 4 weeks on 10 mg. |
| 21 and on (or later) | 15 mg | Step 5 | Maximum dose. Do not go higher. |
Weeks are the earliest possible timing, not a target. The label wording is that the dose "may be increased" in 2.5 mg steps after at least 4 weeks on the current dose, and that the maintenance dose is chosen based on how well it works and how well you tolerate it (Zepbound prescribing information).
For a deeper look at the decision to move up, see our guide on when to increase your tirzepatide dose.
Zepbound vs Mounjaro dosing: what differs
Zepbound and Mounjaro are the same medicine (tirzepatide) made by Eli Lilly, with the same starting dose, the same 2.5 mg steps and the same 15 mg adult maximum. The differences are in what each one is approved for and how the label describes maintenance.
| Zepbound | Mounjaro | |
|---|---|---|
| Approved for | Weight reduction and long-term weight maintenance in adults with obesity, or overweight with a weight-related condition; moderate to severe obstructive sleep apnea in adults with obesity | Blood sugar control in type 2 diabetes (adults and children 10 and older); lowering the risk of major heart events in adults with type 2 diabetes at high risk |
| Starting dose | 2.5 mg weekly for 4 weeks | 2.5 mg weekly |
| When to step up | After 4 weeks, go to 5 mg; then optional 2.5 mg steps every 4+ weeks | If more blood sugar control is needed, 2.5 mg steps every 4+ weeks |
| Maintenance doses | Weight: 5, 10 or 15 mg. Sleep apnea: 10 or 15 mg | No fixed list; the dose that controls blood sugar |
| Maximum | 15 mg weekly | 15 mg weekly (adults); 10 mg weekly (children 10 and older) |
| Forms on the label | Single-dose pen, single-dose vial, multi-dose vial, KwikPen (4 doses per pen) | Single-dose pen, single-dose vial, multi-dose vial, KwikPen (4 doses per pen) |
💡 Zepbound pens, vials and KwikPens
Every Zepbound strength (2.5 mg to 15 mg) comes in a single-dose pen and a single-dose vial, and the current label also lists a multi-dose vial and a KwikPen that each hold 4 weekly doses. Each form is labeled by the mg dose it gives. The label tells prescribers to make sure you are trained on the exact form you receive, and to retrain you if the form changes. If you use Zepbound vials, use a new syringe and needle for every injection, and never share a KwikPen, even with a new needle.
💡 Mounjaro for type 2 diabetes
Mounjaro is dosed to blood sugar, not to a weight target. If your A1C is where your doctor wants it, there may be no reason to go higher. Taking it with insulin or a sulfonylurea raises the risk of low blood sugar, so your doctor may lower those medicines when you start. Mounjaro and insulin are given as separate shots and never mixed.
Do not use Zepbound and Mounjaro together, or either one with another GLP-1 medicine. The Zepbound label says combining them is not recommended.
How long to stay on each dose
The only firm rule is a minimum: at least 4 weeks on a dose before going up. There is no maximum time. You can stay on a dose for months, or for good, if it is working.
Reasons your prescriber may keep you where you are:
- You are still losing weight steadily, or your blood sugar is at goal.
- Your hunger and food noise are well controlled.
- Side effects from the last step have not settled yet.
Reasons they may consider the next step:
- Weight loss has stalled for several weeks at a dose you tolerate well.
- Appetite control fades toward the end of each week.
- For diabetes, your A1C is still above goal.
Moving up only to 5 mg and staying there is a label-approved plan. In the main weight-loss trial, SURMOUNT-1 (Study 1 in the Zepbound label), people on 5 mg lost an average of 15.0% of body weight at 72 weeks, compared with 19.5% on 10 mg, 20.9% on 15 mg and 3.1% on placebo. Higher doses usually add more loss, but the jump from 10 mg to 15 mg was small on average.
Maximum dose
The maximum tirzepatide dose is 15 mg once weekly for adults on both labels. For children 10 and older with type 2 diabetes, the Mounjaro maximum is 10 mg weekly. There is no FDA-approved dose above 15 mg, and taking two doses in one week, or doses closer than 3 days apart, is not part of either label.
Missed doses and changing your injection day
Both labels give the same rules:
| Situation | What to do |
|---|---|
| Missed dose, 4 days (96 hours) or less since it was due | Take it as soon as you remember, then go back to your usual day. |
| Missed dose, more than 4 days since it was due | Skip it. Take the next dose on your usual day. Do not double up. |
| Want a new injection day | Fine, as long as there are at least 3 days (72 hours) between the two doses. |
If you miss several weeks in a row, call your prescriber before your next shot. The labels do not give a restart schedule, so your prescriber decides whether to restart at your old dose or a lower one.
