Tirzepatide Maintenance Dose: The Full Dosage Chart (2026)

What's the tirzepatide maintenance dose, and how long does it take to get there?

There isn't a single number. The maintenance dose is the dose you stay on once you stop stepping up. On the Zepbound label, it is 5mg, 10mg or 15mg once a week. All three are approved, not just the highest.

Everyone starts at 2.5mg, whatever dose they end on. That first dose only lets your body adjust. It is not meant to treat anything.

From there, the dose rises by 2.5mg, no sooner than every 4 weeks. Here is the fastest path to each maintenance dose, if no step gets stretched out:

• 5mg: from week 5, after 4 weeks at 2.5mg
• 10mg: from week 13, after at least 12 weeks
• 15mg, the maximum: from week 21, after at least 20 weeks, or about five months

The full tirzepatide dosing chart: starting dose to maintenance, step by step

Brand-name Zepbound and Mounjaro come in a fixed strength for each dose. That is true of the single-dose pen, the vial and the KwikPen, a pen that holds four weekly doses. You never convert milligrams to units. The chart below is the schedule on the Zepbound label.

That ladder is a ceiling, not a timetable you must keep. Your prescriber can keep you on any step longer if side effects haven't settled. If a maintenance dose doesn't agree with you, the label says to consider a lower one.

Zepbound and Mounjaro share the same dose ladder, with one difference

Zepbound is tirzepatide approved for weight management. Mounjaro is the same molecule, approved for type 2 diabetes. Both start at 2.5mg and step up by 2.5mg. Both wait at least 4 weeks per step and stop at 15mg. What differs is where the dose settles.

On Zepbound, 2.5mg is a starter dose only. After 4 weeks, you move up to 5mg. For weight loss, the maintenance dose is then 5mg, 10mg or 15mg. For obstructive sleep apnea, meaning breathing that stops and starts in your sleep, it is 10mg or 15mg.

Mounjaro follows blood sugar instead. Its label says to step up only if more glucose control is needed. So a clinician may keep a patient on 7.5mg or 12.5mg if her blood sugar is on target there. On the weight side, there is no such reason to stop mid-ladder, unless side effects are the issue.

For Zepbound, the SURMOUNT-1 trial compared the three maintenance doses over 72 weeks. Here is the average weight change in each group:

• 5mg: about 15% of body weight
• 10mg: about 19.5%
• 15mg: about 21%
• Placebo, a dummy shot: about 3%

That spread is why higher doses are often the target for weight loss. Mounjaro's diabetes trials, called SURPASS, tested the same three doses.

How many units is 2.5mg of tirzepatide? Converting mg to units for compounded vials

None of this math applies to a Zepbound or Mounjaro pen or vial. Each one holds a fixed strength for your dose, so there is nothing to calculate.

It matters only for compounded tirzepatide from a vial. Compounded means a pharmacy mixed it, and it is not FDA-approved. You draw your own dose with an insulin syringe. That syringe reads in units, not milligrams.

The formula is simple. Divide your dose in mg by the vial's strength in mg per mL. Then multiply by 100.

Vial strength changes from one pharmacy to the next. Compounded tirzepatide vials run from 5 to 20 mg per mL. So the same syringe reading can mean very different doses.

Conversion at 10 mg/mL

• 2.5mg = 25 units
• 5mg = 50 units
• 7.5mg = 75 units
• 10mg = 100 units, a full standard 1 mL syringe
• 15mg = 150 units. That is more than a standard 100-unit syringe holds, so ask your pharmacy how to handle it.

Conversion at 20 mg/mL

• 2.5mg = 12.5 units
• 5mg = 25 units
• 7.5mg = 37.5 units
• 10mg = 50 units
• 15mg = 75 units

Fifty units can mean two very different doses. On a 10 mg/mL vial, it is 5mg. On a 20 mg/mL vial, it is 2.5mg. Always read the strength printed on your own vial before you draw. If your instructions give a dose in mg but no unit count, ask before you inject.

What if you can't tolerate a dose step, or you miss a shot?

