Mounjaro dosing: forms, strengths, and usage

If you have type 2 diabetes, obesity, or both, your healthcare provider may recommend taking Mounjaro. Mounjaro (tirzepatide) is an injectable prescription medication that helps control blood sugar levels, in combination with diet and exercise. It also slows the rate at which food leaves your stomach and reduces appetite. In clinical trials, people taking Mounjaro have lost 20% or more of their body weight within a year and a half of starting treatment with Mounjaro. 

If this is your first time taking Mounjaro you may have questions about Mounjaro dosage forms. Below we review what you need to know about Mounjaro dosing, including how to use Mounjaro and what to do if you miss a dose. Read on.

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The starting dosage of Mounjaro is 2.5 mg, taken weekly. The maximum dosage is 15 mg weekly. Each pen of Mounjaro contains a single dose of the medication in a liquid solution. You use the pen to inject the solution under the skin of your upper arm, abdomen, or thigh (we explain how to inject Mounjaro in a later section below).

When you first start taking Mounjaro, your healthcare provider will likely start you at the typical starting dosage of 2.5 mg weekly. After four weeks, they may increase your dosage to 5 mg weekly. After another four weeks, they’ll check how the medication is affecting your blood sugar levels. If the 5 mg dosage adequately improves your glycemic control, your healthcare provider may have you stay at this dosage long-term. If your blood sugar is still high, they will continue increasing your dosage of Mounjaro by 2.5 mg every four weeks until they find the right dosage for you. 

For example, if, after four weeks of the 7.5 mg dosage, your blood sugar levels remain high, your healthcare provider may increase your dose to 10 mg. If your blood sugar levels look good after another four weeks at the 10 mg dose, they may have you stay at that dosage. If they’re still too high, they can keep increasing it every four weeks until the maximum dosage of 15 mg. The goal is to find the smallest dosage of Mounjaro that adequately controls your blood sugar levels.

Each dose of Mounjaro comes in a single-dose pen, which contains one dose of the medication. Mounjaro pens come in six 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

Different people may be prescribed different dosages of Mounjaro. For example, some people may require higher doses of Mounjaro to adequately control their blood sugar levels. To allow healthcare providers to provide the best dosage, Mounjaro is available in six strengths from 2.5 mg to 15 mg. The dose of Mounjaro your healthcare provider prescribes for you can depend on several factors, including your age and personal medical history.

Your age

Mounjaro has not been studied in people younger than 18 years old. Across seven clinical trials, about one in three people taking Mounjaro were 65 years of age or older. 

While clinical trials have not found any significant differences in how Mounjaro affects older adults vs. those younger than 65 years of age, some older adults may be more sensitive to Mounjaro.

Other medical conditions you have

Healthcare professionals will use more caution when prescribing Mounjaro to people with certain medical conditions, such as a history of diabetic retinopathy (diabetes-related vision loss or changes), pancreatitis, severe gastrointestinal disease, acute kidney injury, or acute gallbladder disease. Given their medical history, these people may be more likely to experience adverse reactions when using Mounjaro. 

People with a personal or family history of thyroid cancer, including multiple endocrine neoplasia syndrome type 2 (MEN 2) or medullary thyroid carcinoma (MTC), should not use Mounjaro.

The condition you’re using Mounjaro for

Mounjaro is available in six strengths ranging from 2.5 mg to 15 mg. Most people start with the starting dosage of 2.5 mg for four weeks, before increasing to a 5 mg dosage. Your healthcare provider may continue increasing your dose depending on the condition you are taking Mounjaro for — type 2 diabetes mellitus or for weight loss — and the severity of that condition. 

For some people with type 2 diabetes, a 5 mg dose is sufficient to control their blood sugar levels, while others will require a higher dosage of Mounjaro. Higher doses of Mounjaro lead to more weight loss, but may also have more side effects. 

Other medications you’re taking, particularly those that lower blood sugar levels

Because Mounjaro lowers blood glucose, it may increase the risk of hypoglycemia for people who take other medications that lower blood glucose, like insulin or similar medicines. To reduce your risk, your healthcare provider may decrease your current dose of insulin. 

While Mounjaro has no other known drug interactions, it does delay gastric emptying, so it may affect the rate at which your body absorbs other medications you take orally. Be sure to tell your healthcare provider about any medications you are taking prior to starting Mounjaro. 

