Tirzepatide Dosage Chart: The FDA Label Titration Schedule

A standard tirzepatide dosage chart, based on the FDA-approved labels for Zepbound and Mounjaro, begins at 2.5 mg injected subcutaneously once weekly for the first 4 weeks, increases to 5 mg once weekly, and may then rise in 2.5 mg steps no sooner than every 4 weeks up to a maximum of 15 mg once weekly. Tirzepatide is a prescription medicine, and the actual schedule a person follows is determined and adjusted by a licensed provider based on individual response and tolerability. This article is for education, not medical advice. Always talk to a licensed provider before starting, changing, or stopping any medication.

What is the tirzepatide dosage chart from the FDA label?

Tirzepatide is the single active molecule sold under two brand names, Zepbound and Mounjaro. It was first approved in the United States in 2022 as Mounjaro for type 2 diabetes; Zepbound was approved in 2023 for chronic weight management, and in late 2024 for moderate-to-severe obstructive sleep apnea in adults with obesity. The FDA prescribing information describes a stepwise, or titrated, schedule rather than a single fixed dose. The medicine is initiated at a low dose and increased gradually so the body can adjust, with each increase generally separated by at least 4 weeks. The table below summarizes the typical label titration. It is reference information, not a personal dosing plan.

Step	Earliest possible week (if escalated)	Dose (once weekly)	Role on the label
Start	Weeks 1-4	2.5 mg	Initiation only; not an effective maintenance dose
Step 1	Weeks 5-8	5 mg	First potential maintenance dose
Step 2	Weeks 9-12	7.5 mg	Optional increase if needed and tolerated
Step 3	Weeks 13-16	10 mg	Maintenance option
Step 4	Weeks 17-20	12.5 mg	Optional increase if needed and tolerated
Maximum	Week 21+	15 mg	Maximum dose for adults

The week numbers above reflect the minimum-interval scenario, that is, the earliest a dose could be raised if every step is increased at the soonest allowed time. They are not a required timeline. The label mandates only that increases be at least 4 weeks apart; your prescriber decides whether, and when, to advance.

Per the label, after the initial 4 weeks at 2.5 mg the dose is increased to 5 mg once weekly, and thereafter it may be increased in 2.5 mg increments after at least 4 weeks on the current dose. The maximum dose is 15 mg subcutaneously once weekly for all adult indications. Not everyone climbs to the top of the chart. Many people are kept at a lower dose if a higher one is not needed or not well tolerated, and a prescriber may slow the schedule or hold a dose at any point. You can read the full dosing section in the Zepbound prescribing information on DailyMed.

Why does tirzepatide start low and increase slowly?

Slow titration is built into the label primarily to improve tolerability. The most common side effects of tirzepatide are gastrointestinal, including nausea, diarrhea, vomiting, constipation, decreased appetite, indigestion, and abdominal pain. These reactions are dose-dependent, meaning their frequency tends to increase at higher doses, so escalating gradually gives the digestive system time to adjust. That is also why the label states the dose should not be increased more often than every 4 weeks. The starting 2.5 mg dose exists to begin treatment gently; it is not intended to deliver the full therapeutic effect on its own. These tolerability details are described in the Mounjaro prescribing information on DailyMed.

How is tirzepatide supplied, and how does that shape the chart?

Tirzepatide comes in six fixed single-dose strengths, 2.5, 5, 7.5, 10, 12.5, and 15 mg (each per 0.5 mL), with multi-dose pen formats at the same strengths. Because the strengths are fixed, the supply itself reinforces the stepwise schedule rather than encouraging arbitrary in-between amounts. A provider selects the appropriate strength for each phase. Patients should never attempt to calculate, measure, or adjust their own dose from a vial; the FDA has warned that incorrect self-measurement of GLP-1 medicines has led to dosing errors, some serious enough to require hospitalization.

What are the dosing differences between Zepbound and Mounjaro?

Although Zepbound and Mounjaro are the same molecule and share the same titration steps, they are approved for different uses, and their recommended maintenance doses differ. Mounjaro is approved for type 2 diabetes. Zepbound is approved for chronic weight management in adults with obesity, or overweight with at least one weight-related condition, and for moderate-to-severe obstructive sleep apnea in adults with obesity. The table below compares them at a high level. Which product, indication, and dose are appropriate is a clinical decision.

Feature	Mounjaro	Zepbound
Active molecule	Tirzepatide	Tirzepatide
FDA-approved use	Type 2 diabetes	Chronic weight management; obstructive sleep apnea in adults with obesity
Starting dose	2.5 mg once weekly	2.5 mg once weekly
Maximum dose	15 mg once weekly	15 mg once weekly
Typical maintenance	Provider-determined	5, 10, or 15 mg (10 or 15 mg for sleep apnea)

What happens if a dose is missed?

The label gives a specific instruction for missed doses, and a provider or pharmacist should confirm how it applies to any individual. According to the prescribing information, if a dose is missed it should be administered within 4 days (96 hours); if more than 4 days have passed, that dose is skipped and the next dose is taken on the regular weekly schedule. The weekly dosing day may be changed as long as at least 3 days (72 hours) separate two doses. These are label instructions, not a substitute for guidance from your own clinician.

