Zepbound Dosing: Dose Chart, Starting Dose, Max Dose and Vials

The chart shows the fastest pace the label allows. Each later step is optional: the label says the dose "may be increased" and asks prescribers to weigh response and tolerability, so a person may stay at 5 mg or 10 mg.

All doses are once weekly, at any time of day, with or without meals, alongside a reduced-calorie diet and increased physical activity as the label specifies. To see this ladder next to semaglutide's, use the GLP-1 medications comparison or the Wegovy dosing schedule.

The label is explicit that the 2.5 mg dose "is for treatment initiation and is not approved as a maintenance dosage". Its purpose is to let the gut adjust before the first dose that is expected to do the work. The label says the escalation schedule is followed for all indications "to reduce the risk of gastrointestinal adverse reactions", which are the most common side effects. Nausea, diarrhea, vomiting and constipation rates by dose are in the tirzepatide side effects guide.

After 4 weeks the label moves the dose to 5 mg. That differs from Mounjaro, the diabetes brand of the same drug, where every step, including the first, is conditional on needing more blood sugar control (see the Mounjaro dosage chart).

Label points that apply at the start and at each step

• Oral contraceptives: switch to a non-oral method, or add a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase, because delayed stomach emptying can reduce the pill's effect.
• Type 2 diabetes medicines: people on insulin or a sulfonylurea have a higher risk of low blood sugar, and those doses may need adjusting.
• No other tirzepatide or GLP-1 drugs: the label does not recommend combining Zepbound with other tirzepatide products or with any GLP-1 receptor agonist.
• Kidney and liver: no dose adjustment is recommended for renal or hepatic impairment.

For weight reduction and long-term maintenance, the label names 5 mg, 10 mg and 15 mg as maintenance doses and says to consider treatment response and tolerability when choosing. If a maintenance dose is not tolerated, the label says to consider a lower maintenance dose; it is the only part of the label that addresses stepping down.

The label's own trial data give a sense of the trade-off. In Study 1 (adults with obesity or overweight, no diabetes), patients were randomised to fixed doses, escalated over up to 20 weeks, and treated for 72 weeks:

In Study 2, in adults with type 2 diabetes, the changes were -12.8% at 10 mg and -14.7% at 15 mg against -3.2% on placebo. These are group averages from trials with a structured diet and activity programme, not a prediction for any individual.

The label also reports what happened when treatment stopped. In Study 4, patients took Zepbound at their maximum tolerated dose (10 or 15 mg) for 36 weeks, then were randomised to continue or switch to placebo. Over the next 52 weeks body weight in the placebo group rose by an average of 14.0% from its week-36 level, while the group that continued lost a further 5.5%. That is the evidence behind "long-term maintenance" in the indication.

The maximum dose of Zepbound is 15 mg injected under the skin once weekly, and the label applies that ceiling to all indications. With every step taken at the earliest point, the first 15 mg dose falls in week 21. There is no approved dose above 15 mg, and no approved schedule of more than one injection a week.

Mounjaro shares the same 15 mg adult ceiling; its label adds a 10 mg maximum for children aged 10 and older, a group Zepbound is not approved for. The Mounjaro maximum dose page compares the two labels at the ceiling and shows what 15 mg means in syringe units.

The August 2026 label lists four presentations, each in all six strengths. The single-dose vial is sold in a 1-pack or a 4-pack; the single-dose pen in a 4-pack; the multi-dose vial and the KwikPen as single units holding four weekly doses.

Each multi-dose vial and KwikPen holds one strength, so a dose increase means a new product at the next strength. For vials, the label asks for a syringe suited to the dose, for example a 1 mL syringe able to measure 0.5 mL or 0.6 mL. The KwikPen is not recommended for self-injection by people with visual impairment and must never be shared, even with a new needle.

Storage differs too. Single-dose pens and vials can be kept unrefrigerated (up to 30°C/86°F) for a total of 21 days. An opened multi-dose vial or KwikPen is discarded after 30 days at room temperature, 30 days after first use, or after 4 weekly doses, even if liquid remains. Injection sites are the abdomen or thigh, or the back of the upper arm if another person injects; see peptide injection sites for rotation. Cost and access by presentation are covered in cheapest tirzepatide.

The label does not cover restarting after several missed weeks. Because the slow ladder exists to limit GI side effects, whether to resume at the same dose or step back down after a long gap is a question for the prescriber.

Zepbound's second indication is moderate to severe obstructive sleep apnea (OSA) in adults with obesity, again alongside a reduced-calorie diet and increased activity. The starting dose and ladder are the same; only the maintenance range is narrower, at 10 mg or 15 mg once weekly.

That range comes from the trials. Studies 5 and 6 enrolled 469 adults with moderate to severe OSA and obesity, one group not using positive airway pressure (PAP) therapy and one using it. Doses were escalated over up to 20 weeks to the maximum tolerated dose of 10 mg or 15 mg, and after 52 weeks Zepbound produced a statistically significant reduction in the apnea-hypopnea index compared with placebo. Patients with type 2 diabetes were excluded from both studies.

Zepbound and Mounjaro contain the same drug in the same six strengths and presentations, but they are separate labels: Zepbound for weight and sleep apnea, Mounjaro for type 2 diabetes and cardiovascular risk reduction in type 2 diabetes. The Mounjaro dosage chart sets out how that label's ladder differs.

Compounded tirzepatide is neither. The FDA states that compounded drugs are not FDA approved and are not reviewed for safety, effectiveness or quality, and it has received more than 730 adverse event reports for compounded tirzepatide as of May 31, 2026, including reports linked to doses, frequencies or titration faster than the approved label. Compounded vials come in varying concentrations, so syringe units must be worked out for each vial:

units = dose in mg ÷ (vial mg ÷ mL of liquid) × 100 (U-100 syringe)

The 20 mg/mL concentration is only an illustration; at any other concentration every figure changes. The tirzepatide calculator and the mg to mL converter do the arithmetic from your vial's label, and the syringe measurement guide explains reading the marks. The tirzepatide dosage reference collects the label schedules in one place.