Mounjaro Dose Schedule: What the Label Says

The Mounjaro dose on the label starts at 2.5 mg once weekly. Each increase comes in 2.5 mg steps, after at least 4 weeks on the current dose, up to a maximum of 15 mg once weekly. Whether and when to move up is the prescriber's decision.

The figures below come from the FDA Mounjaro label. They also draw on the UK Mounjaro SmPC.

In short

• The FDA Mounjaro label starts at 2.5 mg weekly and steps up by 2.5 mg after at least 4 weeks, to 15 mg.
• In SURMOUNT-1, a 72-week trial in adults without diabetes, average weight loss was 15.0% at 5 mg, 19.5% at 10 mg and 20.9% at 15 mg, against 3.1% on placebo.
• In the Mounjaro label's diabetes trials, nausea was 12% at 5 mg, 15% at 10 mg and 18% at 15 mg, versus 4% on placebo.

What does the 2.5 mg starting dose do on the label?

The Zepbound label gives 2.5 mg once weekly for 4 weeks as the starting dose and states that 2.5 mg is for initiation, not an approved maintenance dose. In other words, the first step is a way in, not a dose to stay on.

The half-life offers a way to read the 4-week minimum. The Mounjaro label gives tirzepatide a half-life of about 5 days. Four weeks is 28 days, which is 5.6 half-lives (28 ÷ 5). That sum is this article's own arithmetic. The label excerpts used here do not state why a 4-week minimum was chosen.

You can read how long it takes each dose to reach a steady level in a companion guide. How a related GLP-1 medicine's level decays between shots applies the same arithmetic. That medicine has a half-life of about 1 week.

What is the starting dose of Mounjaro?

The starting dose of Mounjaro is 2.5 mg injected under the skin once weekly, according to the FDA Mounjaro label. The UK SmPC gives the same start. It then moves to 5 mg once weekly after 4 weeks.

The Zepbound label opens the same way for chronic weight management. It gives 2.5 mg once weekly for 4 weeks, then 5 mg once weekly. Both are tirzepatide.

In the US, Mounjaro's own label covers type 2 diabetes. Zepbound's covers weight management. Which medicine and which dose a person receives is for their prescriber to decide.

How often does the Mounjaro dose increase?

The FDA Mounjaro label allows an increase in 2.5 mg steps after at least 4 weeks on the current dose. The UK SmPC words it as a minimum of 4 weeks.

"At least" sets a floor, not a timetable. The label gives the shortest time on a step. The prescriber decides the real timing.

The arithmetic shows what the floor means. From 5 mg, adding 2.5 mg each step gives 7.5, 10, 12.5 and 15 mg. The first five doses are 2.5, 5, 7.5, 10 and 12.5 mg. At 4 weeks each they add up to 5 × 4 = 20 weeks. So 15 mg could start at week 21 at the earliest. That matches the 20-week dose-escalation period SURMOUNT-1 used.

What is the maximum dose of Mounjaro?

The maximum Mounjaro dose is 15 mg once weekly, according to both the FDA Mounjaro label and the UK SmPC. The SmPC lists 5, 10 and 15 mg as maintenance doses.

The Zepbound label lists maintenance doses of 5, 10 or 15 mg for weight reduction. For obstructive sleep apnea it lists 10 or 15 mg. The maximum is 15 mg for every indication. So 15 mg is a ceiling the label sets, not a target.

In SURMOUNT-1, mean weight loss at week 72 rose with each dose arm. The trial enrolled 2,539 adults with obesity, or overweight plus a weight-related condition, without diabetes. Participants took 5, 10 or 15 mg or placebo once weekly.

The published paper reports 15.0% at 5 mg, 19.5% at 10 mg and 20.9% at 15 mg. Placebo gave 3.1%.

1. Placebo3.1%
2. 5 mg15%
3. 10 mg19.5%
4. 15 mg20.9%

The numbers in this chart

	Mean weight loss
Placebo	3.1%
5 mg	15%
10 mg	19.5%
15 mg	20.9%

Jastreboff et al., NEJM 2022 (SURMOUNT-1)

These are averages for that population, at that dose, over 72 weeks. They do not predict any one person's result.

What does a Mounjaro dose chart look like next to Zepbound's?

A Mounjaro dose chart built from the labels has six steps from 2.5 to 15 mg, each held at least 4 weeks. The Zepbound label shares the 2.5 mg start, the 5 mg first step and the 15 mg ceiling.

The weeks below are the label's minimum, worked out in the section on increases. They are not a plan to follow.

The populations differ, so the columns are not interchangeable. The Mounjaro rates come from pooled placebo-controlled trials in type 2 diabetes. Those had 235 people on placebo, 237 on 5 mg, 240 on 10 mg and 241 on 15 mg.

