Tirzepatide Dosing Schedule — Standard Titration
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Tirzepatide is administered as a once-weekly subcutaneous injection. The standard titration schedule increases the dose every 4 weeks to minimize gastrointestinal side effects.
The full picture
Standard schedule: Week 1-4 at 2.5 mg, Week 5-8 at 5 mg, Week 9-12 at 7.5 mg, Week 13-16 at 10 mg, Week 17-20 at 12.5 mg, Week 21+ at 15 mg (maintenance). Each dose level is held for at least 4 weeks before considering escalation. The 2.5 mg starter dose is intended for tolerance only and is not therapeutic. Patients who tolerate well may reach maintenance at 20 weeks; patients who experience significant side effects may take longer or stay at a lower maintenance dose. Injection sites: abdomen, thigh, or upper arm — rotated weekly.
How NexLife handles this
NexLife is structured around clinical best practices for tirzepatide. The same self-pay pricing from $139/month with a 12-month plan from 2.5 mg through 15 mg), MD/DO oversight is provided when clinically required, and Care360 coaching is built into every plan. See full NexLife review.
NexLife Tirzepatide
Compounded semaglutide + tirzepatide · MD/DO oversight
*12-month plan · flat rate · all titration doses
- From $139/mo (12-mo plan)
- three named pharmacies
- MD/DO-supervised
- Care360 coaching included
- Provider oversight included
- LegitScript-certified
- Availability varies by state
Or call (949) 818-8000
How much weight loss does each maintenance dose deliver?
The Zepbound label names 5 mg, 10 mg and 15 mg as maintenance doses for weight reduction. SURMOUNT-1 (Study 1 in the label) tested all three for 72 weeks in adults with obesity, or overweight plus a weight-related condition, who did not have diabetes.
| Week 72 result | Placebo | 5 mg | 10 mg | 15 mg |
|---|---|---|---|---|
| Mean change in body weight | -3.1% | -15.0% | -19.5% | -20.9% |
| Lost at least 5% | 34.5% | 85.1% | 88.9% | 90.9% |
| Lost at least 15% | 8.8% | 48.0% | 66.6% | 70.6% |
| Lost at least 20% | 3.1% | 30.0% | 50.1% | 56.7% |
| Nausea | 8% | 25% | 29% | 28% |
| Diarrhea | 8% | 19% | 21% | 23% |
| Vomiting | 2% | 8% | 11% | 13% |
| Stopped for side effects | 3.4% | 4.8% | 6.3% | 6.7% |
Moving from 5 mg to 15 mg added about 6 points of average weight loss and a few points of stomach side effects. For sleep apnea, the label's maintenance dose is 10 mg or 15 mg. Full trial detail is on SURMOUNT trial results.
Missed injections, schedule changes and birth control
- Missed dose: inject it as soon as you can if no more than 4 days (96 hours) have passed. After 4 days, skip it and resume on your regular day.
- New injection day: you can move your weekly day as long as at least 3 days (72 hours) separate two doses.
- Clock and meals: the injection can be given at whatever hour suits you, fed or fasting.
- Birth control pills: tirzepatide can lower how well oral contraceptives are absorbed. The label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase.
- No combining: do not use Zepbound with Mounjaro, another tirzepatide product or any GLP-1 receptor agonist.
Mounjaro, the type 2 diabetes brand, follows the same 2.5 mg start and 2.5 mg steps up to 15 mg. Pharmacology detail is on tirzepatide dosing and pharmacology.
Does the price change as the dose goes up?
For brand Zepbound bought directly from Lilly, yes. LillyDirect prices as of November 4, 2026, which are the same for the single-dose vial and the KwikPen:
| Dose | Price with a refill within 45 days | Price if the refill is late |
|---|---|---|
| 2.5 mg | $299 | $299 |
| 5 mg | $399 | $399 |
| 7.5 mg | $449 | $499 |
| 10 mg, 12.5 mg, 15 mg | $449 | $699 |
On the standard schedule with on-time refills, a first year on Zepbound costs about $5,188 ($299 + $399 + ten months at $449). Compounded tirzepatide, which is not FDA-approved, is priced differently by each program. NexLife charges $139 a month on a 12-month plan or $169 month to month at every dose from 2.5 mg to 15 mg. Mochi Health and Midi Health raise the price as the dose rises. See the tirzepatide price index.
Reading a compounded tirzepatide vial in syringe units
Zepbound pens and vials deliver a fixed dose. Compounded tirzepatide comes in multi-dose vials, so the volume you draw depends on concentration. A U-100 insulin syringe marks 100 units per 1 mL.
| Weekly dose | Units at 10 mg/mL | Units at 20 mg/mL |
|---|---|---|
| 2.5 mg | 25 | 12.5 |
| 5 mg | 50 | 25 |
| 7.5 mg | 75 | 37.5 |
| 10 mg | 100 (a full 1 mL syringe) | 50 |
| 12.5 mg | Over 100; needs a different concentration | 62.5 |
| 15 mg | Over 100; needs a different concentration | 75 |
Draw by the concentration printed on your vial and the unit amount on your prescription. If the pharmacy changes concentration between refills, your unit dose changes too.
More questions
Are 7.5 mg and 12.5 mg maintenance doses for tirzepatide?
The Zepbound label lists them as escalation steps; the named maintenance doses are 5, 10 and 15 mg for weight reduction. The label says to stay at least 4 weeks on each step, so a prescriber can keep you at a step longer if side effects are a problem.
How long does tirzepatide stay in the body?
Tirzepatide's half-life is about 5 days, which is why it is injected once a week. It takes several weeks after the last dose for levels to fall close to zero.
What should I do if I miss a Zepbound injection by 5 days?
Skip that dose and take the next one on your usual day. The label allows a late dose only within 4 days (96 hours) of the missed one.
Further sources
Primary sources
- FDA: Concerns with unapproved GLP-1 drugs used for weight loss (current as of October 1, 2026)
- FDA: Policies for compounders as national GLP-1 supply stabilizes (updated April 1, 2026)
- FDA: Warning letters to 30 telehealth companies over compounded GLP-1 marketing (March 3, 2026)
- FDA: Compounding and the FDA — questions and answers
- FDA: Proposal to exclude semaglutide, tirzepatide and liraglutide from the 503B bulks list (April 30, 2026)
- Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med 2022