Zepbound Dosage Chart: Complete Titration Schedule & Guide
FDA-approved Zepbound titration schedule (2.5mg → 15mg), 4-week dose increases, weight loss results at each dose, side effect management, and when to stay at your current dose vs increase.
Quick Dosing Reference
Zepbound follows a 6-step titration schedule, increasing every 4 weeks:
- Weeks 1-4: 2.5mg weekly (starting dose)
- Weeks 5-8: 5mg weekly
- Weeks 9-12: 7.5mg weekly
- Weeks 13-16: 10mg weekly
- Weeks 17-20: 12.5mg weekly
- Week 21+: 15mg weekly (maximum dose)
Most people reach their maintenance dose (10-15mg) by month 5-6.
Complete Zepbound Dosage Chart
This is the FDA-approved titration schedule for Zepbound (tirzepatide for weight loss):
| Dose Level | Weekly Dose | Timeline | Average Weight Loss | Purpose |
|---|---|---|---|---|
| STARTING DOSE | 2.5mg | Weeks 1-4 | 2-4% body weight | Minimize side effects, assess tolerance |
| DOSE 2 | 5mg | Weeks 5-8 | 5-7% body weight | First therapeutic dose, noticeable appetite suppression |
| DOSE 3 | 7.5mg | Weeks 9-12 | 8-10% body weight | Strong appetite control, steady weight loss |
| DOSE 4 | 10mg | Weeks 13-16 | 12-15% body weight | Maintenance dose for many people |
| DOSE 5 | 12.5mg | Weeks 17-20 | 15-18% body weight | For those needing additional weight loss |
| MAXIMUM DOSE | 15mg | Week 21+ | 18-22% body weight | Maximum FDA-approved dose |
IMPORTANT NOTES:
- Wait minimum 4 weeks between dose increases—never increase sooner
- You can stay at any dose longer if experiencing side effects or reaching weight goals
- Not everyone needs 15mg—many maintain weight loss at 7.5-10mg
- Weight loss percentages are cumulative from treatment start (not per dose period)
What to Expect at Each Dose Level
Here's what most people experience at each dose of Zepbound:
Weeks 1-4: Getting Started
Expected Effects:
- Mild appetite reduction (you'll notice less hunger between meals)
- Feeling full faster when eating
- 2-4% weight loss over first month (5-8 lbs for someone starting at 200 lbs)
- Some people experience mild nausea, usually days 1-3 after injection
Common Side Effects:
- Mild nausea (30-40% of people) - usually improves after 2-3 injections
- Fatigue or low energy (first 1-2 weeks)
- Mild constipation or diarrhea
- Decreased appetite
WHAT TO DO:
- Eat small, protein-rich meals even if not hungry
- Stay hydrated (80-100oz water daily)
- Track your food to ensure you're eating 1,200-1,500 calories
- Take medication with food if nausea is bothersome
Weeks 5-8: Real Appetite Suppression Begins
Expected Effects:
- Significant appetite reduction (food thoughts decrease dramatically)
- Strong early satiety (full after small portions)
- 5-7% cumulative weight loss (10-14 lbs from start for 200 lb person)
- Food aversions may develop (meat, greasy foods)
Common Side Effects:
- Nausea (can increase temporarily with dose increase)
- Fatigue or tiredness
- Constipation (more common at this dose)
- Bloating or gas
- Heartburn or acid reflux
WHAT TO DO:
- Prioritize protein at every meal (25-35g per meal)
- Avoid high-fat, greasy, or spicy foods that worsen nausea
- Consider fiber supplement or stool softener for constipation
- Eat slowly (20-30 minutes per meal) to prevent overfullness
Weeks 9-12: Steady Weight Loss Phase
Expected Effects:
- Very strong appetite control (many people struggle to eat enough)
- 8-10% cumulative weight loss (16-20 lbs from start)
- Consistent 1-2 lb weight loss per week
- Changes in food preferences (crave lighter, fresher foods)
Common Side Effects:
- Nausea usually improving at this dose (body adjusting)
- Fatigue (especially if not eating enough calories)
- Constipation (very common at 7.5mg+)
- Hair thinning (if protein intake is insufficient)
WHAT TO DO:
- Force yourself to eat on schedule even if not hungry
- Ensure minimum 80-100g protein daily to prevent muscle loss
- Take multivitamin + B12 + vitamin D daily
- Start or continue resistance training 2-3x/week
Weeks 13-16: Maintenance for Many People
Expected Effects:
- 12-15% cumulative weight loss (24-30 lbs from start)
- Very strong satiety (can skip meals unintentionally)
- This is the maintenance dose for 40-50% of Zepbound users
- Weight loss may slow slightly (but continues steadily)
Common Side Effects:
- Side effects typically stabilized by now
- Constipation (manage proactively)
- Risk of eating too few calories (below 1,000/day)
- Some people experience mild fatigue
DECISION POINT:
Stay at 10mg if: You're losing weight consistently (1+ lb/week), tolerating the medication well, and happy with progress.
