Tirzepatide dosage

What Tirzepatide is

Tirzepatide is a once-weekly peptide that activates both the GIP and GLP-1 receptors and is approved by the FDA for type 2 diabetes (Mounjaro), and for chronic weight management and obstructive sleep apnea in adults with obesity (Zepbound). Randomized phase 3 trials have studied its effects on glycemic control, body weight and sleep apnea severity, with gastrointestinal events the most commonly reported adverse reactions. This entry summarizes the FDA labels and published trials for research reference only.

The FDA label describes tirzepatide as a GIP receptor and GLP-1 receptor agonist that selectively binds to and activates both receptors, the targets for native GIP and GLP-1 ^1. Glucose-related effects According to the label, tirzepatide enhances first- and second-phase insulin secretion and reduces glucagon levels, both in a glucose-dependent manner ^1. In a hyperinsulinemic euglycemic clamp study after 28 weeks… How it works →

Schedules by time period

Label regimens and laid out week by week. Each bar is what the label states or what investigators gave participants; none is a recommendation.

Dosing as stated on the FDA label

• For glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes (Mounjaro): the recommended starting dosage is 2.5 mg injected subcutaneously once weekly. If additional glycemic control is needed, increase the dosage in 2.5 mg increments after at least 4 weeks on the current dose. The maximum dosage is 15 mg once weekly in adults and 10 mg once weekly in pediatric patients. ¹
• Administration of Mounjaro per the label: once weekly, any time of day, with or without meals subcutaneously; if a dose is missed, administer it as soon as possible within 4 days (96 hours), and if more than 4 days have passed, skip the missed dose. ¹
• For chronic weight management in adults with obesity, or with overweight and a weight-related comorbid condition (Zepbound): the recommended starting dosage is 2.5 mg injected subcutaneously once weekly for 4 weeks, which is for treatment initiation and is not a maintenance dosage; after 4 weeks, increase to 5 mg once weekly, and the dosage may then be increased in 2.5 mg increments after at least 4 weeks on the current dose. The recommended maintenance dosage is 5 mg, 10 mg, or 15 mg once weekly. ²
• For moderate to severe obstructive sleep apnea in adults with obesity (Zepbound): the same escalation schedule applies, and the recommended maintenance dosage is 10 mg or 15 mg injected subcutaneously once weekly. ²
• For all Zepbound indications, the maximum recommended dosage is 15 mg injected subcutaneously once weekly; if a maintenance dosage is not tolerated, the label advises considering a lower maintenance dosage. ²
• Mounjaro is also indicated to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes at high risk for these events; the label sets one starting and escalation schedule (2.5 mg once weekly, increased in 2.5 mg increments after at least 4 weeks, maximum 15 mg in adults) for its indications ^1.
• Mounjaro and Zepbound labels: the day of weekly administration can be changed if necessary as long as the time between two doses is at least 3 days (72 hours) ^1,2.
• Zepbound label, missed dose: administer as soon as possible within 4 days (96 hours) after the missed dose; if more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day ^2.
• In SURPASS-CVOT (NCT04255433), as described on the Mounjaro label, 13,299 adults with type 2 diabetes and established cardiovascular disease received once-weekly tirzepatide initiated at 2.5 mg and increased by 2.5 mg every 4 weeks to 15 mg or the maximum tolerated dose, versus dulaglutide 1.5 mg once weekly ^1.

How long did human studies run?

• SURPASS-1, -2 and -5 were 40-week trials, SURPASS-3 was 52 weeks and SURPASS-4 was 104 weeks (52-week primary endpoint), each with tirzepatide 5, 10 or 15 mg once weekly; SURPASS-PEDS was a 30-week placebo-controlled trial (5 or 10 mg) with a 22-week open-label extension ^1.
• SURPASS-CVOT followed participants for a median of 210.1 weeks ^1.
• Zepbound weight-reduction trials: Studies 1 and 2 lasted 72 weeks with an escalation period of up to 20 weeks; Study 3 lasted 84 weeks (12-week intensive lifestyle lead-in, then 72 weeks randomized); Study 4 lasted 88 weeks (36-week open-label lead-in, then 52 weeks randomized withdrawal). The two OSA trials (Studies 5 and 6) lasted 52 weeks, with escalation over up to 20 weeks to 10 mg or 15 mg ^2.

Contraindications on the label

• Boxed warning (risk of thyroid C-cell tumors): Tirzepatide causes thyroid C-cell tumors in rodents at clinically relevant exposures; it is unknown whether Mounjaro or Zepbound causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. Both labels state the drug is contraindicated in patients with a personal or family history of MTC or with MEN 2 ^1,2.
• Mounjaro and Zepbound contraindications: personal or family history of MTC or MEN 2; known serious hypersensitivity to tirzepatide or any excipient (anaphylaxis and angioedema have been reported) ^1,2.