If a step brings side effects that don't settle, you don't have to move up on schedule. Your prescriber can keep you at the current dose for longer. The label also allows a lower maintenance dose if a higher one isn't tolerated. The goal was never 15mg. It is a dose you can keep taking.

For a missed shot, the label gives a 4-day window, which is 96 hours.

• Less than 4 days late: take the missed dose as soon as you remember. Then go back to your usual day.
• More than 4 days late: skip it. Take the next dose on your usual day.
• Moving your injection day: keep at least 3 days, or 72 hours, between two doses.

The label gives no restart plan for someone who has missed several weeks in a row. If that happens, ask your prescriber which dose to restart on.

Does your monthly price go up as your tirzepatide dose increases?

For brand-name Zepbound, yes. LillyDirect is Lilly's own online pharmacy for people paying cash. Its price climbs over the first doses, then stays flat. The pen and the vial cost the same.

• 2.5mg starter dose: about $300 a month
• 5mg: about $400 a month
• 7.5mg up to 15mg: about $450 a month · Refill within 45 days to keep this price

The 45-day clock starts at your last delivery, not your order. Miss it and a higher regular price applies to that fill. At 7.5mg, a late refill costs about $500. From 10mg up, it costs about $700.

Compounded programs handle the dose climb in different ways. It is worth checking before you step up, not after.

• [Mochi Health](/reviews/mochi-health/), priced by dose: about $170–$280 a month, membership included · First month about $90
• [Willow](/reviews/willow/), priced by dose tier: about $400 a month at the lower doses · About $500–$550 at the higher doses · No membership fee

Mochi moved to per-dose pricing in August 2026. At both Mochi and Willow, a slower climb keeps you on a cheaper tier for longer.

Can you stay at a lower maintenance dose than 15mg, or do you have to go all the way up?

You don't have to reach 15mg. The Zepbound label treats 5mg, 10mg and 15mg as three equally valid maintenance doses. It also says to consider a lower one if a higher dose isn't tolerated.

In SURMOUNT-1, the 5mg group still lost about 15% of body weight on average at 72 weeks. That is less than at 15mg, but far from trivial. Whether a lower dose suits you long term is a choice you make with your prescriber. Side effects, results and cost all count.

Is the dosing schedule any different in perimenopause or menopause?

No. There is no separate FDA dose schedule for women in perimenopause or after menopause. No published tirzepatide study sets one either. The ladder from 2.5mg to 15mg is the same at every stage.

A post hoc analysis of the SURMOUNT trials, published in the journal Obesity, looked at results by reproductive stage. Post hoc means researchers went back to the trial data after the fact. Women before, during and after menopause all lost far more weight than on placebo. Nothing in it suggests any group needs a different dose.

In SURMOUNT-1, women in perimenopause lost about 23% of their body weight on tirzepatide. On placebo, they lost about 3%.

A Mayo Clinic study00145-1/abstract) asked a different question. It followed postmenopausal women on tirzepatide, with and without menopause hormone therapy. Those also on hormone therapy lost more weight on average, about 19% versus 14%. That is about how well a dose works, not which dose to take. Neither study changes the ladder above.

Who sets and adjusts your dose, and where to get prescribed

Every step on this ladder is a prescription decision. Your prescriber sets the starting dose. They decide when you step up, hold or drop back. That is the same in an exam room or on a telehealth video call. Bring this chart as a cross-check for your own plan.

Telehealth is now a common route to a tirzepatide prescription for weight loss. That is especially true for women dealing with menopause weight gain. Here is how three programs differ:

• [Henry Meds](/reviews/henry-meds/): tirzepatide as a dissolving tablet, with a prescriber managing each step.
• [Mochi Health](/reviews/mochi-health/): a care team that includes doctors board-certified in obesity medicine. Prices start low and rise with the dose.
• [Willow](/reviews/willow/): a simple intake, one all-in monthly bill and a tablet option, in the states it covers.

All three follow the same FDA ladder. What differs is the price, the format and how closely the clinician follows you. To see why the ladder is built this way, read how tirzepatide works.