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Tirzepatide Dosing for Weight Loss: How Much Do You Need?
Reviewed by Craig Primack, MD, FACP, FAAP, FOMA
Written by Jill Seladi-Schulman
Published 01/21/2025
Updated 01/20/2025
Tirzepatide dosing for weight loss follows a dose escalation scheme. That means your dosage is gradually increased until you reach a maintenance dose. The starting dose of tirzepatide is 2.5 milligrams (mg), and the maximum weekly dose is 15 milligrams.
An estimated 74 percent of adults in the U.S. have overweight or obesity, with many on the lookout for effective, sustainable weight loss strategies.
The popularity of GLP-1 receptor agonist medications has exploded in recent years, largely because of their proven weight loss benefits. One of these drugs is tirzepatide (Zepbound®), a dual GIP/GLP-1 receptor agonist.
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In a clinical trial of tirzepatide for weight loss, participants taking the highest tirzepatide dose lost roughly 21 percent of their baseline body weight over 72 weeks. Those taking the lowest dose had a weight reduction of 15 percent of their baseline body weight within the same timeframe.
Research suggests that adults with overweight or obesity who take tirzepatide may losw more weight than those taking semaglutide. Semaglutide is another GLP-1 receptor agonist and the active ingredient in Ozempic® and Wegovy®.
These benefits make tirzepatide an attractive option for weight loss.
If you’re considering tirzepatide for this purpose, you might be curious about tirzepatide dosing for weight loss. We have all the details on this topic ahead.
Two tirzepatide drugs are approved by the U.S. Food and Drug Administration (FDA). Both are given as an injection.
Brand-name Zepbound was FDA-approved for chronic weight management in November 2023. It’s meant to be used along with a lower-calorie diet and increased physical activity.
Zepbound is prescribed to people with obesity, which is defined as a body mass index (BMI) of 30 or higher.
It may also be prescribed to folks with overweight (a BMI of 27 or higher) who have other weight-related health conditions, such as:
High blood pressure (hypertension)
Dyslipidemia (when blood lipids are too high or low)
Obstructive sleep apnea
Tirzepatide that’s sold under the brand name Mounjaro® is FDA-approved for managing blood glucose levels in people with type 2 diabetes mellitus. It may sometimes be prescribed off-label as a weight loss medication.
Now let’s discuss tirzepatide dosing for weight loss. Tirzepatide injections are given once weekly.
The maximum dose of tirzepatide for weight loss is 15 milligrams. However, this isn’t the dose you’ll start on right away. Your healthcare provider will start you on a low dose of 2.5 milligrams.
The tirzepatide starting dose is much lower than the maximum dose. So your provider will increase your weekly dose of tirzepatide by 2.5 milligrams increments every four weeks.
Gradually increasing the dose of your medication over time is called dose escalation. Using a dose escalation strategy helps your body to get used to tirzepatide and can help reduce side effects as you adjust to the medication.
Over time, you’ll reach the dose you’ll continue to take going forward. This is called a maintenance dose. Depending on your tolerability (how your body is reacting to tirzepatide at each dosage), your maintenance dose could be 5, 10, or 15 milligrams.
The table below shows the dosing schedule used when you take tirzepatide for weight loss. The asterisk (*) indicates that a tirzepatide dosage for weight loss is also a recommended maintenance dose.
Dose |
|---|
Starting dose of 2.5 mg weekly |
After four weeks, increase to 5 mg weekly* |
After four weeks, increase to 7.5 mg weekly |
After four weeks, increase to 10 mg weekly* |
After four weeks, increase to 12.5 mg weekly |
After four weeks, increase to 15 mg weekly* |
You take tirzepatide as a subcutaneous injection. That means it’s injected just under your skin rather than into the muscle.
Tirzepatide injections typically come in pre-filled, single-dose injection pens. Each injection pen will contain the tirzepatide dose you’re supposed to take each week.
When you first start out on tirzepatide, a healthcare professional will show you how to prepare and inject the medication.
There are a few places you can inject tirzepatide. According to the prescribing information for Zepbound, these include the:
Stomach (abdomen)
Thigh
Upper arm
To prevent injection site reactions like bruising, you might want to rotate your tirzepatide injection sites each week.
You’re supposed to take tirzepatide on the same day each week, at any time of the day. But what happens if you miss your weekly dose of tirzepatide?
If you miss a dose of tirzepatide, take your missed dose within 96 hours (four days).
But never take two doses of tirzepatide within 72 hours (three days) of each other.
So, if it’s been more than four days since your missed tirzepatide dose, don’t take your missed dose. Instead, give yourself your next dose of tirzepatide at your regularly scheduled time.
You may have heard of compounded tirzepatide and wondered how it’s different from regular tirzepatide.
FDA-approved tirzepatide under the brand name Zepbound® and Mounjaro® is manufactured by the drug company Eli Lilly.