What are the serious safety considerations and contraindications?

Tirzepatide carries an FDA Boxed Warning, the agency’s most prominent safety alert, for a risk of thyroid C-cell tumors. According to the label, in rats tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors; whether this applies to humans has not been determined. Because of this, tirzepatide is contraindicated in people with a personal or family history of medullary thyroid carcinoma (MTC) and in people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). The labels also describe other potential risks that a provider will review, which may include pancreatitis, gallbladder problems, low blood sugar (especially when combined with certain other diabetes medicines), kidney issues related to dehydration, and severe gastrointestinal reactions. This is a summary, not the complete safety profile; review the full warnings in the labeling and discuss your personal risks with a licensed provider.

What did clinical trials show, and what should the chart not promise?

In the SURMOUNT-1 phase 3 trial, a 72-week study of adults with obesity published in the New England Journal of Medicine in 2022, tirzepatide produced mean body-weight reductions of roughly 15 percent at 5 mg, about 19.5 percent at 10 mg, and about 20.9 percent at 15 mg, compared with about 3.1 percent with placebo, using the treatment-regimen estimand. A separate efficacy estimand in the same trial reported somewhat higher figures (up to about 22.5 percent at 15 mg). Discontinuations, largely due to gastrointestinal side effects, were higher with tirzepatide than placebo. These figures are averages from a specific study population over a defined period, reported in the SURMOUNT-1 publication. They describe trial results, not a guaranteed personal outcome. Individual results vary, and a dosage chart cannot predict how any one person will respond.

What does compounded mean, and what are the 2026 restrictions?

Compounded tirzepatide is prepared by a pharmacy rather than manufactured and reviewed by the brand maker, and it is not FDA-approved. The FDA states that compounded GLP-1 drugs pose a higher risk than approved versions because they do not undergo FDA premarket review for safety, quality, or effectiveness, and the agency has documented problems including dosing errors and unapproved salt forms. During the prior nationwide shortage, some pharmacies were permitted to compound tirzepatide under enforcement discretion. That window has closed. After the FDA declared the tirzepatide shortage resolved through a declaratory order issued December 19, 2024, enforcement discretion ended for state-licensed 503A pharmacies on February 18, 2025, and for 503B outsourcing facilities on March 19, 2025. As of 2026, mass compounding of a copy of tirzepatide is not permitted; only narrow, patient-specific 503A compounding may be possible in limited clinical circumstances. The FDA recommends obtaining GLP-1 prescriptions from a licensed clinician and filling them at a state-licensed pharmacy. See the FDA’s overview of compounding policies as GLP-1 supply stabilized. Compounded tirzepatide should not be presented as the same as, equivalent to, or interchangeable with FDA-approved Zepbound or Mounjaro.

Why should you never self-titrate tirzepatide?

The titration schedule is a prescriber decision based on individual tolerability, and the label explicitly ties each increase to the prescriber and to intervals of at least 4 weeks. Self-titrating, skipping steps, or jumping ahead can increase the likelihood and severity of gastrointestinal side effects and removes the medical oversight the schedule is designed to provide. Obtaining tirzepatide without a prescription, from foreign or gray-market sellers, or from so-called research-peptide sources is not recommended and may be unsafe; sharing injection pens is also unsafe. The safest path is a licensed clinician who determines whether the medication is appropriate, selects the dose, and adjusts it over time.

Frequently asked questions

What is the starting dose of tirzepatide?

According to the FDA-approved labels for Zepbound and Mounjaro, tirzepatide is typically started at 2.5 mg injected under the skin once weekly for 4 weeks. The label notes this starting dose is for treatment initiation only and is not considered an effective maintenance dose. Your provider determines your starting dose and any changes.

What is the maximum dose of tirzepatide?

The maximum dose on the label is 15 mg subcutaneously once weekly for adults across approved uses. Not everyone needs or reaches the maximum; many people are maintained at a lower dose. A licensed provider decides whether increasing toward the maximum is appropriate based on response and tolerability.

How fast can tirzepatide be increased?

The label states the dose should not be increased more often than every 4 weeks, and increases after 5 mg are made in 2.5 mg steps. Slower escalation is used to help reduce gastrointestinal side effects. Patients should never speed up or self-adjust the schedule; dose increases are a prescriber decision.

Is compounded tirzepatide the same as Zepbound or Mounjaro?

No. Compounded tirzepatide is not FDA-approved and is not reviewed by the FDA for safety, quality, or effectiveness, so it should not be considered the same as or equivalent to the branded products. As of 2026 the FDA-declared shortage is resolved and mass compounding is no longer permitted. The FDA recommends getting a prescription from a licensed clinician and filling it at a state-licensed pharmacy.

What should I do if I miss a dose of tirzepatide?

The label says to take a missed dose within 4 days (96 hours); if more than 4 days have passed, skip it and resume on the regular weekly schedule. The dosing day can be changed if at least 3 days separate two doses. Confirm how this applies to you with your provider or pharmacist rather than relying on a chart alone.