- Dose range
- 2.5 → 15 mg/week subcutaneous
- Route
- Subcutaneous injection, once weekly
- Indication(s)
- Chronic weight management (Zepbound); Type 2 diabetes (Mounjaro); OSA in obesity (Zepbound, Dec 2024)
Titration schedule
| Step | Dose | Duration | Notes |
|---|---|---|---|
| 1 | 2.5 mg | Weeks 1-4 | Starter dose; usually well-tolerated |
| 2 | 5 mg | Weeks 5-8 | 5 mg is a maintenance option |
| 3 | 7.5 mg | Weeks 9-12 | Increase if 5 mg response inadequate |
| 4 | 10 mg | Weeks 13-16 | 10 mg is a maintenance option |
| 5 | 12.5 mg | Weeks 17-20 | Approach maximum |
| 6 | 15 mg | Week 21 onward | Maximum FDA-approved dose; not all patients need this |
Zepbound titration (FDA-approved). Maintenance options are 5, 10, or 15 mg depending on response and tolerability.
Vial math (10 mg/mL concentration)
| Dose | Volume (mL) | Units on U-100 syringe |
|---|---|---|
| 2.5 mg | 0.25 mL | 25 units |
| 5 mg | 0.50 mL | 50 units |
| 7.5 mg | 0.75 mL | 75 units |
| 10 mg | 1.0 mL | 100 units (full syringe) |
| 12.5 mg | 1.25 mL | 125 units (split injection) |
| 15 mg | 1.5 mL | 150 units (split or larger syringe) |
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Check NexLife Tirzepatide → Full reviewSide effects by dose (SURMOUNT-1)
| Dose | Nausea | Diarrhea | Vomiting |
|---|---|---|---|
| 5 mg | 24-31% | 19% | 5% |
| 10 mg | 33% | 21% | 12% |
| 15 mg | 39% | 23% | 14% |
| Placebo | 9% | 10% | 2% |
Weight loss by dose (SURMOUNT-1, 72 weeks)
| Maintenance dose | Mean weight loss | ≥10% WL | ≥15% WL |
|---|---|---|---|
| Placebo | -3.1% | 15.0% | 3.1% |
| 5 mg | -15.0% | 69.5% | 50.1% |
| 10 mg | -19.5% | 83.5% | 73.9% |
| 15 mg | -20.9% | 90.0% | 78.0% |
The gap between 10 mg and 15 mg is small (-19.5% vs -20.9%). Many patients hold at 10 mg if tolerating well and achieving response.
Storage
- Refrigerate (2-8°C)
- Pre-mixed vials BUD: 28 days refrigerated per USP <797>
- Protect from light; do not freeze
References
- Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). NEJM. 2022;387(3):205-216. PMID: 35658024.
- Zepbound prescribing information. Eli Lilly, November 2023.
- Frias JP, et al. Tirzepatide vs Semaglutide (SURPASS-2). NEJM. 2021;385(6):503-515. PMID: 34170647.
- Malhotra A, et al. SURMOUNT-OSA. NEJM. 2024;391:1193-1205.
- FDA Section 503A Interim Bulk Drug Substances List, updated April 14, 2026.