Tirzepatide Dosage Chart: Full Titration Schedule

Tirzepatide is a once-weekly injection that is never started at its full strength. The dose climbs a fixed ladder, and that schedule is set by the FDA prescribing information rather than left to guesswork. This page is the chart: the exact dose for every step, how long you hold at each, and where the two brand labels — Zepbound for obesity and sleep apnea, Mounjaro for type 2 diabetes — agree and differ. Every number here comes straight from the official labels, not from clinic protocols or compounding-pharmacy charts.

One important note up front: tirzepatide is a prescription-only medicine. The chart below is the labeled schedule, not a self-dosing plan. Your clinician may move you up the ladder more slowly than the minimum spacing — and the only legitimate source for the brand product is a pharmacy filling a prescription. Compounded tirzepatide, often sold by the milligram or in "units," does not come with this standardized titration and is a separate, riskier category we cover elsewhere — including the math (and the danger) behind how many units is 2.5 mg of tirzepatide.

The standard titration chart (both brands)

The starting schedule is identical for Zepbound and Mounjaro. Treatment begins at 2.5 mg once weekly, and the dose is raised in 2.5 mg increments no sooner than every four weeks¹².

| Step | Dose (once weekly) | Minimum time before next step | |------|--------------------|-------------------------------| | Initiation | 2.5 mg | 4 weeks | | Step 1 | 5 mg | 4 weeks | | Step 2 | 7.5 mg | 4 weeks | | Step 3 | 10 mg | 4 weeks | | Step 4 | 12.5 mg | 4 weeks | | Maximum | 15 mg | — |

The 2.5 mg dose is an initiation dose only. It is meant to introduce the body to the drug, and for type 2 diabetes the Mounjaro label is explicit that 2.5 mg is not intended to control blood glucose on its own². After four weeks you move to 5 mg, the first true maintenance dose¹².

From 5 mg upward, the label allows raising the dose by 2.5 mg at a time, with at least four weeks at the current dose before any increase¹². The recognized maintenance doses are 5, 10, and 15 mg once weekly; the intermediate 7.5 mg and 12.5 mg steps are titration rungs on the way up, and the maximum dose is 15 mg once weekly¹.

Because each step needs a minimum of four weeks, climbing from the 2.5 mg start to the 15 mg ceiling takes about five months at the fastest — and many people stop at a lower dose that already works for them rather than pushing to the top.

Where Zepbound and Mounjaro differ

The two brands are the same drug at the same milligram strengths, but the labels are written for different conditions, which changes a couple of details.

Obesity (Zepbound). The full 2.5-to-15 mg ladder applies, and the 5, 10, and 15 mg maintenance doses are all on the table¹.

Obstructive sleep apnea (Zepbound). For the OSA indication, the Zepbound label uses 10 mg or 15 mg maintenance doses — you still titrate up from 2.5 mg, but the effective maintenance band sits at the higher end¹.

Type 2 diabetes (Mounjaro). Same 2.5 mg start, same 2.5 mg steps every four weeks, same 15 mg maximum². The difference is the goal: the dose is adjusted toward blood-glucose targets rather than purely weight, and 2.5 mg is explicitly a run-in that is not expected to control glucose by itself².

A common point of confusion is worth stating plainly: Zepbound and Mounjaro are not different drugs and not different doses. They are the same tirzepatide molecule at 2.5, 5, 7.5, 10, 12.5, and 15 mg, branded separately for separate FDA indications.

Why the chart is built this way

The four-week spacing is not arbitrary. Gastrointestinal side effects — nausea, diarrhea, vomiting, constipation — are dose-dependent and most frequent during dose increases, and a systematic review across the tirzepatide trial program found they were generally mild to moderate and the leading reason people discontinued³. An updated meta-analysis including SURMOUNT-2 confirmed the same dose-dependent pattern of GI events alongside dose-dependent weight loss⁴.

Climbing slowly gives the gut time to adapt, which is exactly why the label builds in a minimum four weeks between steps¹. If a step is poorly tolerated, the common clinical move is to hold at the current dose longer, or step back down, before trying to advance again — the chart sets a floor on speed, not a mandate to climb on schedule. For the full picture of those side effects and how to manage them, see our tirzepatide dosing ladder and side effects guide, and for when each wave peaks and fades, how long do Zepbound side effects last. For which of the maintenance steps actually drives the most weight loss in the trials, see what dose of Zepbound is most effective. And if you forget a weekly shot while climbing the ladder, the label has a clear rule — take it within 4 days, otherwise skip — explained in our guide to a missed tirzepatide dose.

What the dose-response data show

The titration ceiling exists because higher doses do more — within limits. In SURMOUNT-1, the pivotal obesity trial, mean weight reduction rose with the dose: roughly 15% at 5 mg, about 19.5% at 10 mg, and around 21% at 15 mg over 72 weeks, versus about 3% on placebo⁵. The same dose-stepped pattern appeared in SURPASS-2 in type 2 diabetes, where tirzepatide 5, 10, and 15 mg each beat semaglutide 1 mg on blood-sugar control with larger effects at higher doses⁶. SURMOUNT-2, in people with both obesity and type 2 diabetes, again showed clinically meaningful, dose-related weight loss⁷.

That is the honest reason the chart goes to 15 mg: the data show a real dose-response. But it also explains why not everyone needs the top of the ladder — a 5 or 10 mg maintenance dose already produces large, clinically meaningful results for many people, and the lowest effective dose is usually the goal rather than the maximum.

One more thing the trials make clear: these are maintenance doses, not a cure you finish. In SURMOUNT-4, people who stopped tirzepatide after titrating up regained substantial weight, while those who stayed on their maintenance dose kept the loss⁸. The chart gets you to an effective dose; staying there is what holds the result.

The honest bottom line

The tirzepatide dosage chart is the same for both brands at the top: start at 2.5 mg once weekly, step up 2.5 mg at a time with at least four weeks between increases, and stop at a maintenance dose of 5, 10, or 15 mg — with 15 mg the maximum¹². Zepbound's sleep-apnea indication leans on the 10-15 mg end¹; Mounjaro adjusts toward glucose targets²; but the milligram ladder is identical. The four-week spacing exists because side effects track the dose³, and the climb to 15 mg reflects a genuine dose-response⁵⁶ — not a target everyone must reach. (If you are coming off semaglutide, note that you restart this ladder from 2.5 mg regardless of your prior dose — see switching from semaglutide to tirzepatide.) For the complete evidence base, see the tirzepatide evidence guide; to compare it with the other leading option, tirzepatide vs semaglutide; and to weigh how to get it, start with our best tirzepatide overview.