Dosing guide

Tirzepatide dosage: the titration schedule explained

7 min read Updated August 2026 US-licensed providers

The short answer

The FDA label for Zepbound (tirzepatide) starts at 2.5 mg once weekly for four weeks, then 5 mg, then increases in 2.5 mg steps after at least four weeks at each dose, up to a maximum of 15 mg weekly. Recommended maintenance doses are 5 mg, 10 mg, or 15 mg, and 2.5 mg is for initiation only. Your provider sets your schedule.

The tirzepatide titration schedule, step by step

This is the dose escalation pattern in the FDA prescribing information for Zepbound, the tirzepatide product approved for chronic weight management. Each dose is held for at least four weeks before any increase:

Step	Weekly dose	What this step is for
Weeks 1 to 4	2.5 mg once weekly	Starting dose. The label states it is for treatment initiation and is not intended for chronic weight management
Week 5 onward	5 mg once weekly	First increase, and the lowest of the recommended maintenance doses
After at least 4 weeks at 5 mg	7.5 mg once weekly	Optional escalation step
After at least 4 weeks at 7.5 mg	10 mg once weekly	A recommended maintenance dose
After at least 4 weeks at 10 mg	12.5 mg once weekly	Optional escalation step
After at least 4 weeks at 12.5 mg	15 mg once weekly	A recommended maintenance dose, and the maximum dose

Dose escalation from the FDA prescribing information for Zepbound (tirzepatide): increases of 2.5 mg after at least 4 weeks on the current dose, recommended maintenance dosages of 5 mg, 10 mg, or 15 mg once weekly, and a maximum of 15 mg once weekly. The label also says to consider a lower maintenance dosage if the current one is not tolerated. Labeling is updated over time. Compounded tirzepatide is not FDA-approved and your provider sets your individual schedule.

The diabetes-branded product, Mounjaro, uses the same 2.5 mg starting dose and 2.5 mg increments, but the dosing decisions there are driven by blood sugar control. Which product applies to you is a provider's decision.

Why does tirzepatide need to be titrated at all?

Because tolerability, not impatience, sets the pace. Tirzepatide slows gastric emptying and reduces appetite, and the digestive system adapts gradually. The FDA label notes that most nausea, vomiting, and diarrhea occurred during dose escalation and decreased over time, which is the clearest possible statement of what the schedule is managing.

2.5 mg is not a treatment dose. The label says so explicitly. It exists to get you to 5 mg comfortably.
Four weeks is a minimum, not a maximum. A dose can be held longer if the next step is not tolerated.
Three maintenance doses are recommended. 5 mg, 10 mg, and 15 mg. Not everyone climbs to the top, and stopping at a lower maintenance dose is a normal outcome.
The label allows stepping back down. If a maintenance dosage is not tolerated, a lower one can be considered.

The full safety picture, including the boxed warning and the contraindications, is on tirzepatide side effects.

What a maintenance dose actually means

Maintenance is the dose you settle at once escalation ends, and for Zepbound the label names three: 5 mg, 10 mg, or 15 mg once weekly. Your provider chooses between them based on how you have responded and how you have tolerated each step, and the choice can be revisited.

The 7.5 mg and 12.5 mg doses exist as stepping stones on the way up rather than as recommended maintenance doses, though a provider may keep you at an intermediate dose if that is what suits you. A maintenance dose is also not an endpoint after which you stop: tirzepatide works while it is in your system, which is covered on do you have to take a GLP-1 forever.

What happens if you miss a dose?

The rule for tirzepatide is a four-day window, and it is different from the semaglutide rule, so do not carry one across to the other:

Situation	What the label says to do
You remember within 4 days (96 hours) of the missed dose	Take it as soon as possible, then resume your regular weekly schedule
More than 4 days have passed	Skip the missed dose and take the next one on your regularly scheduled day
You want to move your weekly day	The day can be changed as long as there are at least 3 days (72 hours) between two doses
You have missed several weeks	Speak to your provider before restarting, since your dose may need to be reset

From the FDA prescribing information for Zepbound (tirzepatide). Never take two doses to make up for a missed one.

