What is the tirzepatide dosing schedule?

The labeled ladder (Zepbound and Mounjaro share it): | Weeks | Dose (weekly) | Notes | | --- | --- | --- | | 1–4 | 2.5 mg | Starter — tolerance-building, not therapeutic | | 5–8 | 5 mg | First recognized maintenance dose | | 9+ (optional) | 7.5 → 10 → 12.5 → 15 mg | Each step held 4+ weeks, escalate only as needed | What’s distinctive vs. semaglutide: - Maintenance is a range, not a destination. The label blesses 5, 10, and 15 mg as maintenance doses. SURMOUNT-1’s 5 mg arm still averaged 16% weight loss — many users never need the upper half of the ladder. - More rungs, finer control. Five escalation steps mean more places to park when side effects and results balance. - Dose–response is real but flattening: 15 mg beats 5 mg on averages (20.9% vs 16.0%), so headroom exists for plateaus — but escalate for a reason, not a schedule. Format notes: pens are fixed-dose; LillyDirect’s cheaper vials require syringe draws — fine, but get your draw demonstrated. Compounded tirzepatide protocols may use in-between steps (a legitimate compounding advantage); sublingual tirzepatide ladders (commonly 3–7 mg) are an unrelated scale — see the sublingual caveats. Missed-dose rules and day-shifting work the same as the class generally: missed dose, changing injection day.