Side effects by dose
Stomach and gut side effects are the main ones. The Zepbound label notes that most nausea, vomiting and diarrhea happened during dose increases and decreased over time. So the first week or two after each step is usually the hardest part.
Here is how often the most common side effects happened in the two placebo-controlled Zepbound weight-loss trials, by maintenance dose:
| Side effect | Placebo | Zepbound 5 mg | Zepbound 10 mg | Zepbound 15 mg |
|---|---|---|---|---|
| Nausea | 8% | 25% | 29% | 28% |
| Diarrhea | 8% | 19% | 21% | 23% |
| Vomiting | 2% | 8% | 11% | 13% |
| Constipation | 5% | 17% | 14% | 11% |
| Indigestion | 4% | 9% | 9% | 10% |
| Injection site reactions | 2% | 6% | 8% | 8% |
| Hair loss | 1% | 5% | 4% | 5% |
Source: Zepbound prescribing information, Table 1. About 4.8%, 6.3% and 6.7% of people on 5 mg, 10 mg and 15 mg stopped for side effects, compared with 3.4% on placebo, mostly in the first few months.
In the Mounjaro diabetes trials, rates were lower but followed the same pattern: nausea in 12%, 15% and 18% of people on 5 mg, 10 mg and 15 mg, compared with 4% on placebo (Mounjaro prescribing information).
💡 Birth control pills and dose increases
Tirzepatide slows stomach emptying, which can make birth control pills less reliable. Both labels advise switching to a non-pill method, or adding a barrier method, for 4 weeks after you start and for 4 weeks after each dose increase.
If side effects are hard at a new step
Feeling queasy after a step up is common. Feeling unable to eat or drink is not. Here is what usually helps, and when to call.
Rough week after a dose increase?
Check the column that fits:
✅ Usually manageable at home
- Mild nausea that eases after a few days
- Feeling full fast, smaller appetite
- Some constipation or loose stools
- You can keep fluids down
📞 Call your prescriber
- Vomiting that keeps you from holding down fluids
- Signs of dehydration: dizziness, very little urine
- Side effects not easing after 2 weeks
- Severe belly pain, with or without vomiting
- Eat smaller meals and stop when full.
- Go easy on greasy, fried and very sweet foods in the days after your shot.
- Drink fluids through the day. Vomiting and diarrhea can dehydrate you, and the label warns this can strain the kidneys.
- Ask about staying put or stepping back. You do not have to move up on schedule. The Zepbound label says that if a maintenance dose is not tolerated, a lower maintenance dose can be considered.
Compounded tirzepatide dosing
Compounded tirzepatide is made by a licensed pharmacy for an individual patient. It is not FDA-approved and is not the same as any brand-name medication. Most prescribers use the same mg principles shown above: start low, step up slowly with at least several weeks between changes, and stay at the dose that works.
- Your prescriber sets your dose. Your plan may not follow the chart above step for step, for example a slower climb or an in-between dose.
- Vial strength differs from pharmacy to pharmacy. The same mg dose can mean a different amount of liquid depending on the vial. Always follow the label and instructions on your own vial, not a chart from the internet or another patient's instructions.
- Use the syringe your pharmacy sends. The FDA has warned about dosing mistakes with compounded GLP-1 vials when people mixed up mg, mL and syringe markings. If anything about how much to draw is unclear, stop and call your pharmacy. Our guide on reading a compounded tirzepatide dose in mg explains why, and our needle size guide covers syringes.
- New vial strength? Ask first. If a refill comes at a different strength than your last vial, confirm your dose with the pharmacy before you inject.
The FDA declared the tirzepatide shortage resolved (final decision December 19, 2024). Licensed 503A pharmacies may still compound tirzepatide for an individual patient when the prescriber documents a clinical need for something different from the approved product, such as a different dose. The FDA also warns against GLP-1 products sold online without a prescription or labeled "for research purposes." Read more in our compounded tirzepatide guide.
Paying for tirzepatide
Before you pay cash, check the cheapest path for your situation. Lilly's prices and programs, as listed on its site in October 2026:
- Commercial insurance that covers Zepbound: the Lilly savings card can bring it as low as $25 for a 1, 2 or 3-month fill (limits apply; terms end 12/31/2026).
