The Zepbound Dosage Chart: From Starting Dose to Units on a Vial

What's the Zepbound dosage chart, from starting dose to maintenance?

There are six strengths on one ladder. Everyone starts at the bottom, whatever weight loss they are aiming for. The first step lets your body adjust to tirzepatide, the drug in Zepbound. The label does not count it as a treatment dose.

That is the label's fastest pace, with at least four weeks on each dose. It is not a timeline everyone follows the same way. Your prescriber can keep you on a step longer if side effects need time to settle. Nothing on the schedule requires you to reach the top.

The maintenance dose is the one you stay on long term. For weight loss, it is 5mg, 10mg or 15mg. For obstructive sleep apnea, meaning breathing that stops and starts in your sleep, it is 10mg or 15mg.

How many units is 2.5mg, 7.5mg, or 12.5mg of Zepbound?

For a real Zepbound pen, KwikPen or vial, this question doesn't apply. Each comes in a fixed strength for your dose, so there is nothing to calculate. The KwikPen holds four weekly doses and sets each one for you.

Units are syringe language. They matter only on compounded tirzepatide. Compounded means a pharmacy mixed it, and it is not FDA-approved. The pharmacy fills a vial at a set strength, and you draw your dose with an insulin syringe marked in units.

The conversion depends on the vial's strength in mg per mL. Compounding pharmacies don't use one standard. Two common strengths are 10 mg/mL and 20 mg/mL, but there are others. Here is what 2.5mg, 7.5mg and 12.5mg work out to on each:

At 10 mg/mL

• 2.5mg = 25 units
• 7.5mg = 75 units
• 12.5mg = 125 units. That is more than a standard 100-unit insulin syringe holds, so ask your pharmacy how to draw it.

At 20 mg/mL

• 2.5mg = 12.5 units
• 7.5mg = 37.5 units
• 12.5mg = 62.5 units

Seventy-five units means a very different dose depending on the vial in your fridge. At 10 mg/mL, it is 7.5mg. At 20 mg/mL, it is twice that, 15mg. Always check the strength printed on your own vial before you draw.

Is Zepbound's dosing schedule different from Mounjaro's?

Barely. Zepbound and Mounjaro are the same drug, tirzepatide, made by the same company, Eli Lilly. Both start at 2.5mg and rise by 2.5mg. Both wait at least four weeks per step and stop at 15mg. What separates them is the approval each name carries. Zepbound is for weight management. Mounjaro is for type 2 diabetes. For the basics, see what Zepbound is and how it works.

That difference shapes where the dose settles. On Zepbound, you move from 2.5mg to 5mg after four weeks. The maintenance dose is then 5mg, 10mg or 15mg. Mounjaro's label says to step up only if blood sugar needs more control. So a clinician may keep a patient on 7.5mg if that is where her glucose is on target.

There is no such reason to stop mid-ladder on Zepbound, unless side effects are the issue. One practical point: if your prescription says Zepbound, Mounjaro's coupon and savings program don't apply. That holds even though the medicine inside is the same.

What's the highest Zepbound dose, and do you have to reach 15mg?

The ceiling is 15mg once a week. There is no FDA-approved Zepbound dose above it. You don't have to get there, though. The 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.

The trial data explains why many prescribers still aim high. In the SURMOUNT-1 trial, here is the average weight change at 72 weeks:

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

That is a real difference. It still doesn't make 5mg or 10mg a lesser choice. The right dose for you depends on how you tolerate it, and on what you weigh against cost and side effects.

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

The Zepbound rule is a four-day window, which is 96 hours. It is worth getting right, because other GLP-1 shots use different rules.

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

Semaglutide shots are more forgiving. Ozempic allows a missed dose up to five days late. Wegovy allows it as long as your next dose is more than two days away. So don't carry a rule from one drug over to another.

The Zepbound label gives no restart plan for someone who has missed several weeks in a row. Some prescribers restart at a lower dose, and others don't. A step you can't tolerate has a simpler answer. You can stay at the current dose longer, or drop back to the last one that worked.

Does the Zepbound dose or schedule change in perimenopause or menopause?

No. There is no separate FDA ladder for women in perimenopause or after menopause. The schedule above is the same at every stage. What does exist is research on how well that schedule works across these stages.

A post hoc analysis of the SURMOUNT trials, published in the journal Obesity, looked at results by menopause status. 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. All used the same schedule, and nothing suggested any group should be dosed differently.

A Mayo Clinic study00145-1/abstract) looked at postmenopausal women on tirzepatide, with and without menopause hormone therapy. Those also on hormone therapy lost more weight on average. That is a finding about response, not dosing. Neither study changes the ladder.

Does the price change as your Zepbound dose goes up?

On LillyDirect, yes, in steps. LillyDirect is Eli Lilly's own online pharmacy for people paying cash. 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

Past 7.5mg, a higher dose doesn't raise the price. The 45-day clock starts at your last delivery. Miss it and the price for that fill jumps. At 7.5mg, a late refill costs about $500. From 10mg up, it costs about $700.

Compounded tirzepatide programs price the climb in their own way. Willow and Mochi Health both raise the price with the dose, like LillyDirect does. At Willow, it runs from about $400 a month at the lower doses to about $550 at the top. Compounded tirzepatide is a different product that is not FDA-approved. It is also legal on a narrower basis than a couple of years ago, so read the legal footing next to the price.

For the full comparison across insurance, self-pay and compounded routes, see Zepbound cost and Zepbound without insurance.

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

Every number on this page is a reference to check your plan against. Your prescriber decides your starting dose and when you step up. They also decide whether you hold or drop back.

Telehealth is now a common route to a Zepbound or compounded tirzepatide prescription. That is especially true for women facing menopause weight gain on top of everything else in their forties and fifties. Here is how three programs differ:

• [Henry Meds](/reviews/henry-meds/): compounded tirzepatide, with a prescriber managing each step.
• [Mochi Health](/reviews/mochi-health/): prices that rise by dose, with a care team that includes doctors board-certified in obesity medicine.
• [Willow](/reviews/willow/): a simple intake in the states it covers.

All three follow the same FDA dosing logic. What differs is the price, the format and how closely a clinician follows you. For what to expect on this schedule, dose by dose, see Zepbound results.