The tirzepatide titration schedule, step by step, with dates

The tirzepatide schedule is simple to state and easy to get wrong in practice, because the label gives minimums, not a timetable. Here is what it actually says, and how to turn it into dates.

What the label says

Section 2.1 of the Zepbound label: the recommended starting dosage for all indications is 2.5 mg injected subcutaneously once weekly for 4 weeks. The 2.5 mg dosage is for treatment initiation and is not approved as a maintenance dosage. After 4 weeks, increase to 5 mg once weekly. The dosage may be increased in 2.5 mg increments after at least 4 weeks on the current dose.

Section 2.2: the recommended maintenance dosage for weight reduction is 5 mg, 10 mg or 15 mg once weekly. For obstructive sleep apnea it is 10 mg or 15 mg. The maximum for all indications is 15 mg once weekly. The label adds two sentences people skip: consider treatment response and tolerability when selecting the maintenance dosage, and if a maintenance dosage is not tolerated, consider a lower one.

The Mounjaro label (section 2.1) uses the same start and the same increments, with one difference in framing: increase in 2.5 mg steps after at least 4 weeks "if additional glycemic control is needed". Maximum 15 mg in adults and 10 mg in pediatric patients aged 10 and older.

The minimum timetable

Four weeks per step is a floor. Nothing in the label requires you to move up on day 29, and the label's own tolerability language points the other way. But if every step is taken at the minimum, the calendar is fixed:

So the earliest first 15 mg injection is week 21, 140 days after the first 2.5 mg dose. The earliest first 10 mg injection is week 13, day 85. The earliest 5 mg injection is week 5, day 29.

This matches the trial design. SURMOUNT-1 randomised 2,539 adults to 5, 10 or 15 mg or placebo for 72 weeks "including a 20-week dose-escalation period" (PubMed 35658024). The 72-week results everyone quotes therefore include at least 52 weeks at the assigned maintenance dose.

Using the planner

Enter the date of your first 2.5 mg injection and the maintenance dose written on your prescription. The planner lays out each step at four weeks, or at a longer hold if you enter one, and gives you the first and last date at each dose, the first day at target, and an .ics file for your calendar. It refuses to shorten a step below four weeks and it refuses 2.5 mg as a target, because the label does.

Two things it deliberately does not do. It does not pick the maintenance dose; the drop-down is blank until you choose what your prescriber wrote. And it does not know how you tolerated the last four weeks. Every date past the first is a placeholder for a conversation, not an instruction.

If a step is held longer

A prescriber may keep you at 5 mg for eight weeks, or at 7.5 mg indefinitely. Enter that hold in the planner and the later dates move. The label's four-week minimum still applies to the next increase after the hold. If you are on compounded tirzepatide, the label does not apply to your product at all; your prescriber's written schedule does. Compounded tirzepatide is not FDA approved and is not interchangeable with Zepbound or Mounjaro.

What to read next

The missed-dose rules cover what happens when a date slips. Side effects by dose shows what the label reports for each arm, which is the information a prescriber weighs before each step. For the general injection scheduler that handles other drugs and custom steps, use the injection schedule generator on the FormBlends Calculators site.