Tirzepatide Dosage Chart: Complete Guide to Dosing & Units (2025)
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Understanding Tirzepatide Dosing
Tirzepatide follows a carefully structured dosing protocol that starts low and gradually increases over time. This approach, called "dose escalation," helps your body adjust to the medication and minimizes side effects like nausea and digestive discomfort.
Whether you're using brand-name Mounjaro (for diabetes), Zepbound (for weight loss), or compounded tirzepatide, understanding the dosing schedule is crucial for achieving optimal results safely.
⚠️ Key Principle:
Never start at a high dose or skip the escalation steps, even if you're eager for faster results.
Standard Tirzepatide Dosage Chart
FDA-Approved Brand Name Dosing (Mounjaro/Zepbound)
| Week | Dose (mg) | Duration | Purpose | Expected Results |
|---|---|---|---|---|
| 1-4 | 2.5 mg | 4 weeks | Tolerance assessment | Minimal weight loss (2-4 lbs), reduced appetite |
| 5-8 | 5 mg | 4 weeks minimum | First therapeutic dose | Steady weight loss begins (1-2 lbs/week) |
| 9-12 | 7.5 mg | 4 weeks minimum | Enhanced efficacy | Increased weight loss, appetite suppression |
| 13-16 | 10 mg | 4 weeks minimum | Higher therapeutic range | Peak effectiveness for many users |
| 17-20 | 12.5 mg | 4 weeks minimum | Near-maximum dose | Further weight loss if needed |
| 21+ | 15 mg | Ongoing | Maximum approved dose | Maximum therapeutic effect |
✅ DO:
- Start with 2.5 mg for at least 4 weeks
- Wait minimum 4 weeks before each dose increase
- Stay at your current dose if experiencing good results with minimal side effects
- Inject once weekly on the same day each week
- Rotate injection sites to prevent skin issues
❌ DON'T:
- Skip the 2.5 mg starting dose
- Increase dose faster than every 4 weeks
- Continue increasing if you've reached your weight loss goals
- Double dose if you miss an injection
- Share medication with others
Tirzepatide Unit Conversion Chart
Compounded tirzepatide often requires you to measure doses in units (like insulin syringes) rather than pre-measured pens. Here's how to convert:
Standard Concentration: 5mg/mL
This is the most common concentration for compounded tirzepatide:
| Dose (mg) | Units on Insulin Syringe | mL Volume |
|---|---|---|
| 2.5 mg | 50 units | 0.5 mL |
| 5 mg | 100 units | 1.0 mL |
| 7.5 mg | 150 units | 1.5 mL |
| 10 mg | 200 units | 2.0 mL |
| 12.5 mg | 250 units | 2.5 mL |
| 15 mg | 300 units | 3.0 mL |
Alternative Concentration: 10mg/mL
Some compounding pharmacies use this stronger concentration:
| Dose (mg) | Units on Insulin Syringe | mL Volume |
|---|---|---|
| 2.5 mg | 25 units | 0.25 mL |
| 5 mg | 50 units | 0.5 mL |
| 7.5 mg | 75 units | 0.75 mL |
| 10 mg | 100 units | 1.0 mL |
| 12.5 mg | 125 units | 1.25 mL |
| 15 mg | 150 units | 1.5 mL |
Alternative Concentration: 2.5mg/mL
Less common, typically used for lower doses:
| Dose (mg) | Units on Insulin Syringe | mL Volume |
|---|---|---|
| 2.5 mg | 100 units | 1.0 mL |
| 5 mg | 200 units | 2.0 mL |
| 7.5 mg | 300 units | 3.0 mL |
⚠️ CRITICAL:
Always verify your vial's concentration with your pharmacy. Using the wrong conversion can result in under-dosing or dangerous over-dosing.