Mounjaro should be injected subcutaneously (under the skin) every week. You can inject Mounjaro at any time of day, regardless of when you last ate. Store Mounjaro in its original carton in your refrigerator, at a temperature between 36°F to 46°F (2°C to 8°C). Do not freeze Mounjaro. 

Each box of Mounjaro contains detailed prescribing information for injecting and storing Mounjaro, including illustrations for each step we describe below. Read through the paperwork and ask your healthcare provider if you have any questions. You can also watch a video on Mounjaro.com or ask your healthcare provider to show you or your caregiver how to inject Mounjaro. 

While you should follow your healthcare provider’s instructions, here is a general overview of what you can expect. 

Step 1: Choose your injection site 

Mounjaro is injected in the abdomen, thigh, or upper arm. If you choose your upper arm as your spot, it’s best to have another person or caregiver do so to ensure the medicine gets injected easily. Change your injection site each week, rotating through the different areas of the body. 

If you want to continue injecting in the same area, you can, but don’t inject Mounjaro in the exact same spot. If you also take insulin, you can inject Mounjaro and insulin in the same general area of your body (e.g. abdomen) but they should not be injected right next to each other or mixed together into the same injection. 

Step 2: Remove the gray base cap 

Ensuring the pen is locked, pull the gray base cap off the pen and throw it away. Do not touch the needle.

Step 3: Position the pen on the injection site 

Place the clear base of the pen so it lies flat against the skin of your injection site. Unlock the pen by turning the lock ring.

Step 4: Inject Mounjaro 

Press the purple injection button and hold for 10 seconds. Listen for two clicks. The first click indicates that the injection has started, while the second click indicates that it has completed. The injection is complete when the gray plunger becomes visible.

Step 5: Safely dispose of the used pen 

Mounjaro pens should only be disposed of in an FDA-approved sharps disposal container (a hard plastic container designed for needles). Do not put the pens in your household trash.

What should you do if you forget to take a dose of Mounjaro? It depends on when your last dose was. 

If it has been less than four days (96 hours) since the day you were supposed to take your dose, go ahead and inject Mounjaro as soon as you remember. Then continue with your weekly dosing schedule as usual. If it has been more than four days, though, you should skip that dose of Mounjaro and just take the next dose on your regularly scheduled day. Never take two doses at the same time. If you have any questions about a missed dose, call your healthcare provider.

If you need to change the day you inject Mounjaro, that’s doable. The key is to make sure you don’t take two doses within 72 hours of each other. Again, you can contact your healthcare provider if you have any questions or concerns.

As with most prescription drugs, you may experience side effects when taking Mounjaro. Fortunately, the side effects tend to be most common when you first start using the drug, and go away with time as your body gets used to Mounjaro. For most people, Mounjaro side effects range from mild to moderate, and are typically gastrointestinal in nature. They may include:

• Nausea

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

• Upset stomach or indigestion

• Abdominal pain

Some side effects — including nausea, diarrhea, decreased appetite, vomiting, and constipation — tend to be more common with higher doses of Mounjaro, according to clinical trials of people taking Mounjaro for type 2 diabetes. For example, nausea, diarrhea, and vomiting were reported by 23.1% of people taking 1 mg of Mounjaro, 32.7% taking 5 mg, 51% taking 10 mg, and 66% taking 15 mg. 

In studies of people with obesity, but not type 2 diabetes, gastrointestinal side effects like nausea, diarrhea, and vomiting were also more common among people taking higher doses of Mounjaro (10 mg or 15 mg) vs. those taking 5 mg. 

Adults with type 2 diabetes who also take insulin may have a slightly higher risk of experiencing severe hypoglycemia (low blood sugar) with higher 10-mg and 15-mg doses of Mounjaro, according to another trial. Starting with a low dose and slowly increasing to the highest dose required may help make gastrointestinal side effects more manageable. 

If you experience nausea while taking Mounjaro, Eli Lilly, the makers of Mounjaro recommend the following:

• Avoiding fat or fatty foods

• Eating foods that are bland and light, such as toast, crackers, or rice

• Eating smaller meals

• No longer eating once you feel full

Your healthcare provider will prescribe the appropriate dosage of Mounjaro for you. Follow their medical advice and use Mounjaro exactly as prescribed. If you notice any side effects or have any questions about your dosage of Mounjaro, talk to your healthcare provider. They can offer suggestions for managing side effects. They may adjust your dosage or recommend an alternative medication like Ozempic or Wegovy.

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Current version

September 21, 2023

Written by

Amelia Willson

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.