Zepbound (tirzepatide) dosage for weight loss: finding the right dose for you
Key highlights
- Zepbound (tirzepatide) is a once-weekly injectable drug approved by the U.S. Food and Drug Administration (FDA) for chronic weight management in adults with obesity and overweight, and obstructive sleep apnea (OSA) in adults with obesity.
- The standard starting dose of Zepbound for weight loss is 2.5 mg once weekly for 4 weeks and likely escalated to 5 mg once weekly for 4 weeks. If necessary, the dosage is escalated to 10 mg, 12.5 mg, or 15 mg once weekly.
- For obstructive sleep apnea, Zepbound dosages typically follow the same schedule as weight loss, but the recommended maintenance dosage is 10 mg or 15 mg once weekly.
- Zepbound dosage needs careful calculation, especially for individuals who are under treatment for co-morbidities. The dosage should not be increased by more than 2.5 mg every 4 weeks. The maximum dosage of Zepbound for weight loss and obstructive sleep apnea is 15 mg once weekly.
Weight loss drugs have caught the attention of the general public with their growing popularity. Zepbound is one of the newer medications approved by the FDA for chronic weight management in adults with obesity and overweight and recently approved for mild to moderate obstructive sleep apnea in adults with obesity when paired with a low-calorie diet and increased physical activity.
How much Zepbound do you need to take to achieve your weight loss goals? Like other weight loss drugs, Zepbound requires a gradual increase in its dose over several months and adhering to the correct dosing schedule is essential for safety and efficacy. Working with your healthcare provider to find the optimal maintenance dose will help you achieve optimal results.
The starting dose of Zepbound is 2.5 mg (subcutaneous injection) once weekly for the first 4 weeks. The dosage is escalated by 2.5 mg increments every four weeks until reaching a maximum dosage of up to 15 mg once weekly. Dosage escalation depends on the tolerance of individuals to the medication.
Keep reading to learn about the different Zepbound dosages, determine which dosage works best for you and how to use Zepbound for weight management and sleep apnea.
Understanding Zepbound
Zepbound (tirzepatide) is an injectable GLP-1 and GIP receptor agonist containing the active ingredient tirzepatide. The medication is an FDA-approved drug made by Eli Lilly which helps individuals with weight loss and obstructive sleep apnea (OSA). When used in combination with exercise and a reduced-calorie diet, Zepbound is approved for use by individuals with:
- Obesity (body mass index (BMI) of 30 or higher)
- Overweight (BMI of 27 or higher) with at least one weight-related condition that is caused or worsened by being overweight, such as hypertension (high blood pressure), type 2 diabetes, and sleep apnea
- Moderate to severe obstructive sleep apnea
Zepbound has a dual mechanism of action. It targets the receptors of two hormones in the body: GLP-1 (glucagon-like peptide 1) and GIP (glucose-dependent insulinotropic peptide). The synergistic effect of occupying these receptors suppresses appetite, promotes insulin release, decreases glucagon secretion, and delays the rate at which the stomach empties. This leads to decreased food intake, less frequent hunger cravings, and better blood sugar control, which helps with weight management.
A SARMOUNT-1 clinical trial compared to the efficacy of Zepbound vs. placebo in chronic weight management. After 72 weeks, 91% of individuals in the Zepbound group taking 15 mg of Zepbound lost more than 5% of weight compared to 35% of individuals in the placebo group.
A SARMOUNT-5 clinical trial demonstrated that Zepbound showed 47% greater weight reduction than another GLP-1 receptor agonist, semaglutide (Wegovy).
Obstructive sleep apnea results from the deposition of extra fats in the respiratory tract that obstruct the airway. Zepbound promotes weight loss that improves sleep apnea symptoms. Participants of a 52-week study who took Zepbound reported better relief for their obstructive sleep apnea symptoms than the placebo group.
Zepbound has also been found to reduce the risk of developing type 2 diabetes by 94% in adults with pre-diabetes and obesity or overweight.
What is the Zepbound dosage for weight loss?
Zepbound pens are available in 6 dosage strengths:
- 2.5 mg/0.5 mL
- 5 mg/0.5 mL
- 7.5 mg/0.5 mL
- 10 mg/0.5 mL
- 12.5 mg/0.5 mL
- 15 mg/0.5 mL
As of 2025, Zepbound single-dose vials are available in the lower strength 2.5 mg and 5 mg doses.