How to Read Your Vial Label
Your compounded tirzepatide vial should clearly state the concentration:
Tirzepatide 25mg/5mL
(5mg/mL concentration)
What this means:
- Total medication in vial: 25mg
- Total volume: 5mL
- Concentration: 5mg per 1mL
To calculate your dose:
- Identify your prescribed dose (e.g., 5mg)
- Divide by concentration: 5mg ÷ 5mg/mL = 1mL
- Convert to units: 1mL = 100 units on insulin syringe
Quick Formula
Example:
You need 7.5mg, your concentration is 5mg/mL
- 7.5 ÷ 5 = 1.5
- 1.5 × 100 = 150 units
Dose Escalation Schedule Explained
Why Dose Escalation Matters
Gradually increasing your dose serves several critical purposes:
- Minimizes Side Effects: Your digestive system needs time to adjust
- Identifies Optimal Dose: Not everyone needs the maximum dose
- Improves Tolerability: Reduces risk of severe nausea and vomiting
- Ensures Safety: Allows monitoring for adverse reactions
- Maximizes Adherence: Better experience means you're more likely to continue
Visual Timeline
↓
Month 2: 5mg → First real weight loss begins (4-8 lbs)
↓
Month 3: 7.5mg → Accelerated weight loss (6-10 lbs)
↓
Month 4: 10mg → Peak effectiveness for many (8-12 lbs)
↓
Month 5: 12.5mg → Further optimization if needed
↓
Month 6: 15mg → Maximum dose (if required)
DON'T increase if:
- You're losing 1-2+ lbs per week consistently
- Side effects are still significant
- You've reached your weight loss goal
- Blood sugar is well-controlled (for diabetes patients)
DO increase if:
- Weight loss has stalled for 4+ weeks
- Side effects are minimal or resolved
- Appetite suppression has decreased
- Your provider recommends it based on your progress
When to Decrease Dose
Some situations may require stepping back to a lower dose:
- Severe persistent nausea/vomiting lasting beyond first week
- Inability to eat adequate protein (below 50g daily)
- Dehydration that won't resolve
- Excessive fatigue affecting daily function
- Starting other medications that may interact
Important:
Never adjust dose without consulting your healthcare provider.
Compounded Tirzepatide Dosing
Compounded tirzepatide follows the same escalation schedule as brand-name, but requires more careful measurement.
Starting Dose for Compounded
Standard Protocol:
- Week 1-4: 2.5mg weekly
- Many compounders start here to match FDA-approved protocol
Alternative "Microdosing" Protocol (increasingly popular):
- Week 1-2: 1mg weekly
- Week 3-4: 1.5mg weekly
- Week 5-6: 2mg weekly
- Week 7-8: 2.5mg weekly
- Then continue standard escalation
Why Microdosing?
- Even gentler introduction
- May further reduce side effects
- Allows very gradual adaptation
- Not FDA-approved but used by some providers
Common Compounding Vial Sizes
| Vial Size | Concentration | Weekly Doses | Cost Range |
|---|---|---|---|
| 25mg/5mL | 5mg/mL | 5 weeks at 5mg | $250-$350 |
| 50mg/10mL | 5mg/mL | 10 weeks at 5mg | $400-$600 |
| 30mg/3mL | 10mg/mL | 6 weeks at 5mg | $300-$450 |
| 50mg/5mL | 10mg/mL | 10 weeks at 5mg | $450-$650 |
Money-Saving Tip:
Larger vials often have better per-dose pricing. However, consider:
- Vials typically expire 28 days after reconstitution
- Higher doses use medication faster
- Ensures you won't waste medication if you need to stop
Reconstitution Instructions
If your compounded tirzepatide comes as powder:
Step-by-Step:
- Verify: Check medication name, dose, and expiration
- Calculate: Determine how much bacteriostatic water to add (pharmacy provides this)
- Draw water: Use clean syringe to draw prescribed amount
- Add slowly: Inject water along side of vial, not directly onto powder
- Swirl gently: DO NOT shake vigorously
- Wait: Allow 5-10 minutes for complete dissolution
- Inspect: Solution should be clear and colorless
- Label: Write reconstitution date on vial
