A week-by-week tirzepatide dosing chart, based on the Zepbound and Mounjaro labels

This is a week-by-week tirzepatide dosing chart built from the FDA-approved prescribing information for Zepbound and Mounjaro, the two approved tirzepatide products. It shows the labeled schedule: where it starts, how it steps up, and where it tops out. It is not a Luvo protocol and not a plan for you. Your dose is set by a licensed provider who knows your history. This article is educational and not medical advice.

The labeled schedule, week by week

Both labels start every patient at 2.5 mg once weekly for four weeks. The Zepbound label says the 2.5 mg dose is for starting treatment and is not approved as a maintenance dose [1]. After four weeks, the dose goes to 5 mg. From there it may be increased in 2.5 mg steps, with at least four weeks on each dose before the next increase [1, 2]. The maximum dose is 15 mg once weekly [1, 2].

The chart below shows the earliest week each dose could begin if a provider increased it at every four-week mark. Many people stay at a dose longer, and many never reach the top.

The Zepbound label lists 5 mg, 10 mg, and 15 mg as the recommended maintenance doses for weight reduction and long-term maintenance [1]. The 7.5 mg and 12.5 mg doses are steps along the way. For obstructive sleep apnea, a separate Zepbound indication, the recommended maintenance doses are 10 mg and 15 mg [1].

Mounjaro is approved for blood sugar control in type 2 diabetes. Its label uses the same starting dose and the same four-week steps, but it calls for increases only if additional blood sugar control is needed [2].

For how this compares with semaglutide, see our semaglutide and tirzepatide dosing guide.

What "maintenance dose" means

On the label, a maintenance dose is the dose a person stays on after the step-up phase. The Zepbound label tells prescribers to consider both how well treatment is working and how well it is tolerated when choosing one [1]. It also says that if someone does not tolerate a maintenance dose, a lower maintenance dose can be considered [1].

In other words, the top of the chart is a ceiling, not a target. Where a person settles is an individual decision made with a provider. For more, see What is a GLP-1 maintenance dose?

Missed doses and changing your injection day

Both labels give the same instructions [1, 2]:

• Missed dose: take it as soon as possible within 4 days (96 hours) of the missed dose.
• More than 4 days late: skip the missed dose and take the next one on your regular day.
• Changing your injection day: allowed, as long as at least 3 days (72 hours) pass between two doses.

The labels do not cover restarting after several missed weeks. If that happens, ask your provider before your next dose rather than picking up where you left off.

Why a provider may go slower or hold a dose

The Zepbound label says the step-up schedule exists to reduce the risk of stomach and digestive side effects [1]. In the label's weight-reduction trials, most nausea, vomiting, and diarrhea happened during dose increases and eased over time [1].

"At least four weeks" is a minimum, not a deadline. A provider may keep you on a dose longer, or hold off on an increase, if side effects are bothering you or if the current dose is doing its job. Moving up faster than the label allows is not part of the labeled schedule.

Compounded tirzepatide is a different situation

Compounded tirzepatide contains tirzepatide, the same molecule studied in FDA-approved products, but compounded formulations are not FDA-approved and are not evaluated for safety, effectiveness, or quality [3]. That has practical consequences for this chart:

• The chart describes how the approved products were studied and labeled. It is not a dosing schedule for any compounded formulation.
• A compounded product's concentration and volume per dose are set by the prescription and the dispensing pharmacy, so the dose volumes printed on approved pens and vials do not carry over.
• When a provider prescribes a compounded formulation, the dose and formulation are decided for that individual patient.

See the compounded tirzepatide injection page for how a provider may consider it, and the Zepbound page for the approved product.

Side effects to know about

Like any prescription medication, tirzepatide carries risks and possible side effects your provider will review with you. The Zepbound label lists nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion, injection site reactions, fatigue, allergic reactions, burping, hair loss, and acid reflux among the most common [1]. Both labels carry a boxed warning about thyroid C-cell tumors seen in rats, and tirzepatide should not be used by people with a personal or family history of medullary thyroid cancer or MEN 2 [1, 2].

One dosing-specific point: tirzepatide can make birth control pills less effective. The labels advise switching to a non-oral method, or adding a barrier method, for four weeks after starting and for four weeks after each dose increase [1, 2].

For more, see tirzepatide side effects.

Common questions

Can I stay on 2.5 mg?
The label describes 2.5 mg as a starting dose that is not approved for maintenance [1]. Staying at a lower dose long term is outside the labeled schedule, and whether it makes sense is a decision for your provider. See our microdosing tirzepatide guide.

What is the highest dose?
15 mg once weekly, for both Zepbound and adult Mounjaro use [1, 2].

What if I skip a week?
If you are within 4 days of your usual day, take it as soon as you can. If more than 4 days have passed, skip it and take the next dose on schedule [1, 2]. If you have missed more than one dose, check with your provider first.

How long until the next step?
At least four weeks on the current dose [1, 2]. Your provider decides whether and when to go up.

Next steps

If any of this sounds like what you are dealing with, the next step is a conversation with a licensed provider who can review your history and decide whether treatment makes sense for you. Nothing is prescribed or shipped without that review.

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