Zepbound (tirzepatide) dosage for weight loss

Zepbound (tirzepatide) is an FDA-approved weight loss medication that may be prescribed to adults with a body mass index (BMI) of 30 or higher (defined as “obesity”) or those with a BMI of 27 or higher (defined as “overweight”) and at least one weight-related health condition such as type 2 diabetes mellitus, high blood pressure, and/or high cholesterol. Zepbound comes in prefilled, single-dose injection pens that you inject once a week.

The medication is known as a dual GIP/GLP-1 receptor agonist, which stands for the two receptors it activates in your gut: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Tirzepatide is the active ingredient in Zepbound.

Similar to other injectable weight loss drugs, such as Wegovy or Saxenda, Zepbound follows a ramp-up dosage schedule, where you gradually increase your dosage over a period of weeks.

If you’re considering taking Zepbound for weight loss, you may be wondering what you can expect. Below, we provide a general guide to Zepbound dosing, but ultimately, you should follow the weekly dosing schedule and medical advice prescribed by your healthcare provider.

Zepbound is a liquid solution that comes in prefilled injection pens. Each pen contains a single dose of Zepbound in a 0.5 milliliter (mL) solution. Below is a brief overview of available dosages of Zepbound.

What dosages does Zepbound come in? 

Zepbound comes in the following six dosage strengths. Each box of Zepbound contains four single-dose pens of the medication, which is roughly a month’s supply.

• 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

Zepbound dosage schedule 

Typically, healthcare providers recommend starting at the lowest 2.5 mg dosage of Zepbound. Then, every four weeks, they will gradually increase your dosage in 2.5 mg increments until you find a dosage that works best for you. Each week, you’ll administer your injection of Zepbound on the same day of the week, at any time of the day. A typical Zepbound dosage schedule may look something like this:

• Weeks 1–4: 2.5 mg of Zepbound

• Weeks 5–8: 5 mg of Zepbound

• Weeks 9–12: 7.5 mg of Zepbound

• Weeks 13–16: 10 mg of Zepbound

• Weeks 17–20: 12.5 mg of Zepbound

• Weeks 20 and onward: 15 mg of Zepbound

Gradually increasing the dosage in this way helps your body get used to the medication and minimizes common side effects like nausea, diarrhea, and vomiting. While this dosing schedule shows someone who was increased all the way up to 15 mg of Zepbound, not all patients need the maximum dose to have the appropriate effect. 

When you use Zepbound, the goal is to find the lowest effective dosage that produces the desired effect (weight loss) while keeping side effects manageable. The lowest effective maintenance dosage of Zepbound is 5 mg weekly, while the maximum is 15 mg weekly. 

Depending on your body’s reaction to the medication and tolerance for side effects, your healthcare provider may have you stop increasing at any point in the schedule above (after the 5 mg dosage) once they find an effective dosage for you.

What is Zepbound’s form? 

Zepbound comes in a clear liquid solution, which may range from totally colorless to slightly yellow. (If it is cloudy or you see particles, dispose of the pen and don’t use it.) Each pen of Zepbound comes pre-filled with one dose of the medication, so you don’t have to worry about attaching needles. 

Once a week, you will inject the pen subcutaneously (under the skin) of your thigh, abdomen, or upper arm. Rotate through the injection sites every week to give your body time to heal and prevent irritation. Then, you can throw away the pen in a sharps disposal container to prevent someone else from accidentally getting injured. You can take Zepbound at any time of day, with or without meals, but it is important to try to take it on the same day each week. 

In between doses, Zepbound should be kept in the refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). It can also be stored at room temperature (up to 86°F or 30°C) for up to 21 days. Once you store it at room temperature, it should not be returned to the refrigerator.

Zepbound is a treatment option for chronic weight management that’s designed to be used on a long-term basis, in combination with a reduced-calorie diet and increased physical activity. When taking Zepbound, the goal is to find the lowest effective dosage that produces weight loss while keeping side effects manageable. This dose will be your maintenance dosage. Recommended maintenance dosages include 5 mg, 10 mg, and 15 mg. 

Your healthcare provider will monitor how your body responds to Zepbound and advise you on when to increase your dosage. If side effects feel intolerable, they may recommend lowering your dosage. Communicate with your healthcare provider throughout your treatment and let them know if you experience any side effects that concern you. 

Factors that can affect dosage

The main factors that can affect your Zepbound dosage include how your body responds to treatment and your tolerance for side effects. Between 30%–70% of people experience gastrointestinal side effects while taking GLP-1 drugs like Zepbound, most of which occur during the first two weeks of treatment and range from mild to moderate. 