- Store: Refrigerate immediately
Common Reconstitution Ratios:
- 10mg powder + 2mL water = 5mg/mL concentration
- 25mg powder + 5mL water = 5mg/mL concentration
- 50mg powder + 5mL water = 10mg/mL concentration
Dosing for Weight Loss vs Diabetes
While the medication is the same, dosing strategies may differ based on your primary goal:
For Weight Loss (Zepbound Protocol)
Typical Progression:
- Most patients achieve goals between 10-15mg
- Maximum dose: 15mg weekly
- Average time to goal: 6-12 months
- Maintenance: Usually 5-10mg after reaching goal
Weight Loss Expectations by Dose:
- 2.5mg: 2-4% body weight over 4 weeks
- 5mg: 5-8% by week 8
- 7.5mg: 10-12% by week 12
- 10mg: 15-18% by week 20
- 15mg: 20-22% by week 36-72
For Type 2 Diabetes (Mounjaro Protocol)
Typical Progression:
- Many patients achieve glycemic control at 5-10mg
- Maximum dose: 15mg weekly
- HbA1c reduction: 1.5-2.5% on average
- Bonus: Weight loss of 12-15% as secondary benefit
Blood Sugar Expectations:
- 5mg: HbA1c reduction of ~1.5%
- 10mg: HbA1c reduction of ~2.0%
- 15mg: HbA1c reduction of ~2.5%
Important for Diabetics:
- Monitor blood sugar closely during dose increases
- May need to reduce other diabetes medications
- Risk of hypoglycemia if on insulin or sulfonylureas
- More frequent monitoring required initially
Maintenance Dose After Weight Loss
Once you reach your goal weight, the question becomes: what dose maintains your results?
Determining Your Maintenance Dose
| Maintenance Dose | Percentage of Patients | Notes |
|---|---|---|
| 5mg weekly | 40% | Works for many patients |
| 7.5mg weekly | 30% | Sufficient for most |
| 10mg weekly | 25% | Needed by some patients |
| 12.5-15mg weekly | 5% | Required by few patients |
How to Find Your Maintenance Dose
- Step 1: Stay at your current dose for 4-8 weeks after reaching goal
- Step 2: Attempt to reduce by one dose level (e.g., 10mg → 7.5mg)
- Step 3: Monitor weight for 8 weeks
- Step 4: If weight remains stable (±3 lbs), stay at reduced dose
- Step 5: If weight increases >5 lbs, return to previous dose
Maintenance Strategies
Strategy 1: Standard Maintenance
- Continue weekly injections at reduced dose
- Most reliable for weight stability
- Ongoing cost but consistent results
Strategy 2: Extended Dosing (off-label)
- Inject every 10-14 days instead of weekly
- Reduces cost by 50%
- May work due to medication's 5-day half-life
- Not FDA-approved, discuss with provider
Strategy 3: Pulse Dosing (experimental)
- Monthly "pulse" doses during maintenance
- Very limited data, not generally recommended
- Higher risk of weight regain
Strategy 4: Medication Holiday (not recommended)
- Stopping medication entirely
- Almost always results in weight regain
- Average regain: 14% of lost weight within 1 year
Our Recommendation:
Plan for long-term maintenance dosing. Clinical evidence strongly suggests continued treatment is necessary to prevent weight regain.
Special Dosing Situations
Switching from Semaglutide to Tirzepatide
If you're transitioning from Wegovy/Ozempic:
Conversion Approach 1: Conservative
- Start tirzepatide at 2.5mg regardless of semaglutide dose
- Follow standard escalation
- Safest approach, minimizes side effects
Conversion Approach 2: Direct Switch
| Current Semaglutide Dose | Starting Tirzepatide Dose |
|---|---|
| 0.25mg weekly | 2.5mg weekly |
| 0.5mg weekly | 2.5-5mg weekly |
| 1mg weekly | 5mg weekly |
| 1.7mg weekly | 7.5mg weekly |
| 2.4mg weekly | 10mg weekly |
Timing:
Take your last semaglutide dose, then start tirzepatide one week later
Restarting After a Break
If you stopped tirzepatide and want to restart:
- Break <4 weeks: Resume at your previous dose
- Break 4-8 weeks: Drop back one dose level
- Break >8 weeks: Restart at 2.5mg and re-escalate
Why restart low?