The practical details of taking it

Once weekly, any time of day. The label says it can be taken with or without meals.
Where to inject. Subcutaneously, rotating injection sites. Follow the instructions for use supplied with your specific product.
Inspect before you inject. The label says the solution should be clear and colorless to slightly yellow, and not to use it if you see particles or discoloration.
Storage. Follow the storage instructions supplied with your product by your pharmacy.
Oral contraception. The Zepbound label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase. Raise this at your consult.
Pick a sensible day. Symptoms are most likely in the days after a dose, particularly after a step up.

Do not adjust your own dose or improvise a schedule from something you read. Dose changes are clinical decisions, and dosing errors are one of the more common ways people get hurt on these medications.

Your provider sets your schedule

The table above is the labeled schedule, not your prescription. At Expert Health, compounded tirzepatide starts at $332 per month ($997 for a 3-month supply), and the dose management is what the plan is built around:

A free consultation with a health specialist, with no obligation to buy
A US-licensed provider sets your starting dose and titration pace from your history and goals
Tirzepatide compounded by an FDA-regulated US pharmacy, with free discreet shipping
Provider check-ins every four weeks, which lines up with the minimum interval between dose increases

Compounded medications are not FDA-approved. Compounded products may also be supplied in different concentrations to the brand pens, so follow your own prescription rather than a schedule from a forum. Compare with the semaglutide dosing schedule.

Tirzepatide, as low as $332/mo Prescribed by a US-licensed provider, compounded by a licensed US pharmacy, shipped free. See the full plan and what is included.

See Tirzepatide

Frequently asked questions

What is the tirzepatide dosing schedule?

The FDA label for Zepbound starts at 2.5 mg once weekly for four weeks, then increases to 5 mg once weekly. After that the dose may increase in 2.5 mg increments after at least four weeks at the current dose, up to a maximum of 15 mg once weekly. Recommended maintenance dosages are 5 mg, 10 mg, or 15 mg.

What is the maximum dose of tirzepatide?

15 mg once weekly for Zepbound, the weight-management product. The label also names 5 mg and 10 mg as recommended maintenance dosages, so reaching the maximum is not the goal for everyone.

What is the starting dose of tirzepatide?

2.5 mg once weekly for the first four weeks. The label states plainly that this dose is for treatment initiation and is not intended for chronic weight management, which is why it is followed by an increase to 5 mg.

What happens if I miss a dose of tirzepatide?

Take it as soon as possible within 4 days (96 hours) of the missed dose, then resume your regular weekly schedule. If more than 4 days have passed, skip it and take the next dose on your regularly scheduled day. Never take two doses to catch up.

Can I change the day I take tirzepatide?

Yes. The label allows the day of weekly administration to be changed as long as there are at least 3 days (72 hours) between two doses. Tell your provider so the change is documented alongside your titration plan.

How long do you stay on each tirzepatide dose?

At least four weeks before any increase, per the label. If a step up is not tolerated, staying longer at the current dose or moving to a lower maintenance dosage are both options your provider can use.

Is 5 mg of tirzepatide enough?

It can be. 5 mg is one of the three recommended maintenance dosages on the Zepbound label, alongside 10 mg and 15 mg. Your provider chooses the maintenance dose based on how you respond and how you tolerate it.

Is compounded tirzepatide dosed the same as Zepbound?

Not necessarily. Compounded tirzepatide is not FDA-approved and may be supplied at different concentrations, so follow the instructions on your own prescription. A US-licensed provider sets your dose and titration schedule.

Sources

Zepbound (tirzepatide) injection, Prescribing Information · U.S. Food and Drug Administration
Mounjaro (tirzepatide) injection, Prescribing Information · U.S. Food and Drug Administration

This article is for general educational purposes and is not medical or legal advice. Statements have not been evaluated by the FDA, and treatments referenced are not intended to diagnose, treat, cure, or prevent any disease. Compounded medications are not FDA-approved. Individual results vary. Always consult a licensed provider before starting any treatment.