Meanwhile, compounded tirzepatide products are essentially made from scratch by licensed pharmacists, licensed physicians, or individuals under the supervision of a licensed pharmacist. They aren’t FDA-approved.
A tirzepatide compound dosage chart will likely look the same as a brand-name tirzepatide dosing schedule. Still, be extra careful about dosing, as not all compounded tirzepatide will come in a pre-filled pen.
If you do get compounded GLP-1 drugs, make sure it’s prescribed by a licensed healthcare provider and comes from a trusted source that partners with an accredited pharmacy.
Tirzepatide has several common side effects. Many affect the digestive system and tend to be mild to moderate in severity. Clinical trials reported that gastrointestinal side effects were more common during dose escalation (after increasing your dose).
According to the product prescribing information, the most common side effects of Zepbound are:
Nausea
Vomiting
Diarrhea
Constipation
Abdominal pain
Stomach upset (dyspepsia)
Injection site reactions
Fatigue
Belching
Hair loss
Gastroesophageal reflux disease (GERD)
Hypersensitivity reactions (allergic reactions)
There are also more serious side effects associated with Zepbound. Though these are rare, they can include:
Severe digestive disease
Acute pancreatitis or gallbladder disease
Acute kidney injury
Risk of hypoglycemia (dangerously low blood sugar) in people with type 2 diabetes who are taking insulin or sulfonylureas
Problems related to diabetic retinopathy in people who also have type 2 diabetes
Suicidal ideations or behaviors
The prescribing information also notes that animal studies of tirzepatide led to thyroid C-cell tumors in some cases. While it’s unclear if this is a risk for humans, you shouldn’t use tirzepatide if you have a personal or family history of medullary thyroid cancer.
Significant Side Effects From Tirzepatide for Weight Loss
What happens if you have significant side effects while taking tirzepatide for weight loss? A 2024 review noted that up to seven percent of people in tirzepatide clinical trials discontinued it due to side effects.
If you have very bothersome side effects from tirzepatide, solutions are available. For instance, there are multiple recommended maintenance doses for tirzepatide.
In other words, if you don’t tolerate higher doses of tirzepatide, such as a 15-milligram maintenance dose, your healthcare provider may drop it to 10 milligrams or even a 5-milligram dose.
Here’s a recap of what we covered about tirzepatide dosing for weight loss:
Tirzepatide follows a dose escalation schedule. The starting dose is usually 2.5 milligrams weekly, and the maximum is 15 milligrams.
This tirzepatide dosing schedule has shown to be effective for weight loss, along with healthy eating and exercise.
If you experience substantial side effects that don’t subside over time, your healthcare provider might adjust your dosage or suggest a lower maintenance dose of 5 or 10 milligrams.
Tirzepatide isn’t right for everyone. If it’s not working for you, there are other weight loss strategies to try.
Alternative weight loss medications include other GLP-1 receptor agonists. Semaglutide and liraglutide (sold under the brand name Saxenda®) are both approved by the FDA for chronic weight management.
Metformin and other oral medications might be an option as well.
As you move forward on your weight loss journey, know that your healthcare provider is there to help you along the way. If you have any concerns while taking tirzepatide or any other medication for weight loss, be sure to raise them. Your provider can give you medical advice and work with you to find solutions.
If you’re interested in exploring prescription weight loss medications, start with our free online assessment.
13 Sources
- Centers for Disease Control and Prevention (CDC). (2024). Adult obesity facts. https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html
- Centers for Disease Control and Prevention (CDC). (2023). Overweight and obesity. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm
- Jastreboff AM, et al. (2022). Tirzepatide once weekly for the treatment of obesity. https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
- Jensen TL, et al. (2024). The body weight reducing effects of tirzepatide in people with and without type 2 diabetes: a review on efficacy and adverse effects. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861994/
- Mounjaro® (tirzepatide) injection, for subcutaneous use. (2022). https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215866s000lbl.pdf
- National Heart, Lung, and Blood Institute (NHLBI). (n.d.). Calculate your body mass index. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
- Rodriguez PJ, et al. (2024). Semaglutide vs tirzepatide for weight loss in adults with overweight or obesity. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080
- Saxenda® (liraglutide) injection, for subcutaneous use. (2023). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/206321s016lbl.pdf
- U.S. Food and Drug Administration (FDA). (2024). Compounding and the FDA: questions and answers. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
- U.S. Food and Drug Administration (FDA). (2024). FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products. https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-patients-dosing-errors-associated-compounded
- U.S. Food and Drug Administration (FDA). (2021). FDA approves new drug treatment for chronic weight management, first since 2014. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
- U.S. Food and Drug Administration (FDA). (2023). FDA approves new medication for chronic weight management. https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management
- Zepbound® (tirzepatide) injection, for subcutaneous use. (2023). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/217806s000lbl.pdf
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