Dosage guide
Zepbound dose escalation schedule
Week-by-week titration for Zepbound (tirzepatide) — starting dose, step-up schedule, maintenance, maximum, and what to do if you miss a dose.
Starting dose
2.5 mg once weekly
Maintenance
5, 10, or 15 mg subcutaneous once weekly
Maximum dose
15 mg/week
Dose form & administration
- Dose form
- Single-dose prefilled pen and single-dose vials, subcutaneous injection
- Dosing frequency
- Once weekly, same day each week
Titration timeline
FDA-labeled step-up schedule. Most clinicians follow this exactly, but may pause at a step for an additional 4 weeks if side effects are intolerable.
- 1
Weeks 1–4
2.5 mg/week
Initiation dose.
- 2
Weeks 5–8
5 mg/week
First therapeutic maintenance option.
- 3
Weeks 9–12
7.5 mg/week
- 4
Weeks 13–16
10 mg/week
Second maintenance option.
- 5
Weeks 17–20
12.5 mg/week
- 6
Week 21+
15 mg/week
Third (max) maintenance option.
If a step-up is poorly tolerated
Hold the current dose for an additional 4 weeks before stepping up if GI symptoms persist. Maintenance can be 5, 10, or 15 mg — not every patient needs the maximum.
Missed-dose protocol
Max skip window
4 days
Inject within 4 days if dose was missed. Beyond 4 days, skip and resume the regular weekly schedule.
When to contact your prescriber
- Multiple consecutive missed doses.
- Severe abdominal pain or signs of pancreatitis.
- Confirmed or planned pregnancy.
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