Increase to 12.5mg if: Weight loss has plateaued for 3+ weeks, appetite is returning, or you need more weight loss to reach your goal.
Weeks 17-20: For Additional Weight Loss
Expected Effects:
- 15-18% cumulative weight loss (30-36 lbs from start)
- Very powerful appetite suppression
- May need to set alarms to remember to eat
- Continued steady weight loss
Common Side Effects:
- Similar to 10mg (usually well-tolerated by this point)
- Constipation (requires active management)
- Risk of malnutrition if not eating enough
WHAT TO DO:
- Track calories religiously—ensure minimum 1,200 daily
- Consider protein shakes to meet protein goals
- Monitor for excessive fatigue or hair loss (sign of inadequate nutrition)
Week 21+: Maximum FDA-Approved Dose
Expected Effects:
- 18-22% cumulative weight loss (36-44 lbs from start for 200 lb person)
- Maximum appetite suppression
- This is as high as the dose goes—can't increase further
- Clinical trial average: 20.9% weight loss at 72 weeks
Common Side Effects:
- Generally well-tolerated (body fully adjusted by now)
- Constipation remains common
- Need vigilance about adequate food intake
LONG-TERM STRATEGY:
Once you reach your goal weight on 15mg, work with your provider to determine your maintenance dose. Some people can drop to 10-12.5mg and maintain weight loss. Others need to stay at 15mg long-term.
Weight Loss Results by Dose (Clinical Trial Data)
Data from the SURMOUNT-1 clinical trial (2,539 participants over 72 weeks):
Average Weight Loss by Final Dose
| Maintenance Dose | Average Weight Loss | Example (Starting 200 lbs) |
|---|---|---|
| 5mg | 15.0% body weight | 30 lbs lost (170 lbs final) |
| 10mg | 19.5% body weight | 39 lbs lost (161 lbs final) |
| 15mg | 20.9% body weight | 42 lbs lost (158 lbs final) |
Key Findings:
- 91% of people lost at least 5% of their body weight
- 69% of people lost at least 15% of their body weight
- 50% of people lost at least 20% of their body weight (on 10-15mg doses)
- 36% of people lost at least 25% of their body weight (mostly on 15mg)
- Weight loss continued throughout the 72-week trial (didn't plateau)
When to Increase Dose vs Stay at Current Dose
Not everyone needs to increase to the maximum dose. Here's how to decide:
INCREASE DOSE IF:
- You've been at current dose for 4+ weeks (minimum wait time)
- Weight loss has plateaued for 3+ consecutive weeks
- Appetite is returning or food cravings are coming back
- You're tolerating the current dose well (minimal side effects)
- You haven't reached your goal weight yet
- Your provider recommends increasing based on your progress
STAY AT CURRENT DOSE IF:
- You're experiencing significant side effects (nausea, vomiting, fatigue)
- You're still losing weight consistently (1+ lb per week)
- You've reached your goal weight and want to maintain
- You're struggling to eat enough calories at current dose
- It's been less than 4 weeks at your current dose
- You have concerning symptoms (severe abdominal pain, persistent vomiting)
CONSIDER DECREASING DOSE IF:
- Side effects are severe and not improving after 2-3 weeks
- You're unable to eat more than 800-1,000 calories daily
- Experiencing extreme fatigue, dizziness, or other concerning symptoms
- You've reached goal weight and want less appetite suppression for maintenance
Managing Side Effects During Dose Increases
Each dose increase may temporarily worsen side effects. Here's how to manage them:
Nausea & Vomiting
Most common in first 2-3 days after injection, especially with dose increases.
What Helps:
- Eat small, frequent meals (6 mini-meals vs 3 large)
- Avoid high-fat, greasy, or spicy foods
- Eat bland foods (crackers, rice, toast, bananas)
- Ginger tea, peppermint, or anti-nausea medication (ask doctor)
- Don't lie down immediately after eating
- Inject at night so nausea hits while you're sleeping
Constipation
Very common at higher doses (10mg+) due to slowed digestion.
What Helps:
- Drink 80-100oz water daily (critical)
- Fiber supplement (Metamucil, Benefiber) - start low, increase slowly
- Stool softener (Colace/docusate) daily
- Magnesium supplement (400mg) - also helps with sleep
- Light exercise (walking 20-30 min daily)
- MiraLAX if needed (talk to doctor)
Fatigue & Low Energy
Often caused by eating too few calories or insufficient protein.
