What is the dosing schedule for tirzepatide?

The short answer

Evidence tier: 1 — every dosing number on this page is taken from the FDA prescribing information for Mounjaro and Zepbound, both revised 08/2026.

Tirzepatide starts at 2.5 mg injected once a week for 4 weeks, then goes up in 2.5 mg steps, with at least 4 weeks on each dose, to a maximum of 15 mg once weekly. For weight management (Zepbound) the labeled maintenance doses are 5, 10 or 15 mg; for obstructive sleep apnea they are 10 or 15 mg. For type 2 diabetes (Mounjaro) the dose is raised only if more glucose control is needed. Which dose a person stays on is a prescriber's decision.

This page is the dosing reference. For the molecule itself, see the tirzepatide profile; for how it works and what the trials showed, see the tirzepatide deep dive; for how its ladder compares with semaglutide's, see the GLP-1 titration schedule guide.

What is the starting dose of tirzepatide?

Evidence tier: 1 — the 2.5 mg starting dose and its initiation-only status are in section 2.1 of both labels.

The starting dose is 2.5 mg, injected under the skin once a week. Both labels use the same starting dose, and both say the escalation exists to reduce the risk of gastrointestinal side effects such as nausea, vomiting and diarrhea.

The Zepbound label is explicit that 2.5 mg "is for treatment initiation and is not approved as a maintenance dosage." In other words, the first month is a run-in, not a treatment dose. The pivotal weight-loss trial, SURMOUNT-1, used a 20-week dose-escalation period, the length of five 4-week steps from 2.5 mg to 15 mg (Jastreboff et al., 2022).

What is the tirzepatide dosing schedule week by week?

Evidence tier: 1 — step size and minimum interval are from section 2.1 of both labels. The week ranges are the earliest the label allows, not a target.

Each step is 2.5 mg, and each dose is held for at least 4 weeks before the next increase. If every step were taken at the earliest point, the schedule would look like this:

Three points keep this table in proportion:

• "At least 4 weeks" is a floor. Prescribers can hold a dose longer, and many do when side effects persist.
• Nobody has to reach 15 mg. The Zepbound label says to consider "treatment response and tolerability" when choosing the maintenance dose, and to consider a lower maintenance dose if one is not tolerated.
• The 7.5 mg and 12.5 mg steps are not listed as weight-management maintenance doses on the Zepbound label, although the strengths exist and are used during escalation.

What are the maintenance doses for each indication?

Evidence tier: 1 — section 2.2 of the Zepbound label and section 2.1 of the Mounjaro label.

The three weight-management maintenance doses also mirror a trial. SURMOUNT-1 randomised 2,539 adults with obesity or overweight, without diabetes, to 5, 10 or 15 mg or placebo for 72 weeks:

Going from 10 mg to 15 mg added 1.4 percentage points of weight loss, against 4.5 points from 5 mg to 10 mg, and adverse-event discontinuation was similar at the two higher doses.

The OSA doses mirror the trial design too. In the two SURMOUNT-OSA trials, adults with moderate to severe sleep apnea and obesity received their maximum tolerated dose of tirzepatide, either 10 mg or 15 mg, or placebo for 52 weeks (Malhotra et al., 2024).

The Mounjaro label also now carries an indication to reduce the risk of major cardiovascular events in adults with type 2 diabetes at high cardiovascular risk. It uses the same dosing instructions.

What is the maximum dose of tirzepatide?

Evidence tier: 1 — section 2 of both labels; the Zepbound label states that 15 mg once weekly is the maximum for all its indications.

The maximum is 15 mg once weekly for every adult indication on both labels, and 10 mg once weekly for children aged 10 and older on Mounjaro. There is no approved tirzepatide dose above 15 mg, and 15 mg was the highest dose tested in SURMOUNT-1 and the SURMOUNT-OSA trials. Taking more than the labeled maximum is outside the evidence the approvals rest on. Our guide to what comes after the top GLP-1 dose explains why this differs from semaglutide, which now has a 7.2 mg option.

What if you miss a dose of tirzepatide?

Evidence tier: 1 — section 2.3 of the Zepbound label and section 2.1 of the Mounjaro label use identical wording.

The rule turns on 4 days (96 hours):

• Within 4 days of the missed dose: take it as soon as possible.
• More than 4 days have passed: skip it and take the next dose on the usual day.

Either way, the regular once-weekly schedule then resumes. Two doses should never be taken close together to "catch up." After several missed weeks, whether to restart at the same dose or step back is a question for the prescriber, because the label does not address longer gaps.

How far apart must tirzepatide doses be, and can you change your injection day?

Evidence tier: 1 — the 3-day (72-hour) minimum gap and the injection-site instructions are in section 2 of both labels.