The Zepbound rates come from pooled weight-reduction Studies 1 and 2, with 958, 630, 948 and 941 people. SURMOUNT-1 is a separate trial in adults without diabetes.

The schedule differs by use, not by product. Zepbound's maintenance range for obstructive sleep apnea is 10 or 15 mg.

How do side-effect rates change at each step?

In the Mounjaro label's pooled diabetes trials, nausea was reported by 12% on 5 mg, 15% on 10 mg and 18% on 15 mg, against 4% on placebo. At 15 mg that is 18 minus 4 = 14 percentage points above placebo.

The Zepbound label's weight-reduction table reads differently. Nausea was 25% at 5 mg, 29% at 10 mg and 28% at 15 mg, against 8% on placebo. Diarrhea was 19%, 21% and 23% against 8%. Vomiting was 8%, 11% and 13% against 2%. Constipation was 17%, 14% and 11% against 5%.

So the rates do not all climb together in that table. Constipation fell as the dose rose. Nausea was flat from 10 to 15 mg.

The labels name signs that need a doctor right away. These are severe stomach pain that does not go away, with or without vomiting, and swelling of the face or trouble breathing. A lump in the neck, hoarseness or trouble swallowing are also listed. Severe allergic reactions need emergency care.

The label lists further warning signs, including gallbladder symptoms and signs of dehydration or low blood sugar. Read the full medication guide for the complete list.

What quietly misleads when reading a dose chart?

A dose chart misleads when a reader takes a label's minimum, a trial average or a rate from another population for a personal expectation. Five readings are worth avoiding.

• Read "at least 4 weeks" as a floor. The label gives the shortest time on a step, and the prescriber decides the actual timing.
• Keep the two indications apart. The Mounjaro table covers type 2 diabetes and the Zepbound table covers weight reduction, so their percentages should never be averaged into one figure.
• Treat trial results as averages. SURMOUNT-1's figures describe a population over 72 weeks, not a single person.
• Leave syringe-unit charts out. The label schedule is written in mg per weekly dose, and a chart in other units is not the label.
• Do not treat the UK review point as a target. The SmPC says a decision is required on whether to continue if less than 5% of initial body weight has been lost 6 months after reaching the highest tolerated dose. That decision belongs to the prescriber.

Where can Dose & Lose help you keep track?

Dose & Lose is a tracking app that can hold the record of your own doses for your next appointment. It does not prescribe, give dosing advice or say when to step up.

You log each dose with the medication, the dose, the date and time, the injection site, a pain level from 0 to 10 and notes. The medication and dose are filled in from your own schedule. You can also rate symptoms such as nausea from 0 to 10 and see them over time next to your doses.

The app draws an estimate of the medication level from the doses you log. It is an estimate, not a lab value. To try the half-life arithmetic yourself, you can estimate how much tirzepatide is left from the dose, number of shots and time of the last shot.

See the Dose & Lose app.

Frequently asked questions

Is 5 mg a maintenance dose or a step on the way up?

Both, according to the labels. The UK SmPC lists 5, 10 and 15 mg as maintenance doses, and the Zepbound label lists the same for weight reduction. 5 mg is also the first step after 2.5 mg. Which dose a person stays on is the prescriber's decision.

What if I miss a Mounjaro dose?

The FDA labels say to give a missed dose as soon as possible within 4 days (96 hours). Beyond that, the label says to skip it and resume the regular weekly day. This is what the label states, not advice for one person. Ask your prescriber or pharmacist what applies to you.

Who decides when to increase the Mounjaro dose?

The prescriber decides. The labels set only a floor of at least 4 weeks on the current dose. The UK SmPC adds a decision point for weight management. If 5% of body weight has not been lost 6 months after the highest tolerated dose, the prescriber must decide whether to continue.

Does the dose schedule differ between type 2 diabetes and weight management?

The start is the same: 2.5 mg weekly for 4 weeks, then 5 mg. The Zepbound label then lists 5, 10 or 15 mg for weight reduction and 10 or 15 mg for obstructive sleep apnea. The maximum is 15 mg for all indications. Mounjaro's US label covers type 2 diabetes.

Sources

• Mounjaro prescribing information, FDA via DailyMed: dosage, missed dose and diabetes adverse-reaction rates.
• Zepbound prescribing information, FDA via DailyMed: weight-management dosing and adverse-reaction rates.
• Mounjaro SmPC, UK electronic medicines compendium: posology and the 6-month review point.
• Jastreboff et al., NEJM 2022 (SURMOUNT-1): trial design and weight loss by dose.

Published by Petros IT Solutions SRL, byline Dose & Lose Editorial Team. See the editorial policy for how figures are checked. Corrections: office@doseandlose.com.