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Complete guide to Zepbound (tirzepatide) dosing including escalation schedule, maintenance doses, weight loss results by dose level, and optimal titration timeline for maximum results.
Zepbound starts at 2.5 mg weekly for 4 weeks, then increases to 5 mg for 4 weeks, 7.5 mg for 4 weeks, 10 mg for 4 weeks, 12.5 mg for 4 weeks, and finally 15 mg weekly as the maximum dose. This gradual titration minimizes side effects while delivering 20-25% average weight loss. Most people maintain on 10-15 mg weekly.
Clinical trials show average weight loss of 15% at 10 mg, 20% at 12.5 mg, and up to 22.5% at the maximum 15 mg dose over 72 weeks. Your provider may adjust dosing based on tolerance and results.
| Week | Dose | Injection Volume | Purpose | Expected Weight Loss |
|---|---|---|---|---|
| 1-4 | 2.5 mg | 0.5 mL | Starting dose - minimize side effects | 2-5 lbs total (0.5-1.25 lbs/week) |
| 5-8 | 5 mg | 0.5 mL | First escalation - build tolerance | 4-8 lbs total (1-2 lbs/week) |
| 9-12 | 7.5 mg | 0.5 mL | Therapeutic dose - noticeable results | 6-10 lbs total (1.5-2.5 lbs/week) |
| 13-16 | 10 mg | 0.5 mL | Common maintenance - strong effects | 8-12 lbs total (2-3 lbs/week) |
| 17-20 | 12.5 mg | 0.5 mL | Higher maintenance - enhanced results | 8-14 lbs total (2-3.5 lbs/week) |
| 21+ | 15 mg | 0.5 mL | Maximum dose - peak efficacy | Continued 2-3 lbs/week until goal |
Most Common Maintenance
Higher Maintenance
Maximum Dose
Weeks 1-4
Initial dose to introduce your body to tirzepatide. Minimal side effects expected. Begin noticing reduced appetite and portion sizes.
Weeks 5-12
Doubling to 5 mg, then increasing to 7.5 mg. Weight loss accelerates significantly. Side effects may temporarily increase with each dose change but typically resolve within 1-2 weeks.
Weeks 13-20
Strong appetite suppression and steady weight loss. Many people find their ideal maintenance dose in this range and stop escalating.
Week 21+
Highest available dose for maximum weight loss. Continued steady loss until goal weight achieved, then maintained long-term.
No, you must start at 2.5 mg and follow the escalation schedule. Starting at higher doses causes severe nausea, vomiting, and other GI side effects that can be dangerous. The gradual titration allows your body to adapt while still delivering excellent results - clinical trials showed 20-25% weight loss using the standard schedule. Rushing the process doesn't improve outcomes and often leads to discontinuation.
Zepbound and Mounjaro contain the same medication (tirzepatide) at the same doses and follow identical escalation schedules. The only difference is the indication: Mounjaro is FDA-approved for type 2 diabetes, while Zepbound is approved for weight loss. The dosage chart, titration timeline, and injection volumes are exactly the same. Some insurance covers one but not the other, so your provider may prescribe whichever is covered.
The standard protocol is 4 weeks at each dose level. This allows your body to adjust, minimizes side effects, and lets you assess effectiveness. However, you can stay at any dose longer if needed - some people remain at 5 mg or 7.5 mg for 8-12 weeks if experiencing good weight loss with minimal side effects. Only escalate when you've tolerated the current dose well for at least 4 weeks and your provider approves.
If side effects become intolerable at a higher dose, you can drop back to the previous dose level. Many people find their ideal maintenance dose is 10 mg or 12.5 mg rather than the maximum 15 mg. There's no requirement to reach the highest dose - the goal is finding the lowest effective dose that delivers your desired weight loss with tolerable side effects. Discuss any severe or persistent side effects with your provider.
Yes, Zepbound (tirzepatide) uses different doses than Wegovy/Ozempic (semaglutide). Zepbound ranges from 2.5-15 mg while Wegovy goes from 0.25-2.4 mg - but you can't compare them directly because they're different medications. Zepbound's dual GIP/GLP-1 mechanism typically produces 20-25% weight loss vs 15-20% with semaglutide. The escalation schedules are also different: Zepbound uses 4-week intervals while Wegovy uses monthly increases.
No, never split Zepbound into multiple doses per week. The medication is formulated for once-weekly administration only. Daily or twice-weekly dosing hasn't been studied and could cause unpredictable medication levels, increased side effects, and reduced effectiveness. Each 0.5 mL injection must be taken all at once on your designated weekly injection day. If experiencing side effects, talk to your provider about staying at a lower dose rather than splitting injections.
No, many people achieve excellent results at 10 mg or 12.5 mg. Clinical trials showed 15% average weight loss at 10 mg and 20% at 12.5 mg - both outstanding outcomes. The 15 mg dose delivers 22-25% weight loss on average, which is beneficial for those with more weight to lose or who plateau at lower doses. Work with your provider to find the lowest effective dose that helps you reach your goals with tolerable side effects.
Most people notice reduced appetite within 1-3 days of their first injection and start losing weight in the first week. Expect 0.5-1 pound per week at the 2.5 mg starting dose, increasing to 1-2 pounds per week at 5-7.5 mg, and 2-3 pounds per week at higher doses (10-15 mg). Weight loss is typically fastest in the first 20-40 weeks, then continues at a slower pace until you reach your goal. Total average weight loss is 20-25% of starting body weight over 72 weeks.
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