Zepbound is injected once weekly on the same day each week. The starting weekly dose is 2.5 mg for 4 weeks and can be increased gradually to a maximum of 15 mg once weekly. The dosing schedule of Zepbound is as follows:
Starting dose
The recommended starting dose of Zepbound is 2.5 mg once weekly for 4 weeks. The medication is injected subcutaneously (under the skin) once a week using a single-use pen or syringe. Your healthcare provider starts you on a lower dose to make sure your body can adjust to the action of the drug without causing major side effects. This also makes it easier for doctors to treat symptoms if a patient is allergic to Zepbound.
Dose escalation (titration) schedule
At week 5, the medication dose typically increases to 5 mg once weekly for 4 weeks. If more adjustments are needed, the dose is further increased by 2.5 mg every 4 weeks. These 2.5 mg increments are tested until reaching a maintenance dose of up to 15 mg once weekly. The recommended titration schedule is as follows:
- 5 mg once weekly for 4 weeks
- 7.5 mg once weekly for 4 weeks
- 10 mg once weekly for 4 weeks
- 12.5 mg once weekly for 4 weeks
- 15 mg once weekly (maximum recommended dose)
For sleep apnea treatment, the dose is typically raised to 7.5 mg once weekly at week 9, and then to 10 mg once a week at week 13. Further dose increments follow the same schedule as for weight loss, depending on your response to treatment.
While using Zepbound, stay in touch with your healthcare for personalized guidance. Don’t escalate the dosage quickly, as it can cause severe side effects. If you experience any side effects when taking Zepbound, immediately consult with your healthcare provider.
Maintenance dose
Zepbound’s maintenance dose for weight loss varies between 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg once weekly.
For sleep apnea, the maintenance dose is 10 mg or 15 mg once weekly.
Depending on body weight and metabolic rate, some people lose weight faster and at lower doses, whereas others require longer treatment at higher doses to realize their desired results.
Fluctuation in blood sugar levels, weight changes, your body’s response to Zepbound and potential side effects of the medication may influence your dosage schedule. It is important to follow your healthcare provider’s instructions and avoid adjusting the dose independently to prevent unwanted side effects.
Maximum Zepbound dosage
The highest recommended dose of Zepbound is 15 mg once a week. Taking more than this increases the risk of side effects without providing additional benefits. You may experience severe gastrointestinal issues, low blood sugar levels (hypoglycemia), nausea, vomiting, and diarrhea. For this reason, it is essential to follow the dosage schedule as directed by your healthcare provider and never exceed the maximum dosage.
Zepbound dosage schedule
Once your healthcare provider has calculated your required dose, Zepbound has a simple dosage schedule, as exhibited by the results of the 72-week SURMOUNT-1 trial. You need to inject a specific amount of the medication under your skin the same day every week. The weekly dose schedule of Zepbound is as follows:
- Weeks 1-4: 2.5 mg once weekly
- Weeks 5-8: 5 mg once weekly
- Week 9 and ongoing: Incrementally add 2.5 mg to the current dose every 4 weeks until you reach the dosage suitable for you. If tolerated, the next dose is 7.5 mg once weekly for weeks 9-12, and the next dose increases to 10 mg once weekly for weeks 13-16. After week 16, the dosage may be escalated to 12.5 mg for the next 4 weeks. Afterwards, the dose may be escalated to 15 mg for the next four weeks and onwards.
- Maximum dosage: 15 mg (subcutaneous injection) once weekly is the maximum dosage for Zepbound.
Zepbound dosage chart
| Week | Recommended Zepbound dosage |
|---|---|
| Weeks 1-4 | 2.5 mg once weekly |
| Weeks 5-8 | 5 mg once weekly |
| Week 9+ | Weight loss: Dosage can be increased by a maximum of 2.5 mg increments every 4 weeks. Sleep apnea: Dosage can be increased to 7.5 mg once weekly and increased again to 10 mg once weekly at week 13. At week 17, the dosage can be increased again by a maximum of 2.5 mg. Subsequent dosage increases should be separated by at least 4 weeks. |
| Recommended maintenance dosage for weight loss | 5 mg, 10 mg, or 15 mg once weekly |
| Recommended maintenance dosage for obstructive sleep apnea | 10 mg or 15 mg once weekly |
| Maximum dosage | 15 mg |
Factors influencing Zepbound dosage adjustments
Zepbound’s dosage depends on how your body responds to the medication, particularly its effect on GLP-1 and GIP receptors. Genetic factors, such as variations in the TCF7L2 gene, can influence how quickly you lose weight. Some people see noticeable weight loss — such as 5% or more of their entire body weight within 12 weeks, while others experience a slower response due to metabolic resistance.
Although most side effects of Zepbound resolve within 4 to 8 weeks, persistent symptoms may require a slower dose increment to improve tolerance. Your doctor will carefully adjust the dose according to your tolerance to the medication.
