Mounjaro Dosage Chart: Complete Titration Schedule & Guide
FDA-approved Mounjaro titration schedule for type 2 diabetes (2.5mg → 15mg), 4-week dose intervals, A1C reduction data from SURPASS trials, weight loss as secondary benefit, and dosing strategies for diabetes control vs weight loss.
Quick Dosing Reference
Mounjaro follows a 6-step titration schedule, increasing every 4 weeks:
- Weeks 1-4: 2.5mg weekly (starting dose)
- Weeks 5-8: 5mg weekly (first maintenance dose for some)
- Weeks 9-12: 7.5mg weekly (if needed for glycemic control)
- Weeks 13-16: 10mg weekly (common maintenance dose)
- Weeks 17-20: 12.5mg weekly (for additional control)
- Week 21+: 15mg weekly (maximum FDA-approved dose)
Most type 2 diabetics maintain at 5mg, 10mg, or 15mg depending on A1C goals.
Complete Mounjaro Dosage Chart
This is the FDA-approved titration schedule for Mounjaro (tirzepatide for type 2 diabetes):
| Dose Level | Weekly Dose | Timeline | A1C Reduction | Weight Loss | Purpose |
|---|---|---|---|---|---|
| STARTING | 2.5mg | Weeks 1-4 | -1.0% | 3-5% | Starting dose for tolerance |
| DOSE 2 | 5mg | Weeks 5-8 | -2.0 to -2.1% | 7-9% | Maintenance for some patients |
| DOSE 3 | 7.5mg | Weeks 9-12 | -2.1 to -2.2% | 10-12% | Additional glycemic control |
| DOSE 4 | 10mg | Weeks 13-16 | -2.2 to -2.3% | 13-15% | Common maintenance dose |
| DOSE 5 | 12.5mg | Weeks 17-20 | -2.3 to -2.4% | 16-18% | For tighter glycemic control |
| MAXIMUM | 15mg | Week 21+ | -2.4 to -2.5% | 18-21% | Maximum FDA-approved dose |
IMPORTANT NOTES:
- 4-week intervals: Must wait minimum 4 weeks between dose increases
- Individualized dosing: Not everyone needs 15mg—many maintain at 5-10mg
- Primary goal is A1C: Increase dose if A1C not at goal (typically <7%)
- Weight loss is bonus: Mounjaro is approved for diabetes, not weight loss (that's Zepbound)
- Same medication as Zepbound: Both are tirzepatide with identical dosing schedules
A1C Reduction Data from SURPASS Clinical Trials
The SURPASS trial program included over 10,000 patients with type 2 diabetes. Here's what the data shows:
A1C Reduction by Mounjaro Dose (40 weeks)
| Mounjaro Dose | Average A1C Reduction | Patients Reaching A1C <7% | Patients Reaching A1C <5.7% |
|---|---|---|---|
| 5mg weekly | -2.0 to -2.1% | 79-82% | 31-35% |
| 10mg weekly | -2.2 to -2.3% | 85-86% | 42-51% |
| 15mg weekly | -2.4 to -2.5% | 87-93% | 51-62% |
Example A1C Reduction Scenarios:
Patient Starting with A1C 8.5%:
- On 5mg: A1C drops to ~6.4-6.5% (excellent control)
- On 10mg: A1C drops to ~6.2-6.3% (near-normal)
- On 15mg: A1C drops to ~6.0-6.1% (non-diabetic range)
Patient Starting with A1C 9.5%:
- On 5mg: A1C drops to ~7.4-7.5% (may need higher dose)
- On 10mg: A1C drops to ~7.2-7.3% (closer to goal)
- On 15mg: A1C drops to ~7.0-7.1% (at or near goal)
Key SURPASS Trial Findings:
- Superior to other GLP-1s: Mounjaro reduced A1C more than Ozempic, Trulicity, and insulin
- Dose-response relationship: Higher doses = better A1C control
- Sustained effect: A1C reduction maintained throughout 40-52 week trials
- 50%+ reached non-diabetic A1C: At 15mg dose, over half achieved A1C <5.7%
- Fasting glucose: Reduced by 50-70 mg/dL on average
- Cardiovascular benefits: Improvements in blood pressure, lipids, and cardiovascular risk markers
Weight Loss as Secondary Benefit
While Mounjaro is FDA-approved for type 2 diabetes, significant weight loss is a major secondary benefit:
Weight Loss by Mounjaro Dose (SURPASS Trials)
| Dose | Average Weight Loss | Example (Starting 220 lbs) | Pounds Lost |
|---|---|---|---|
| 5mg | 7-9% body weight | 200-204 lbs | 15-20 lbs |
| 10mg | 13-15% body weight | 187-191 lbs | 29-33 lbs |
| 15mg | 18-21% body weight | 174-180 lbs | 40-46 lbs |
Comparing Mounjaro to Other Diabetes Medications for Weight Loss:
| Medication | Average Weight Loss | Weight Change Compared to Placebo |
|---|---|---|
| Metformin | 2-3 kg (4-7 lbs) | Minimal |
| Trulicity (dulaglutide) | 2-3 kg (4-7 lbs) | Small benefit |
| Ozempic 1mg (semaglutide) | 4-6 kg (9-13 lbs) | Moderate benefit |
| Ozempic 2mg | 6-7 kg (13-15 lbs) | Good benefit |
| Mounjaro 15mg | 10-12 kg (22-26 lbs) | BEST weight loss for diabetes medication |
Why Weight Loss Matters for Type 2 Diabetes:
- Improves insulin sensitivity: Weight loss reduces insulin resistance
- Lowers A1C independently: Weight loss contributes to A1C reduction beyond medication effect
- Reduces cardiovascular risk: Weight loss improves blood pressure, cholesterol, and heart health
- May achieve remission: Some patients with 15%+ weight loss achieve diabetes remission
- Reduces medication needs: Weight loss may allow reduction of other diabetes medications
Dosing for Diabetes Control vs Weight Loss
While Mounjaro is FDA-approved only for type 2 diabetes, dosing strategy differs based on whether the primary goal is glycemic control or weight loss:
PRIMARY GOAL: Diabetes Control
Dose Selection Strategy:
- Start at 2.5mg for 4 weeks
- Increase to 5mg—stay here if A1C reaches goal
- If A1C >7% after 3 months at 5mg, increase to 10mg
- If A1C still >7% after 3 months at 10mg, increase to 15mg
- Use lowest effective dose that achieves A1C <7%
Typical Outcome:
- Many patients achieve goal A1C at 5mg or 10mg
- Weight loss (15-30 lbs) is a welcome bonus
- May be able to reduce or stop other diabetes medications
- Focus on A1C, fasting glucose, and post-meal glucose
PRIMARY GOAL: Weight Loss (with diabetes)
Dose Selection Strategy:
- Start at 2.5mg for 4 weeks
- Increase to 5mg for 4 weeks
- Continue increasing every 4 weeks: 7.5mg → 10mg → 12.5mg → 15mg
- Goal is to reach 10-15mg for maximum weight loss
- Don't stop at 5mg even if A1C is at goal (if weight loss is priority)
Typical Outcome:
- Average 15-21% weight loss at 10-15mg doses
- A1C often drops to non-diabetic range (<5.7%)
- May achieve diabetes remission with significant weight loss
- Focus on weight loss metrics alongside glycemic control
IMPORTANT: Mounjaro vs Zepbound
- Mounjaro: FDA-approved for type 2 diabetes only
- Zepbound: FDA-approved for weight loss (same drug, different indication)
- Insurance coverage: Mounjaro usually covered for diabetes, Zepbound coverage varies
- Dosing schedule: Identical (2.5mg → 15mg)
- For weight loss without diabetes: Must use Zepbound or compounded tirzepatide
When to Increase Dose vs Stay at Current Dose
Decision guide for dose escalation based on diabetes control:
INCREASE DOSE IF:
- A1C is not at goal (>7%) after 3+ months at current dose
- Fasting blood glucose consistently >130 mg/dL
- Post-meal blood glucose frequently >180 mg/dL
- You're tolerating current dose well (minimal side effects)
- You've been at current dose for minimum 4 weeks
- You want additional weight loss for health benefits
STAY AT CURRENT DOSE IF:
- A1C is at goal (<7%, or your individualized target)
- Blood sugars are well-controlled throughout the day
- You're experiencing significant side effects at current dose
- You've reached your weight loss goals
- It's been less than 4 weeks at current dose
- Your provider recommends staying based on overall health
CONSIDER DECREASING DOSE IF:
- Experiencing severe nausea, vomiting, or other intolerable side effects
- Frequent hypoglycemia (low blood sugar), especially if on insulin or sulfonylureas
- Unable to maintain adequate caloric intake (eating <1,000 cal/day)
- A1C has dropped too low (<6%) and you're at risk for hypoglycemia
- Your provider recommends dose reduction based on side effects or other concerns
Managing Side Effects
Most common side effects and how to manage them:
Common Side Effects by Frequency
| Side Effect | Frequency | Management Strategy |
|---|---|---|
| Nausea | 25-30% | Smaller meals, avoid fatty foods, ginger, eat slowly |
| Diarrhea | 20-25% | Reduce fat intake, stay hydrated, probiotic |
| Decreased appetite | 20-30% | Eat on schedule, protein shakes, calorie tracking |
| Constipation | 15-20% | More water, fiber supplement, magnesium, exercise |
| Fatigue | 10-15% | Ensure adequate calories, B12 supplement, sleep |
Special Consideration: Hypoglycemia Risk
Mounjaro alone rarely causes hypoglycemia. However, risk increases when combined with:
- Insulin: May need to reduce insulin dose by 20-40% when starting Mounjaro
- Sulfonylureas (glipizide, glyburide): Increase hypo risk—consider reducing dose
- Other diabetes medications: Discuss with provider
Monitor blood sugar closely when starting Mounjaro or increasing dose if you're on insulin or sulfonylureas.
