Tirzepatide Dosage Chart (2026): Zepbound & Mounjaro Dose Ladder, 2.5 mg to 15 mg Maximum

Tirzepatide — sold as Zepbound for chronic weight management and Mounjaro for type 2 diabetes — is a once-weekly subcutaneous injection that always starts at a deliberately low, non-therapeutic 2.5 mg dose for the first 4 weeks, then climbs a fixed ladder: 2.5 → 5 → 7.5 → 10 → 12.5 → 15 mg. The FDA label is explicit: begin at 2.5 mg once weekly, increase to 5 mg after 4 weeks, and if more glycemic control or weight loss is needed, increase in 2.5 mg increments no sooner than every 4 weeks up to a maximum of 15 mg once weekly. Crucially, there is not one “target” dose — Zepbound has three recognized maintenance doses (5, 10, or 15 mg), and the right one is the lowest dose that gets you the result you and your prescriber are aiming for at a side-effect burden you can live with. This guide lays out the full chart week by week, explains why tirzepatide escalates so slowly, and covers missed doses, titration pauses, and how compounded tirzepatide dosing differs. It is editorial research, not medical advice — every dose change is a decision you make with your prescriber.

The Zepbound / Mounjaro dose ladder

Tirzepatide is the same molecule whether it's labeled Zepbound (FDA-approved for chronic weight management and obstructive sleep apnea) or Mounjaro (FDA-approved for type 2 diabetes), and the dosing schedule is the same for both: once weekly, subcutaneously, on the same day each week, at any time of day, with or without food. Both come in six pen/vial strengths — 2.5, 5, 7.5, 10, 12.5, and 15 mg — and you climb the ladder one rung at a time. The full schedule, straight from the FDA label, looks like this:

Why tirzepatide escalates in 2.5 mg steps every 4 weeks

The slow, stepwise titration isn't bureaucratic caution — it is the single most important thing you can do to tolerate tirzepatide. The most common adverse effects (nausea, diarrhea, vomiting, constipation) are dose-dependent and worst right after a dose increase. Starting at the full dose would put most people on the bathroom floor; the 2.5 mg lead-in gives your gut four weeks to adapt before you reach a dose that actually drives weight loss or glycemic control. A few reasons the schedule is built the way it is:

• The 2.5 mg starting dose is non-therapeutic on purpose. The FDA label states 2.5 mg is a starting dose and not intended for glycemic control (Mounjaro) or as a weight-management maintenance dose (Zepbound). Its job is tolerability — letting the GI tract acclimate to incretin-receptor activation before the effective doses arrive.
• Four weeks lets steady-state catch up. Tirzepatide has a roughly 5-day half-life, so it takes about 4 weeks to approach steady-state concentrations at each new dose. Holding ≥4 weeks before the next increase means you're judging tolerability at the full effect of the current rung, not a partial one.
• GI side effects are dose- and titration-paced. Slower escalation, longer holds at a tolerated dose, and dose reductions when needed are the standard levers for managing nausea and GI upset — the label explicitly allows holding or stepping back down.
• There is no benefit to rushing. Jumping rungs early doesn't speed results; it mostly buys side effects that drive people to quit. The dose that works is the one you can actually stay on.

This is also why “why am I still on 2.5 mg / 5 mg” is the wrong question to ask the internet and the right question to ask your prescriber. Some people get excellent results and stop climbing at 5 or 10 mg; others need 15 mg. The ladder is a menu of stopping points, not a staircase you're obligated to climb to the top. Our GLP-1 titration planner can map your personal week-by-week schedule, and the GLP-1 dose plotter visualizes where each rung falls on the calendar.

Maintenance doses (5, 10, or 15 mg — multiple maintenance options)

One of the most misunderstood facts about tirzepatide is that there is no single “goal” dose. For Zepbound, the FDA label recognizes three maintenance doses — 5 mg, 10 mg, and 15 mg once weekly. That is deliberate: it lets you and your prescriber stop the climb at whichever dose delivers an acceptable result with tolerable side effects, rather than pushing everyone to the maximum.

• 5 mg — the lowest maintenance dose. If you're hitting your goals and feeling well at 5 mg, there's no requirement to go higher. In SURMOUNT-1, the 5 mg arm still produced substantial mean weight loss (see below).
• 10 mg — a very common landing spot, balancing strong efficacy with manageable tolerability for many people.
• 15 mg — the maximum dose and the highest-efficacy maintenance dose, for those who need more response and tolerate the climb.
• 7.5 mg and 12.5 mg are titration steps, not maintenance doses. You generally pass through them on the way up; they exist to make the 2.5 mg jumps gentler, not as endpoints.