If you have conditions like cardiovascular disease, diabetes, or kidney disease, your healthcare provider will closely monitor and adjust your Zepbound dosage to ensure the treatment is effective without causing any side effects. In addition, taking medications for these conditions alongside Zepbound can also affect the dosage as they may interact with Zepbound.
Zepbound forms and strengths
Zepbound comes as a solution that is administered under your skin once a week in doses between 2.5 mg to 15 mg per 0.5 ml. It is available as a single-dose pen or vial.
Single-dose injection pens
The single-dose injection pen is the most convenient option for Zepbound administration. It comes prefilled in six different doses — 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. While it saves time and reduces dosing errors, the pen may not be ideal for those needing dose adjustments due to comorbidities.
Single-dose vials
A single dose vial is a small container containing a solution of Zepbound. The required amount of this solution is drawn using a sterile syringe and injected subcutaneously. Zepbound vials are only available in the lower doses of 2.5 mg and 5 mg.
How to take Zepbound safely
Zepbound is injected subcutaneously once a week, on the same day each week. It is injected in fat-rich portions of your body like your abdomen, thighs and upper arms so the medication can get slowly absorbed into your tissues over 7 days. Zepbound can be injected with or without food.
If you are self-administering Zepbound, choosing single-dose pens may be more convenient than single-dose vials. To maintain the drug’s effectiveness, store the pens in the refrigerator (2- 8°C). Keep Zepbound in its original packaging to protect it from light and heat.
After taking Zepbound out of the refrigerator, you can use it immediately. Don’t heat the pen using a microwave, oven, or hot water, or expose it to direct sunlight. Check the solution before administering it. Always check the appearance of the Zepbound solution before administration. It should be clear or slightly yellow and free of any particles.
To safely self-administer Zepbound, wash your hands and choose an injection site on your abdomen, arm, or thigh. Clean the area with an alcohol wipe and let it fully dry. Remove the pen’s cap, and hold it flat against your skin. Unlock it, and press the injection button. Wait for 10 seconds while the entirety of the solution gets injected into your body.
Common side effects of Zepbound dosage adjustments
Zepbound is a generally safe medication. It has commonly been associated with mild side effects, such as:
- Feeling nauseous or vomiting
- Changes in bowel movements, such as diarrhea or constipation
- Indigestion and acid reflux
- Stomach discomfort and pain
- Excessive burping
- Injection site reactions like bruising, itching, or pain
- Unusual tiredness or fatigue
- Thinning of hair or hair loss
- Slight increase in heart rate
- Drop in blood pressure
- Mild allergic response to the injection
However, Zepbound sometimes causes severe side effects that need urgent medical attention. Severe side effects of Zepbound include:
- Hypoglycemia
- Acute pancreatitis (inflammation of the pancreas)
- Gallbladder stones
- Osteoporosis
- Kidney injury
- Mental health issues
- Increases risk of thyroid cancer
There is a black box warning of possible thyroid tumors, including thyroid cancer.
To avoid these unwanted side effects, never escalate Zepbound dosage too quickly. Follow the schedule provided by your doctor to ensure you experience minimal side effects while adjusting the dose of medication. Consult your healthcare professional to seek medical advice in case of allergy to the medication or any side effects.
Overdose risks and precautions
Overdoses of weight loss drugs are becoming more common, mostly because of dosing errors. Zepbound should be administered in small, carefully calculated doses that are gradually increased over time by 2.5 mg increments every 4 weeks. Exceeding the recommended doses or injecting yourself too frequently can result in a Zepbound overdose. The symptoms of Zepbound overdoses are similar to severe side effects of Zepbound, such as severe nausea, vomiting, and severe abdominal pain that does not resolve on its own or with standard medications. Overdoses may also be accompanied by severe hypoglycemia (low blood sugar levels).
If you suspect you have taken too much Zepbound or you experience an allergic reaction, immediately call poison control and seek immediate medical attention. Not all Zepbound overdoses result in hospitalization, but you may need to be monitored for a few hours at a healthcare facility to make sure you are vitally stable.
Frequently asked questions
How long does it take to start seeing results on Zepbound?
Weight loss on Zepbound first becomes noticeable by week 4 of taking the medication. However, more significant weight loss is usually observed by weeks 8 to 12.
Are dosage adjustments needed for certain health conditions or interactions?
Dosage adjustments are usually not required if patients taking Zepbound have certain health conditions, such as kidney or liver issues. However, Zepbound has several drug interactions:
- Zepbound should not be taken with oral contraceptives as it lowers their efficacy. Individuals taking Zepbound may need to switch to another method of birth control such as an IUD.
