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 mg, 10 mg or 15 mg once weekly (10 or 15 mg for obstructive sleep apnea)
Maximum dose
15 mg once weekly
Dose form & administration
- Dose form
- Single-dose pen, single-patient-use KwikPen, or single-dose vial used with a syringe; subcutaneous injection
- Dosing frequency
- Once weekly, any time of day, with or without meals
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
Starting dose only; not approved for maintenance.
- 2
Weeks 5–8
5 mg/week
First 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 maintenance option and the maximum.
If a step-up is poorly tolerated
Increases come in 2.5 mg steps after at least 4 weeks on the current dose. If a maintenance dose is not tolerated, the label says to consider a lower maintenance dose.
Missed-dose protocol
Max skip window
4 days (96 hours)
Inject the missed dose as soon as possible within 4 days (96 hours) of the missed day. If more than 4 days have passed, skip it and inject on your usual day. Two doses must be at least 3 days (72 hours) apart.
When to contact your prescriber
- You have missed several doses in a row.
- Severe abdominal pain or signs of pancreatitis.
- You are pregnant or planning a pregnancy.
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