What the doses translate to in results: in the pivotal SURMOUNT-1 trial (Jastreboff AM et al., N Engl J Med 2022), adults with obesity and without diabetes lost a mean of −15.0% body weight on tirzepatide 5 mg, −19.5% on 10 mg, and −20.9% on 15 mg at 72 weeks, versus −3.1% on placebo.^[3] More dose buys more average weight loss — but even the lowest maintenance dose produced clinically meaningful loss, which is exactly why 5 mg is a legitimate place to stay. For ranked, vetted prescribers who manage this titration, see Best tirzepatide providers 2026.

Compounded tirzepatide dosing differs (provider-directed)

Important distinction: compounded tirzepatide is not the same product as Zepbound or Mounjaro, and its dosing is not governed by the FDA label. Compounded tirzepatide is made by a compounding pharmacy; it is not FDA-approved and not reviewed by the FDA for safety, effectiveness, or quality. Because the FDA declared the tirzepatide shortage resolved in 2024, the legal basis for routine large-scale compounding narrowed sharply, though patient-specific (503A) compounding for documented clinical needs continues. If you are on compounded tirzepatide, a few things change about dosing:

• The schedule is set by the prescribing provider, not the FDA label. Compounders and telehealth platforms often use their own titration protocols, which may differ from the 2.5 → 5 → 7.5 → 10 → 12.5 → 15 mg branded ladder — sometimes with intermediate doses or different escalation intervals.
• Concentration matters more. Compounded tirzepatide is supplied in multi-dose vials at provider-specified concentrations (mg/mL), so your dose is a volume you draw up with a syringe, not a pre-set pen click. A dosing error is easier to make — follow the provider's written instructions exactly and never estimate.
• Some compounds add other ingredients (e.g., vitamin B12 or other additives). These are not present in branded Zepbound/Mounjaro and are not FDA-evaluated in combination.
• The 2.5 mg-step, 4-week-minimum logic still applies clinically even off-label — slow titration is what makes tirzepatide tolerable regardless of source. But the exact numbers are whatever your prescriber directs.

Bottom line on compounded: follow your provider's specific dosing instructions, confirm the vial concentration and the exact volume per dose, and understand you are using a non-FDA-approved product. If you're weighing compounded against genuine brand tirzepatide, our reviews of vetted telehealth platforms — Found and Ro — and the tirzepatide providers ranking walk through the trade-offs.

Missed dose and titration pauses

Life happens — you forget a dose, you run out, you take a break for a procedure. Here is how the FDA label handles the gaps, with the prescriber-directed framing that always applies:

• Missed a dose, ≤ 4 days (96 hours) late? Per the label, take it as soon as possible, then resume your regular weekly schedule on your usual day.
• More than 4 days late? Skip the missed dose and take the next dose on the regularly scheduled day. Do not double up to “catch up.”
• Switching injection day: the day of weekly administration can be changed if needed, as long as the time between two doses is at least 3 days (72 hours).
• Restarting after a longer pause: if you've been off tirzepatide for an extended period, do not assume you resume at your old dose. A prescriber may restart you lower and re-titrate, because tolerability fades when you stop — this is a clinical judgment call, not a fixed rule.
• Pausing the climb for side effects is normal. The 4-week interval is a minimum; holding at a tolerated dose for longer, or stepping back down a rung, is a standard, label-permitted way to manage GI side effects. Slower is fine.

Choosing a maintenance dose with your prescriber

Because Zepbound has multiple valid maintenance doses, “what dose should I be on” is a genuinely individual decision. The dose isn't a competition — the best maintenance dose is the lowest one that achieves your goal at a side-effect burden you can sustain. Factors that go into that conversation with your prescriber:

• Are you meeting your weight or glycemic goal? If yes at your current dose, there's often no reason to climb higher.
• How are you tolerating it? Persistent nausea, vomiting, or GI upset is a reason to hold, slow down, or step back — not to push through.
• Has your response plateaued? A stall at a sub-maximal dose may be a reason to step up one rung after ≥4 weeks; it may also be a reason to revisit diet, activity, and adherence first.
• Cost and supply. Higher doses and certain forms (pen vs. self-pay vial vs. compounded) carry different prices; this is a legitimate part of the dose conversation.
• Other medical factors. Renal status, GI disease, other medications, and history all shape how aggressively to titrate. Your prescriber weighs these — the label is the floor, your clinician applies it to you.