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Dosage information

Zepbound dosage

Zepbound dosage follows a step-up schedule in the FDA label: 2.5 mg once weekly for 4 weeks, then 5 mg, with optional 2.5 mg increases after at least 4 weeks on each dose.1 Maintenance is 5, 10 or 15 mg weekly for weight reduction and 10 or 15 mg for sleep apnea.1 The prescriber chooses the maintenance dose.1

This page summarizes published sources for information only. It is not medical advice and does not tell anyone to use a product. Questions about your own health belong with a licensed clinician. For questions about an order or a product, contact us.

The label schedule

Zepbound's label raises the dose in steps, and it says following this schedule lowers the risk of digestive side effects.1 Increases after 5 mg are optional, and each one needs at least 4 weeks on the current dose.1 The middle column shows the earliest week each dose could start if the prescriber raised it at every 4-week point.1

Weekly dose Earliest start Role in the label
2.5 mg Week 1, for 4 weeks Starting dose only, not a maintenance dose1
5 mg Week 5 Maintenance dose for weight reduction1
7.5 mg Week 9 Escalation step, not a listed maintenance dose1
10 mg Week 13 Maintenance dose for weight reduction or sleep apnea1
12.5 mg Week 17 Escalation step, not a listed maintenance dose1
15 mg Week 21 Maintenance dose for either use, and the maximum1

The prescriber chooses the maintenance dose by weighing response and tolerability.1 If a maintenance dose is not tolerated, the label says a lower maintenance dose may be considered.1

The maintenance doses match the doses tested in the label's trials: SURMOUNT-1 tested 5 mg, 10 mg and 15 mg, the three weight maintenance doses.5191 The sleep apnea trials raised each person to the highest tolerated dose of 10 mg or 15 mg, the two sleep apnea maintenance doses.111

How each presentation measures the dose

Each single-dose pen and single-dose vial holds one full weekly dose in 0.5 mL, so the strength printed on it is the whole dose.2 A multi-dose vial holds 2.4 mL, and each weekly dose is 0.6 mL.2 Vials of 10 mg to 60 mg in total therefore give four doses of 2.5 mg to 15 mg each.2 A KwikPen holds four fixed weekly doses, set by turning the dose knob until it stops.212

Timing, missed doses and changing the day

Situation What the label says
Time of day Any time, with or without meals4
Missed dose, 4 days (96 hours) or less Given as soon as possible6
Missed dose, more than 4 days Skipped; the next dose is given on the usual day6
Changing the weekly day Allowed if the two doses are at least 3 days (72 hours) apart6

Adjustments and combinations in the label

  • Kidney or liver impairment: no dose change is recommended.13
  • Insulin or sulfonylureas: the dose of these drugs may need to be lowered when Zepbound starts, to reduce the risk of low blood sugar.1415
  • Other tirzepatide or GLP-1 medicines: the label does not recommend using Zepbound with other tirzepatide products, such as Mounjaro, or with any GLP-1 receptor agonist.16
  • Birth control pills: Zepbound may make them work less well.15 The label advises a non-oral method, or adding a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase.15 Non-oral hormonal methods should not be affected.15
  • Overdose: the label points to the Poison Help line or a medical toxicologist.8 Observation may be needed for a while, given the half-life of about 5 days.8

How the Mounjaro schedule differs

Mounjaro, the same drug approved for type 2 diabetes, also starts at 2.5 mg once weekly.17 The difference is the trigger for each step.117 Zepbound's label moves to 5 mg after 4 weeks and does not approve 2.5 mg as a maintenance dose.1 Mounjaro's label raises the dose in 2.5 mg steps, after at least 4 weeks, only if more blood sugar control is needed.17 Its maximum is 15 mg weekly in adults and 10 mg weekly in children 10 and older.18 The full schedule is in Mounjaro dosage.

Doses studied in published trials

These are the doses tested in trials. They show what was studied, not a dose for any person.

