Tirzepatide Dosage Chart: Every Step From 2.5 mg to 15 mg

Tirzepatide has one labeled dose ladder, and it is short enough to state completely: start at 2.5 mg once weekly for four weeks, then increase in 2.5 mg steps no sooner than every four weeks, up to a maximum of 15 mg once weekly ¹.

Everything else people search for — the chart, the units, the "when can I go up", the compounded variations — hangs off those three numbers. This page gives you the schedule as the label writes it, then the parts the label does not answer and a compounded provider will.

The chart

Each step is once weekly, subcutaneous, and the escalation interval is at least four weeks — not exactly four. The label's phrasing is "after at least 4 weeks", which makes four weeks a floor, not a schedule to hit ¹.

The part most charts get wrong: not every step is a destination

The label names 5 mg, 10 mg or 15 mg as the recommended maintenance doses for weight reduction. 7.5 mg and 12.5 mg exist as escalation steps, not as places the label expects you to stop ¹.

That distinction matters when a provider or a chart implies you must climb to 15 mg. You do not. The label says to consider "treatment response and tolerability when selecting the maintenance dosage" ¹ — so the right maintenance dose is the lowest one doing the job you can tolerate, and for many people that is 5 mg or 10 mg.

For obstructive sleep apnea the label is narrower: maintenance is 10 mg or 15 mg ¹. We cover that indication in GLP-1 and sleep apnea.

Why the four-week floor exists

Tirzepatide's most common adverse events are gastrointestinal, and they cluster around dose increases. The four-week hold is what gives the gut time to adapt before the next step. Escalating faster is the single most reliable way to make yourself sick on this drug, and a large pharmacovigilance analysis found GLP-1 receptor agonists carry elevated risk of gastrointestinal adverse events including gastroparesis and bowel obstruction ³.

If a step is rough, holding at the current dose longer is explicitly allowed — "at least" four weeks has no upper bound. What is not allowed by the label is compressing it. Our side effects guide covers managing the ones that do appear.

What the doses actually delivered

In SURMOUNT-1, the phase 3 obesity trial, tirzepatide was tested at 5 mg, 10 mg and 15 mg once weekly over 72 weeks, and weight reduction rose with dose across those three arms ². That is the evidence behind "higher does more" — and also the reason the ladder tops out at 15 mg rather than continuing.

It is worth reading that alongside the tolerability picture rather than as a reason to climb: the highest dose you can reach is not automatically the dose you should sit on.

Missed a dose?

The label is specific. Take it as soon as possible within 4 days (96 hours) of the missed dose. If more than four days have passed, skip it and take the next one on the regular day ¹.

Do not double up. And if you have missed enough consecutive doses that you are unsure where you are on the ladder, that is a prescriber question — restarting sometimes means stepping back down.

Compounded tirzepatide: the same ladder, different packaging

Compounded tirzepatide is not FDA-approved, and the compounder is not bound to the branded product's presentation. In practice most compounded providers follow the same 2.5 mg ladder, because it is the only escalation schedule with evidence behind it — but two things change:

- The concentration is whatever the compounder chose, so the same milligram dose is a different volume, and a different number of units on a syringe, from one vial to the next. Never carry a unit figure across vials. - Some providers publish a "microdose" or low-dose tier below 2.5 mg. That sits beneath every dose the label defines and beneath every dose the trials tested.

We cover what compounded actually means in is compounded GLP-1 legit and safe? and how the two supply routes differ in compounded vs brand-name GLP-1s.

The short version

Start 2.5 mg. Hold four weeks. Step up 2.5 mg at a time, never sooner than every four weeks. Stop at the lowest dose that works — 5 mg and 10 mg are labeled maintenance doses, not waypoints. Ceiling is 15 mg. Miss a dose, take it within four days or skip it.

The dosing schedule for both molecules side by side is in our GLP-1 dosing and titration guide, and how tirzepatide compares with semaglutide on results and tolerability is in semaglutide vs tirzepatide.