Side effects reported in studies

• Nausea
  25% to 29% across tirzepatide dose groups vs 8% placebo · Pooled placebo-controlled weight-reduction trials, adults with obesity or overweight (Zepbound) ²
• Diarrhea
  19% to 23% vs 8% placebo · Pooled placebo-controlled weight-reduction trials, adults ²
• Vomiting
  8% to 13% vs 2% placebo · Pooled placebo-controlled weight-reduction trials, adults ²
• Constipation
  11% to 17% vs 5% placebo · Pooled placebo-controlled weight-reduction trials, adults ²
• Injection site reactions
  6% to 8% vs 2% placebo · Pooled placebo-controlled weight-reduction trials, adults ²
• Hair loss
  4% to 5% vs 1% placebo (7.1% of women vs 0.5% of men on tirzepatide) · Pooled placebo-controlled weight-reduction trials, adults ²
• Any gastrointestinal adverse reaction
  56% across tirzepatide dose groups vs 30% placebo · Pooled placebo-controlled weight-reduction trials, adults ²
• Permanent discontinuation due to adverse reactions
  4.8% to 6.7% across tirzepatide dose groups vs 3.4% placebo · Pooled placebo-controlled weight-reduction trials, adults ²

Tirzepatide draw calculator

Pick the vial strength and the water added, enter an amount, and see the concentration, the units to draw and how many draws the vial holds. Arithmetic only.

1 · Vial strength

sizes on the market

5 mg10 mg15 mg20 mg30 mg40 mg60 mg100 mg

2 · Water added

1 mL2 mL3 mL5 mL

3 · Amount per draw

mcgmg

4 · Syringe

30u50u100u

Your mix

10 mg + 2 mL water = 5 mg/mL

10 units holds 0.5 mg (500 mcg)

Draw toEnter an amount in step 3

U-100 syringe · 100 units = 1 mL

Computed from your inputs. Not a dose or a recommendation.

Compare water volumes for this vialShow

More water = lower concentration = a larger, easier-to-measure draw. Tap a row to use it.

Water	mg/mL	Draw
0.5 mL	20	—
1 mL	10	—
1.5 mL	6.667	—
2 mL	5	—
2.5 mL	4	—
3 mL	3.333	—
5 mL	2	—

Supplies and handling

• Lyophilized vial
  Sealed vial with the freeze-dried cake. Check the label, lot and the certificate of analysis before opening.
• Sterile diluent
  The diluent named on the product documentation. Bacteriostatic water contains benzyl alcohol; sterile water does not.
• Graduated syringes
  Sized to the volume being measured. U-100 insulin syringes are graduated in units where 100 units = 1 mL.
• Alcohol prep pads
  For wiping vial stoppers before each puncture.
• Nitrile gloves
  Clean gloves for aseptic handling.
• Sharps container
  Puncture-resistant container for used needles.

Storage

Handling of research material should follow the supplier's documentation and certificate of analysis, including storage temperature, protection from light and freeze-thaw limits. Approved products have their own storage instructions in the 'How supplied/storage and handling' section of the respective FDA labels.

• Lyophilized (unmixed) vials: typically stored cold and dry, away from light, as the documentation directs. Many are stable longer frozen.
• Reconstituted vials: typically refrigerated (about 2–8 °C), protected from light and not frozen.
• Bacteriostatic water contains benzyl alcohol, which inhibits bacterial growth in multi-use vials; sterile water has no preservative.

Handling mistakes and troubleshooting

Added the wrong volume of diluent

The concentration changes, not the amount of compound in the vial. Recalculate with the volume actually added and relabel the vial.

Shook the vial and it foamed

Let it settle in the refrigerator. Foam is a sign of agitation; some peptides aggregate when shaken. Note it on the label.

The solution is cloudy or has particles

Do not use it. Cloudiness can indicate incomplete dissolution, contamination or degradation. Record the lot and contact the supplier with the certificate of analysis.

The powder cake looks melted or shrunken before reconstitution

This can indicate the vial was exposed to heat or moisture. Record the lot and condition on arrival.

Liquid sprayed back when the needle was removed

Pressure built up in the vial. Withdraw a small volume of air while adding diluent to keep pressure neutral.

Regulatory status

Status

Approved by the FDA as Mounjaro (original approval 2022) as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes, and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who are at high risk for these events ^1,3. Approved as Zepbound (original approval 2023) to reduce excess body weight and maintain weight reduction long term in adults with obesity, or with overweight and at least one weight-related comorbid condition, and to treat moderate to severe obstructive sleep apnea in adults with obesity ^2,3.

United States (FDA)

Approved under NDA 215866 (Mounjaro, original approval May 2022) and NDA 217806 (Zepbound, original approval November 2023), per Drugs@FDA application records ^3. Current FDA labels were reviewed from DailyMed ^1,2.

Sport (WADA)

Tirzepatide is not named on the WADA 2026 Prohibited List ^8. In its 21 September 2026 announcement of the 2027 List, WADA stated that the status of GLP-1 receptor agonists, including semaglutide and tirzepatide, remains unchanged for 2027 pending further data ^7.

Status varies by country and changes over time. How we describe regulatory status.

Tirzepatide compared with related compounds

Combinations that include Tirzepatide

• Cagrilintide + Tirzepatide

Frequently asked questions

References

1. MOUNJARO (tirzepatide) injection: prescribing information (Eli Lilly), DailyMed set ID d2d7da5d-ad07-4228-955f-cf7e355c8cc0 FDA label (DailyMed). 2026
2. ZEPBOUND (tirzepatide) injection: prescribing information (Eli Lilly), DailyMed set ID 487cd7e7-434c-4925-99fa-aa80b1cc776b FDA label (DailyMed). 2026
3. Drugs@FDA application records for NDA 215866 (Mounjaro) and NDA 217806 (Zepbound): original approval dates Drugs@FDA (via openFDA). 2026
4. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1) N Engl J Med. 2022
5. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2) N Engl J Med. 2021
6. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA) N Engl J Med. 2024
7. WADA publishes 2027 Prohibited List (news release, 21 September 2026) WADA. 2026
8. International Standard Prohibited List 2026 WADA Prohibited List. 2026