- Your tolerance to the medication decreases during breaks
- Side effects likely worse if restarting at high dose
- Safety precaution to prevent adverse reactions
Missed Dose Protocol
- Missed by <4 days: Take dose as soon as you remember, continue regular schedule
- Missed by >4 days: Skip the missed dose, take next scheduled dose
- Never: Take two doses to "catch up"
Dosing During Illness
If you're sick (cold, flu, stomach virus):
- Consider skipping your dose if you can't keep food/water down
- Resume once you're eating and drinking normally
- Consult provider if illness lasts >1 week
Dosing for Special Populations
Older Adults (65+)
- No dose adjustment needed based solely on age
- May be more sensitive to side effects
- Consider slower escalation (6 weeks per dose increase)
- Monitor for dehydration more carefully
- Assess fall risk if experiencing dizziness
Kidney Impairment
- Mild to moderate impairment: No adjustment needed
- Severe impairment: Use with caution, monitor closely
- Dialysis patients: Limited data, discuss with nephrologist
Liver Impairment
- No dose adjustment typically needed
- Monitor liver enzymes periodically
- Report any signs of jaundice or severe fatigue
Obesity Classes
- BMI 30-35 (Class I): May achieve goals at lower doses (5-10mg)
- BMI 35-40 (Class II): Typically require moderate to high doses (10-12.5mg)
- BMI >40 (Class III): Often need maximum dose (15mg)
Optimizing Your Dose
Signs Your Dose Is Too Low
- Weight loss stalls for 4+ consecutive weeks
- Appetite returns to pre-medication levels
- No longer feeling satisfied after meals
- Blood sugar control worsening (if diabetic)
- Cravings have returned
Action: Discuss dose increase with provider
Signs Your Dose Is Too High
- Severe, persistent nausea lasting >1 week
- Unable to eat adequate protein (below 50g daily)
- Vomiting more than occasionally
- Constant fatigue affecting work/life
- Severe constipation or diarrhea
- Loss of >3 lbs per week consistently
Action: Consider staying at current dose longer or reducing
The "Sweet Spot" Dose
Your optimal dose is when:
- ✅ Losing 1-2 lbs per week consistently
- ✅ Reduced appetite but can still eat comfortably
- ✅ Minimal or manageable side effects
- ✅ Maintaining good energy levels
- ✅ Blood sugar well-controlled (if diabetic)
Remember: Your optimal dose may be lower than the maximum. More is not always better.
Tracking Your Doses
What to Track
Keep a dosing journal with:
- Date of injection
- Dose taken (mg and units)
- Injection site used
- Side effects experienced
- Weekly weight
- Energy level (1-10 scale)
- Appetite level (1-10 scale)
Helpful Apps
- MyFitnessPal: Track nutrition alongside dosing
- Lose It!: Weight tracking with medication notes
- Glucose Buddy: For diabetics tracking blood sugar
- Simple spreadsheet: Custom tracking solution
Common Dosing Mistakes to Avoid
❌ Mistake #1: Starting Too High
What people do: Start at 5mg or higher to "get results faster"
Why it's wrong: Causes severe side effects, often leading to discontinuation
Correct approach: Always start at 2.5mg for 4 weeks
❌ Mistake #2: Escalating Too Fast
What people do: Increase dose every 1-2 weeks
Why it's wrong: Doesn't allow proper adaptation, increases side effects
Correct approach: Wait minimum 4 weeks between increases
❌ Mistake #3: Wrong Unit Calculation
What people do: Confuse mg with units or use wrong concentration
Why it's wrong: Can result in dangerous over-dosing or under-dosing
Correct approach: Always verify vial concentration and double-check calculations
❌ Mistake #4: Chasing Higher Doses
What people do: Keep increasing even when current dose is working
Why it's wrong: More isn't always better; increases side effects and cost
Correct approach: Stay at effective dose, don't chase maximum
❌ Mistake #5: Inconsistent Timing
What people do: Inject on random days of the week
Why it's wrong: Disrupts steady medication levels