- Self-pay through LillyDirect: Zepbound KwikPen or vials start at $299 for a month of the 2.5 mg dose. The KwikPen price rises with dose, up to $699 a month for 10 mg to 15 mg, with lower prices on some doses for on-time refills.
- Medicare Part D: eligible patients prescribed Zepbound for weight management may pay no more than $50 a month through the Medicare GLP-1 Bridge.
- Mounjaro for type 2 diabetes: check your plan first. Lilly's Mounjaro savings card is only for people with commercial insurance.
Cost by dose is broken down in our Zepbound cost by dose guide. For how tirzepatide compares with the other weekly GLP-1, see semaglutide vs tirzepatide.
Getting treatment through Rx.com
If you do not have coverage and want a flat monthly price, Rx.com offers compounded tirzepatide from $149/month on a 12-month plan, with the online provider visit, medication, supplies and cold shipping included. It is one flat price at every dose, and no insurance is needed. Your provider sets and adjusts your dose. Compounded medications are not FDA-approved. You can start with a short eligibility quiz.
🚨 When to Contact Your Healthcare Provider
Call your prescriber promptly for any of these. Call 911 for trouble breathing, swelling of the face or throat, fainting or chest pain.
- Severe belly pain that will not go away, with or without vomiting, possibly spreading to your back: a possible sign of pancreatitis.
- Pain in the upper right belly, fever, yellow skin or eyes: possible gallbladder problems.
- Vomiting or diarrhea that keeps you from holding down fluids: risk of dehydration and kidney injury.
- A lump or swelling in the neck, trouble swallowing, or lasting hoarseness: tell your provider (the label carries a thyroid tumor warning).
- Shaky, sweaty or confused if you also take insulin or a sulfonylurea: possible low blood sugar.
- You think you took too much: call your provider or Poison Control at 1-800-222-1222.
- A planned surgery or procedure with sedation: tell the care team you take tirzepatide.
Frequently Asked Questions
What is the starting dose of tirzepatide?
2.5 mg injected once a week for 4 weeks. It is a starter dose to help your body adjust, not a weight-loss maintenance dose.
How fast can I increase my tirzepatide dose?
No faster than 2.5 mg every 4 weeks, per both FDA labels. Increases after 5 mg are optional, and many people stay at a lower dose.
What is the maximum dose of tirzepatide?
15 mg once weekly for adults. For children 10 and older taking Mounjaro for type 2 diabetes, the maximum is 10 mg weekly.
What are the Zepbound maintenance doses?
For weight loss, 5 mg, 10 mg or 15 mg once weekly. For obstructive sleep apnea, 10 mg or 15 mg once weekly.
Are Zepbound and Mounjaro doses the same?
The strengths and steps are the same (2.5 mg to 15 mg). Zepbound is approved for weight loss and sleep apnea; Mounjaro is approved for type 2 diabetes and is dosed to blood sugar control.
What if I miss a tirzepatide dose?
Take it within 4 days (96 hours) of when it was due. If more than 4 days have passed, skip it and take the next dose on your normal day. Never take two doses to catch up.
Can I change the day I take my shot?
Yes, as long as there are at least 3 days (72 hours) between your last dose and the new one.
Can I go back down a dose if side effects are bad?
Ask your prescriber. You never have to step up on schedule, and the Zepbound label says a lower maintenance dose can be considered if a dose is not tolerated.
How is compounded tirzepatide dosed?
Your prescriber sets the mg dose, usually starting low and stepping up slowly. Vial strengths vary, so follow the instructions on your own vial and use the syringe your pharmacy provides. Compounded tirzepatide is not FDA-approved.
Sources
- Eli Lilly and Company. Zepbound (tirzepatide) injection, full prescribing information, revised 08/2026 (sections 1, 2, 3, 5, 6, 8 and 14; Study 1 is SURMOUNT-1, NCT04184622). pi.lilly.com
- Eli Lilly and Company. Mounjaro (tirzepatide) injection, full prescribing information, revised 08/2026. pi.lilly.com
- Eli Lilly and Company. Zepbound coverage and savings (LillyDirect self-pay, savings card, Medicare GLP-1 Bridge). zepbound.lilly.com
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (updated 04/01/2026). fda.gov
- U.S. Food and Drug Administration. FDA's concerns with unapproved GLP-1 drugs used for weight loss (current as of 10/01/2026). fda.gov
- U.S. Food and Drug Administration. FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products. fda.gov