  • SURMOUNT-1 (phase 3, 2,539 adults with obesity, or overweight plus a weight-related condition, and no type 2 diabetes): 5 mg, 10 mg or 15 mg once weekly, or placebo, for 72 weeks, including a 20-week dose escalation period.519
  • Label Study 2 (938 adults with type 2 diabetes and a BMI of 27 or more): 10 mg or 15 mg once weekly, or placebo, for 72 weeks.5
  • Label Study 3 (579 adults who first lost at least 5% in a 12-week intensive diet and exercise program): the highest tolerated dose of 10 mg or 15 mg, or placebo, for the next 72 weeks.5
  • SURMOUNT-OSA (phase 3, 469 adults with obesity and moderate to severe sleep apnea): 52 weeks of treatment, with doses raised over up to 20 weeks to the highest tolerated dose, 10 mg or 15 mg.26119
  • SURMOUNT-5 (phase 3b, open-label, 751 adults with obesity and no type 2 diabetes): 72 weeks of once-weekly treatment, each drug at its highest tolerated dose (tirzepatide 10 mg or 15 mg, semaglutide 1.7 mg or 2.4 mg).20
  • SURMOUNT-MAINTAIN (phase 3b, adults with obesity in the US, Lancet 2026): after 60 weeks on the highest tolerated dose of 10 mg or 15 mg, 378 participants were randomized.2122 They stayed on that dose, stepped down to 5 mg, or switched to placebo.21 At week 112, the estimated weight loss from the start was 21.9%, 16.6% and 9.9%.2223 The authors wrote that reducing to 5 mg might be an alternative to stopping, though individual response may vary.24

Who sets the dose

Zepbound is a prescription medicine, and its label leaves the maintenance dose to the prescriber.251 This page summarizes the label and published trials for reference. It is not dosing advice for any person.

The overview, with forms, injection steps and storage, is at What is Zepbound?. Digestive effects during dose increases are covered in Zepbound side effects. Results by dose are in Zepbound benefits and uses. For the class as a whole, see GLP-1 dosage.

More on Zepbound

  • Zepbound side effects

    Side effects of Zepbound as reported in labels, trials and published studies, with links to the full profile. Reviewed by a qualified reviewer.

  • Zepbound benefits and uses

    What published sources report about Zepbound and its uses, with the evidence level of each finding. No promises.

Frequently asked questions

Is Zepbound 12.5 mg available?

Yes. The August 2026 label lists a 12.5 mg strength in all four presentations: the single-dose pen, single-dose vial, multi-dose vial and KwikPen.2 FDA declared the tirzepatide injection shortage resolved on December 19, 2024.3 In the label schedule, 12.5 mg is a step reached after at least 4 weeks on 10 mg.1 It is not one of the listed maintenance doses, which are 5, 10 and 15 mg.1

How often should you eat when taking Zepbound?

The label sets no meal schedule or eating frequency.4 Zepbound can be injected at any time of day, with or without meals, and is meant to be used with a reduced-calorie diet and more physical activity.4 In weight Studies 1 and 2, participants were counseled toward a deficit of about 500 kcal a day and at least 150 minutes of physical activity a week.5

What if I miss a dose of Zepbound?

The label allows a missed dose to be taken as soon as possible within 4 days (96 hours) of the scheduled day.6 If more than 4 days have passed, the missed dose is skipped and the next one is taken on the usual day.6 Two doses should never be taken within 3 days (72 hours) of each other.67

How long does Zepbound stay in your body?

The label gives tirzepatide a half-life of about 5 days, or 5 to 6 days in people with overweight or obesity, with or without sleep apnea.8 That means the amount in the blood falls by roughly half about every 5 days after the last dose.8 With once-weekly dosing, steady levels are reached after 4 weeks.8 The long half-life is also why an overdose may need observation for some time.8

What is the highest dose of Zepbound?