While these side effects are normally transient, in some cases they can be bothersome enough to lead people to stop taking Zepbound. Higher doses of Zepbound may cause worse side effects than lower doses. One study found that around 4% of people taking 5 mg of Zepbound discontinued the medication due to side effects, whereas 7.1% of people taking the 10 mg dose and 6.2% of people taking the 15 mg dose discontinued the medication.

Commonly reported side effects of Zepbound include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Indigestion

• Injection site reactions

• Fatigue

• Allergic reactions

• Belching

• Hair loss

• Acid reflux or heartburn

Zepbound slows stomach emptying, which can affect the way your other medications are absorbed. For example, Zepbound may change the way your body handles oral birth control pills or medications that can lower your blood sugar, but these aren’t the only medications that it can change the effect of.

Before starting Zepbound, be sure to share a full list of prescription and over-the-counter medications you are currently taking with your healthcare provider. This is the best action you can take to ensure Zepbound and your other medications continue working at their best, even if they are taken together.

Finally, some people may be at increased risk of experiencing serious side effects when taking Zepbound, which may affect the way your healthcare provider prescribes the medication. These individuals include people with severe gastrointestinal disease, kidney or gallbladder problems, or a history of diabetic retinopathy or pancreatitis. Zepbound should not be used by people with a personal or family history of thyroid cancer or anyone who is currently pregnant, planning pregnancy, or breastfeeding.

If you miss a dose of Zepbound, your next steps depend on how much time has passed since the day of your missed dose.

• If it has been less than 4 days (96 hours) since your missed dose, take your missed dose as soon as possible.

• If it has been more than 4 days (96 hours), skip the missed dose and wait to take your next dose on your regularly scheduled day.

Never double up on your dose of Zepbound or take two doses within 3 days (72 hours) of each other.

To avoid missing a dose of Zepbound, schedule your injection day on a day of the week that you usually have free, or pair it with another activity you reliably do the same day each week (like grocery shopping or laundry). You can also schedule it on your calendar or set a reminder on your phone.

Yes, Zepbound should be taken weekly, on the same day each week. You can take it at any time of the day, with or without meals. When you start taking Zepbound, try to choose a day of the week that will consistently work for you. If you ever need to change the day you take Zepbound, you can do so as long as it has been at least 3 days (72 hours) since your last dose. If you have questions about changing your Zepbound dosage schedule, talk to your healthcare provider. 

You should avoid taking two doses of Zepbound within 3 days (72 hours) of each other. If you accidentally take too much Zepbound, contact America’s Poison Centers at (800) 222-1222 or visit their website at poisonhelp.org for next steps. You can also contact your healthcare provider or visit your local Urgent Care or Emergency Department if you are concerned about your health and want immediate attention from a healthcare provider.

If you notice any of the following, they could be signs of a serious side effect, such as low blood sugar or acute pancreatitis. Stop taking Zepbound and seek emergency medical care.

• Persistent stomach pain, which may or may not feel severe

• Pain that radiates from the abdomen to the back, with or without vomiting

• Fever

• Jaundice (yellowing skin or eyes)

• Clay-colored stool

• Swelling of your face, lips, tongue, or throat

• Feeling faint or dizzy

• Difficulty breathing or swallowing

• Rapid heartbeat

• Severe rash or itching

• Sweating

• Confusion

• Blurred vision

• Slurred speech

• Shakiness

• Feeling jittery

• Weakness

• Mood changes

• Vision changes

• Suicidal thoughts 

Zepbound starts working fairly soon once you begin taking it, although it may take a few weeks before you start noticing any changes in your appetite or cravings, and sometimes longer before you start noticing the body weight drop off. 

In one clinical trial, the weight loss became noticeable as early as week 5, with participants taking Zepbound having lost nearly 6 pounds (compared with only about 2 pounds for those taking a placebo). After 28 weeks, people taking Zepbound had lost an average of 24 pounds. In another trial, participants experienced an average weight loss of 20.9% from their starting weight after 36 weeks of taking 10 mg or 15 mg of Zepbound. Remember, Zepbound is FDA-approved in addition to a reduced calorie diet and increased physical activity, so make sure to include these behaviors to see the effects.

If you have questions about the way your Zepbound is working, you can always reach out to your healthcare provider. Remember - never change your dosage of Zepbound without talking to a healthcare provider first.

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Current version

March 29, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.