SEEK IMMEDIATE MEDICAL ATTENTION IF:
- Severe abdominal pain (especially upper abdomen radiating to back—possible pancreatitis)
- Persistent vomiting preventing you from keeping down food or water
- Signs of severe hypoglycemia (confusion, loss of consciousness, seizures)
- Severe allergic reaction (difficulty breathing, severe rash, facial swelling)
- Vision changes or eye problems
- Signs of thyroid tumor (lump in neck, hoarseness, trouble swallowing)
- Symptoms of gallbladder problems (severe pain in upper right abdomen, yellowing skin/eyes)
Get Tirzepatide for Diabetes or Weight Loss
At CoreAge RX, we provide compounded tirzepatide (same active ingredient as Mounjaro) for diabetes management and weight loss at one affordable price.
What You Get:
- Premium compounded tirzepatide for just $99/month
- All doses same price (2.5mg through 15mg)
- For type 2 diabetes, weight loss, or both
- Medical consultation and prescription included
- Provider support for dose optimization and A1C management
- Free shipping directly to your door
- Save $900+/month vs brand-name Mounjaro without insurance
IDEAL FOR:
- Type 2 diabetics who can't afford $1,000+/month Mounjaro
- Patients whose insurance won't cover Mounjaro
- Anyone wanting superior A1C control with weight loss benefits
- People seeking flat-rate pricing regardless of dose
Takes 5 minutes. All doses same price. For diabetes or weight loss.
Frequently Asked Questions
What's the difference between Mounjaro and Zepbound?
Both are tirzepatide with identical dosing schedules. Mounjaro is FDA-approved for type 2 diabetes, Zepbound is FDA-approved for weight loss. They're the same medication marketed for different indications. Many doctors prescribe Mounjaro off-label for weight loss.
How long does it take to see A1C reduction with Mounjaro?
Most patients see significant A1C reduction within 3-4 months. Peak A1C reduction typically occurs at 6 months. Your doctor will recheck A1C after 3 months to determine if dose adjustment is needed.
Can I use Mounjaro with insulin?
Yes, Mounjaro can be combined with insulin. However, you'll likely need to reduce your insulin dose (often by 20-40%) to prevent hypoglycemia. Work closely with your provider to adjust insulin doses as your blood sugars improve on Mounjaro.
Do I need to reach 15mg or can I stay at a lower dose?
Many patients achieve excellent A1C control at 5mg or 10mg. Only increase if your A1C isn't at goal or you want additional weight loss benefits. The goal is the lowest effective dose that achieves your diabetes control targets.
Is Mounjaro better than Ozempic for diabetes?
Clinical trials show Mounjaro produces slightly better A1C reduction (-2.0% to -2.5% vs -1.5% to -1.9% for Ozempic) and significantly more weight loss (15-21% vs 9-14%). However, both are excellent medications. Choice often depends on insurance coverage, cost, and individual response.
Can Mounjaro cause diabetes remission?
Yes, especially with significant weight loss. Some patients achieve non-diabetic A1C levels (<5.7%) and can reduce or stop other diabetes medications. However, this typically requires staying on Mounjaro long-term. Stopping the medication usually results in A1C rising again.
The Bottom Line
Mounjaro follows a 6-dose titration schedule (2.5mg → 15mg) with 4-week intervals, providing superior A1C reduction and significant weight loss for type 2 diabetes patients.
Key takeaways:
- A1C reduction: -2.0% to -2.5% depending on dose
- Weight loss: 15-21% average at higher doses (bonus benefit)
- Maintenance dose: Many patients maintain at 5mg, 10mg, or 15mg
- Superior to other GLP-1s: Better A1C and weight loss than semaglutide
- 4-week intervals: Must wait minimum 4 weeks between increases
- Individualized dosing: Use lowest effective dose for your A1C goals
Work with your healthcare provider to optimize your Mounjaro dose for both glycemic control and weight loss benefits.