- Zepbound increases the risk of hypoglycemia when taken with insulin and sulfonylureas, so their dose may have to be reduced.
- Individuals taking Zepbound should not take any other GLP-1 or GIP agonist because of an increased risk of side effects.
- Patients taking both Zepbound and kidney or heart medications need to be monitored for adverse events.
What happens if I miss a dose of Zepbound?
If you have missed a dose of Zepbound, you can still take it within 96 hours or 4 days of the missed dose. However, if more than 4 days have passed since the day of your scheduled dose, it is best to skip the dose. Instead, resume the treatment from your next scheduled dose. If you have been skipping your Zepbound doses for over two weeks, it is best to contact your healthcare provider, as you may need a lower dose to avoid side effects.
How do I change the Zepbound injection day?
You can change the day you are supposed to administer Zepbound if there is a gap of at least 72 hours or 3 days between both days. If over four days have passed since you last took your medication, you should take it on your next scheduled dose day.
Are there any dosage changes for medication interactions or other health conditions?
Zepbound can be taken in most renal and hepatic conditions without adjusting doses. However, if a patient is taking heart and kidney medication, they may need to be monitored closely for side effects like dehydration. In addition, the doses of antidiabetic medication are typically lowered when administered alongside Zepbound to reduce the chances of hypoglycemia. Zepbound should not be used in pregnancy and breastfeeding or in people who are at risk of a thyroid tumor (medullary thyroid carcinoma) and MEN 2 syndrome (multiple endocrine neoplasia syndrome type 2).
Can the dosage be adjusted over time?
Zepbound is used for chronic weight management and obstructive sleep apnea, so it needs to be taken for long durations. The dosage needs to be adjusted over time to reach its maximum efficacy without causing major side effects. The medication is started at a low dose of 2.5 mg once weekly, which is then gradually adjusted and increased by 2.5 mg increments every 4 weeks until an optimal maintenance dose is reached.
What should I do if I take too much Zepbound?
If you take too much Zepbound, it is important to call poison control at 800-222-1222 and to get urgent medical attention right away. Most Zepbound patients only experience heightened side effects of the drug. However, proper management includes observation of serious side effects for at least five days, which is the half-life of Zepbound.
How do you determine the maintenance dose of Zepbound for weight loss?
The maintenance dose of Zepbound is calculated by factoring in your body’s needs and current metabolic rate. The starting dose is 2.5 mg once weekly, which is increased to 5 mg after 4 weeks. Afterwards, the dosage is increased every 4 weeks by 2.5 mg increments until the ideal dose is achieved. This ideal maintenance dose usually falls between 10 mg and 15 mg once weekly, with 15 mg once weekly being the maximum recommended dose.
What dose of Zepbound is most effective?
The “most effective” dose of Zepbound is different for each individual. The most commonly prescribed doses are 5 mg, 10 mg and 15 mg once weekly. Doses above the maximum recommended dose of 15 mg do not cause additional weight loss and can cause more side effects. In the SURMOUNT-1 trial, the mean weight loss with Zepbound was 16.1 kg on a dose of 5 mg, -22.2 kg on a dose of 10 mg, and -23.6 kg on a dose of 15 mg compared to only -2.4 kg with placebo after 72 weeks.
How long should you take Zepbound?
Zepbound is intended for long-term use. It typically takes at least 8-9 months to help patients realize significant weight loss results. Patients usually need to take the drug for several years. Stopping Zepbound causes weight regain. It is also important not to quit the medication abruptly or without the supervision of your healthcare provider in order to avoid unwanted side effects.
Is compounded tirzepatide the same medication as Zepbound?
Compounded tirzepatide contains the same active ingredient (tirzepatide) as Zepbound and Mounjaro. However, compounded tirzepatide is produced by compounding pharmacies, as prescribed by healthcare providers. Zepbound is FDA-approved for weight loss and obstructive sleep apnea and compounded tirzepatide is not approved by the FDA.
Bottom line
Zepbound treatment typically starts with a dosage of 2.5 mg, which is administered subcutaneously once a week for 4 weeks. It is then followed by a gradual increase or titration of 2.5 mg increments every four weeks until the desired maintenance dose of 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg is reached. 15 mg is the maximum dosage for Zepbound. The titration of Zepbound dosage takes time, depending on the patient’s tolerance to the medication. Incorrect dosage of Zepbound results in unwanted side effects and even overdose.
Before starting the medication, consult your healthcare provider for personalized treatment, dose adjustments, and continuous monitoring.