The injection day can be changed if needed, as long as the two doses are at least 3 days (72 hours) apart. Doses can be taken at any time of day, with or without meals. The labels list the abdomen, thigh or back of the upper arm (the arm only when someone else injects) as sites, and say to rotate sites with each dose.

What tirzepatide pens and vials are available?

Evidence tier: 1 — section 3 (Dosage Forms and Strengths) of both labels.

Both Mounjaro and Zepbound now come in four presentations, each in all six strengths (2.5, 5, 7.5, 10, 12.5 and 15 mg):

The labels add some handling rules:

• Vial users need a syringe that can measure the prescribed volume, and a new syringe and needle for every injection.
• A KwikPen must never be shared between people, even with a new needle.
• The KwikPen is not recommended for self-injection by people with visual impairment, and the Mounjaro label adds that it is not recommended for self-injection by children.
• Anyone whose presentation changes should be retrained and read the new Instructions for Use.

For pen technique, see GLP-1 pen problems and how to use them.

These are branded, FDA-approved products with fixed doses. This page does not cover compounded tirzepatide, "unit" conversions or off-label low dosing; any dose change outside the labeled steps is a prescriber decision. For the legal status of compounded products, see compounded GLP-1s and the 503A/503B rules.

How much does tirzepatide cost?

Evidence tier: 2 — self-pay prices are from Lilly's own LillyDirect page (accessed 3 November 2026); the list price is from a secondary source citing Lilly. Prices change often.

On LillyDirect, Zepbound self-pay prices for a 28-day supply (four single-dose vials, or one KwikPen) were:

Lilly says the lower prices for 7.5 mg and above come from its Zepbound Journey Program, require eligibility and may change or end at any time. Needles and syringes are bought separately. The single-dose pen is not sold at a self-pay price; it is the insurance-billed presentation, with a commercial-insurance savings card.

The list price is much higher: a June 2026 summary citing Lilly gave about $1,086 for four Zepbound pens and $1,112 for four Mounjaro pens (28 days each). Insured costs depend on the plan, and weight-management coverage is often excluded.

For ways people reduce the cost legally, see GLP-1 cost-saving strategies.

Limitations

This page summarises labels; it is not medical advice or a dosing plan.

• Labels change. Both were revised in 08/2026 and have changed several times since approval. Check the current prescribing information.
• The schedule table shows the fastest allowed pace. It is not a recommendation to escalate on that timeline.
• Prices were checked on 3 November 2026 and may already be different. Lilly states no effective date on its page.
• The list-price figures are secondary. Lilly's own pricing page could not be accessed directly.
• Coverage, prior authorization and pharmacy pricing vary by plan and country; this page covers US branded prices only. For Europe, see tirzepatide EU availability.

The bottom line

The tirzepatide schedule is simple on paper: 2.5 mg for 4 weeks, then 2.5 mg steps no sooner than every 4 weeks, to a ceiling of 15 mg. Maintenance is 5, 10 or 15 mg for weight, 10 or 15 mg for sleep apnea, and whatever controls glucose for type 2 diabetes. The two timing rules to remember are 4 days for a missed dose and at least 3 days between doses.

The schedule is a set of limits, not a target. Many people stay on a lower dose that works and is tolerated, and that choice, along with any pause, step back or switch, belongs with the prescriber. LillyDirect self-pay prices run from $299 to $699; check the current figure.

Related on this site

• Tirzepatide profile
• Tirzepatide deep dive
• GLP-1 titration schedule
• What comes after the top GLP-1 dose
• GLP-1 side effects and how to manage them
• Switching between GLP-1s
• GLP-1 cost-saving strategies
• Semaglutide vs tirzepatide

References

• US Food and Drug Administration (Drugs@FDA). Zepbound (tirzepatide) injection, NDA 217806: prescribing information, revised 08/2026.
• US Food and Drug Administration (Drugs@FDA). Mounjaro (tirzepatide) injection, NDA 215866: prescribing information, revised 08/2026.
• Eli Lilly and Company. 2026 (revised 08/2026). Zepbound (tirzepatide) injection: full prescribing information.
• Eli Lilly and Company. 2026 (revised 08/2026). Mounjaro (tirzepatide) injection: full prescribing information.
• Jastreboff AM, Aronne LJ, Ahmad NN, et al. 2022. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med. 387(3):205-216. PMID 35658024 · doi:10.1056/NEJMoa2206038
• Malhotra A, Grunstein RR, Fietze I, et al. 2024. Tirzepatide for the treatment of obstructive sleep apnea and obesity. N Engl J Med. 391(13):1193-1205. PMID 38912654 · doi:10.1056/NEJMoa2404881
• Eli Lilly and Company. LillyDirect: Zepbound self-pay pricing (page last modified 2 September 2026; accessed 3 November 2026).
• Ro. 2026 (updated 9 June 2026). How much does tirzepatide cost? (secondary source for list prices, citing Lilly's pricing pages).