The maximum is 15 mg once weekly, for both weight reduction and sleep apnea.1 Under the label it is reached only through 2.5 mg steps from 5 mg, with at least 4 weeks on each dose.1 The earliest first 15 mg dose therefore falls in week 21.1 In the weight and sleep apnea trials, doses were raised over up to 20 weeks before maintenance.59

Why does Zepbound start at 2.5 mg?

The label calls 2.5 mg a starting dose only; it is not approved as a maintenance dose.1 The label says following its step-up schedule lowers the risk of digestive side effects.1 In the 72-week trials, most nausea, vomiting and diarrhea occurred during dose increases, and these effects became less common over time.10

Written by D2C Peptides Editorial Team.

Pending qualified review.

Updated .

Sources

  1. Zepbound Prescribing Information, revised 08/2026: Sections 2.1 and 2.2 Dose Escalation, Maintenance and Maximum Dosage. Eli Lilly and Company; posted by U.S. Food and Drug Administration, 2026.
  2. Same source as 1: Sections 3 Dosage Forms and Strengths, 11 Description, 16.1 How Supplied.
  3. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (update of December 19, 2024). U.S. Food and Drug Administration, 2026.
  4. Same source as 1: Section 2.4 Important Administration Instructions.
  5. Same source as 1: Section 14.1 Weight Reduction Studies 1, 2 and 3 (Tables 2 to 5).
  6. Same source as 1: Section 2.3 Recommendations Regarding Missed Dose.
  7. Same source as 1: Zepbound Medication Guide, revised 04/2026 (in the 08/2026 label file).
  8. Same source as 1: Section 10 Overdosage and Section 12.3 Pharmacokinetics.
  9. Same source as 1: Section 14.2 Obstructive Sleep Apnea Studies 5 and 6 (Tables 8 and 9).
  10. Same source as 1: Section 6.1 Clinical Trials Experience (Table 1 and text).
  11. Same source as 1: Sleep apnea study dosing.
  12. Same source as 1: Zepbound KwikPen Instructions for Use, issued January 2026 (in the 08/2026 label file).
  13. Same source as 1: Section 8 Use in Specific Populations (pregnancy, lactation, pediatric, geriatric, renal, hepatic).
  14. Same source as 1: Sections 5.2 to 5.10 Warnings and Precautions.
  15. Same source as 1: Section 7 Drug Interactions and Section 8.3 Contraception.
  16. Same source as 1: revised 08/2026 (NDA 217806/S-041): Section 1 Indications and Usage.
  17. MOUNJARO Prescribing Information, revised 08/2026: Recommended dosage. U.S. Food and Drug Administration (label for Eli Lilly and Company), 2026.
  18. Same source as 17: Maximum dosage.
  19. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med 2022;387(3):205-216. PMID 35658024, doi:10.1056/NEJMoa2206038 (PubMed record). New England Journal of Medicine (record via NCBI PubMed E-utilities), 2022.
  20. Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med 2025;393(1):26-36. PMID 40353578, doi:10.1056/NEJMoa2416394 (PubMed record). New England Journal of Medicine (record via NCBI PubMed E-utilities), 2025.
  21. SURMOUNT-MAINTAIN abstract: randomization (PMID 42119587). The Lancet (via NLM PubMed E-utilities), 2026.
  22. Same source as 21: Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN), PMID 42119587: maximum tolerated dose arm.
  23. Same source as 21: 5 mg and placebo arms (PMID 42119587).
  24. Same source as 21: interpretation (PMID 42119587).
  25. Drugs@FDA: NDA 217806, Zepbound (tirzepatide) application overview. U.S. Food and Drug Administration, 2026.
  26. Malhotra A et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA). N Engl J Med 2024;391(13):1193-1205. PMID 38912654, doi:10.1056/NEJMoa2404881 (PubMed record). New England Journal of Medicine (record via NCBI PubMed E-utilities), 2024.