Correct approach: Same day each week, ±2 days maximum
❌ Mistake #6: Stopping Abruptly
What people do: Stop medication once goal weight is reached
Why it's wrong: Almost always leads to weight regain
Correct approach: Plan for long-term maintenance dosing
Cost Optimization Strategies
Brand Name vs Compounded Cost Comparison
| Option | Monthly Cost | Annual Cost | Pros | Cons |
|---|---|---|---|---|
| Mounjaro/Zepbound | $1,000-$1,400 | $12,000-$16,800 | FDA-approved, consistent, convenient | Very expensive without insurance |
| Compounded | $250-$400 | $3,000-$4,800 | Much cheaper, customizable dosing | Not FDA-approved, requires mixing |
Money-Saving Tips
For Brand Name:
- Check manufacturer savings programs (up to $150/month off)
- Use GoodRx or similar discount programs
- Ask about patient assistance programs
- Consider switching insurance during open enrollment
- Some employers offer weight loss medication coverage
For Compounded:
- Buy larger vials for better per-dose pricing
- Shop around - prices vary significantly between pharmacies
- Consider group buying with friends/family
- Ask about bulk discounts for 3-6 month supplies
- Some telehealth companies offer subscription discounts
Maintenance Phase Savings:
- Many patients can maintain on lower doses (5-7.5mg vs 15mg)
- This can reduce costs by 50-70%
- Work with provider to find your minimum effective maintenance dose
Frequently Asked Questions
Q: Can I start at a higher dose if I've used other GLP-1 medications?
A: While some providers may allow starting at 5mg if you've been on semaglutide, the safest approach is still starting at 2.5mg. Tirzepatide works differently and side effects can still occur.
Q: How long should I stay at each dose?
A: Minimum 4 weeks, but you can stay longer if you're seeing good results with minimal side effects. Some patients stay at 5-7.5mg for months if it's working well.
Q: What if I'm not losing weight at 2.5mg?
A: This is normal and expected. 2.5mg is primarily for tolerance building. Real weight loss typically begins at 5mg and accelerates at higher doses.
Q: Can I split my weekly dose into smaller daily doses?
A: No. Tirzepatide is specifically formulated for once-weekly dosing. Daily dosing would require different concentrations and hasn't been studied.
Q: Is it safe to increase dose faster if I have no side effects?
A: No. The 4-week minimum isn't just about side effects - it's about allowing your body to fully adapt and determining if the current dose is effective.
Q: What's the difference between Mounjaro and Zepbound dosing?
A: They're the same medication with identical dosing schedules. The only difference is FDA indication (diabetes vs weight loss) and insurance coverage.
Q: How do I know if compounded tirzepatide is real?
A: Use only FDA-registered 503B compounding pharmacies. Ask for certificates of analysis and verify the pharmacy's credentials. Avoid suspiciously cheap sources.
Q: Can I use a different type of syringe?
A: Insulin syringes (U-100) are recommended because they're marked in units that correspond to our conversion charts. Other syringes may have different markings.
Q: What if my pharmacy uses a different concentration than listed here?
A: Always verify with your pharmacy and recalculate. Use the formula: (Desired dose ÷ Concentration) × 100 = Units to inject.
Q: Should I continue increasing dose if I'm happy with my current weight loss?
A: No. If you're losing 1-2 lbs per week with minimal side effects, stay at your current dose. The goal is finding your optimal dose, not reaching the maximum.
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⚠️ Medical Disclaimer
This dosage chart is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider before starting, stopping, or changing your tirzepatide dose. Individual responses to medication vary, and your provider may recommend different dosing based on your specific situation.