What Helps:
- Ensure minimum 1,200 calories daily
- Eat 80-100g protein daily (use shakes if needed)
- Take B12 supplement (500-1,000 mcg daily)
- Get bloodwork (check for anemia, thyroid issues)
- Prioritize sleep (7-9 hours nightly)
Diarrhea
Less common than constipation but can occur, especially with high-fat meals.
What Helps:
- Reduce fat intake (keep to 20-30% of calories)
- Avoid greasy, fried foods
- Eat smaller, more frequent meals
- Stay hydrated (replace electrolytes)
- Consider probiotic supplement
WHEN TO CALL YOUR DOCTOR:
- Severe abdominal pain that doesn't improve
- Vomiting that prevents you from keeping down food/water for 24+ hours
- Signs of dehydration (dark urine, dizziness, extreme thirst)
- Rapid heartbeat or chest pain
- Severe allergic reaction (rash, difficulty breathing, swelling)
- Symptoms of pancreatitis (severe upper abdominal pain radiating to back)
- Symptoms of gallbladder issues (pain in upper right abdomen after eating)
Get Zepbound with Medical Support Through Every Dose
At CoreAge RX, we provide compounded tirzepatide (same active ingredient as Zepbound) with comprehensive medical guidance to help you navigate dose increases safely.
What You Get:
- Premium compounded tirzepatide for just $99/month
- Same price for all doses (2.5mg through 15mg)
- Medical consultation and prescription included
- Provider support for managing dose increases and side effects
- Guidance on when to increase vs stay at current dose
- Free shipping directly to your door
- Save $200-$700/month vs other compounded providers
WHY COREAGE RX FOR DOSING:
- No price increases as you titrate up (always $99/month)
- Medical team helps you optimize your dose for results and tolerance
- Can adjust dose up or down based on your response
- Access to provider support for side effect management
Takes 5 minutes. All doses same price. Medical support included.
Frequently Asked Questions
Can I increase my Zepbound dose faster than every 4 weeks?
No. The FDA-approved titration schedule requires waiting minimum 4 weeks between dose increases. Increasing faster significantly increases risk of severe nausea, vomiting, and other side effects. Your body needs time to adjust to each dose level before increasing.
Do I have to go all the way to 15mg?
No. Many people achieve their weight loss goals at 7.5mg, 10mg, or 12.5mg and never need to increase to 15mg. You only increase if you're tolerating the medication well, weight loss has plateaued, and you need additional weight loss. Work with your provider to find your optimal maintenance dose.
What happens if I miss a dose or need to delay my next increase?
If you miss a dose and it's been less than 4 days, take it as soon as you remember. If more than 4 days have passed, skip that dose and resume your regular schedule. You may need to drop down a dose if you've missed 2+ weeks. Always consult your provider before making dose changes after missing injections.
Can I stay at 2.5mg or 5mg if I'm losing weight well?
Yes, but 2.5mg is considered a sub-therapeutic dose (intended only for initial tolerance). Most providers recommend increasing to at least 5mg for meaningful weight loss. However, if you're getting excellent results and tolerating 5mg well, you can stay there as long as weight loss continues. The goal is finding the lowest effective dose for you.
How long does it take to reach the maximum dose?
Following the standard titration schedule (increasing every 4 weeks), it takes 20 weeks (5 months) to reach 15mg. However, many people find their maintenance dose before reaching 15mg and don't need to continue increasing.
Can I decrease my dose if side effects are too severe?
Yes. If you're experiencing severe side effects that aren't improving after 2-3 weeks at a new dose, your provider may recommend dropping back to your previous dose. It's better to stay at a lower, tolerable dose than push through severe symptoms. You can always try increasing again in the future.
What's the difference between Zepbound and Mounjaro dosing?
Zepbound and Mounjaro use identical dosing schedules (both are tirzepatide). The only difference is the indication: Mounjaro is FDA-approved for type 2 diabetes, Zepbound is FDA-approved for weight loss. The medication, doses, and titration schedule are exactly the same.
The Bottom Line
Zepbound follows a 6-dose titration schedule, starting at 2.5mg and increasing every 4 weeks up to a maximum of 15mg weekly.
Key takeaways:
- Wait minimum 4 weeks between dose increases—never rush titration
- Not everyone needs the maximum dose—many maintain at 10-12.5mg
- Average weight loss is 15-21% of body weight depending on final dose
- Side effects are usually worst during the first few weeks at a new dose
- Stay at your current dose if you're losing weight well and tolerating it
- Only increase if weight loss plateaus or appetite returns
Work closely with your healthcare provider to find the optimal dose for your individual goals, tolerance, and weight loss response.