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[GLP-1 · Zepbound · FDA label guide]

Zepbound (tirzepatide) dose schedule, titration chart and side effects

Eli Lilly and Company · Once weekly injection · Label reviewed as of

Short answer: Per the FDA label (2.1, 2.2), Zepbound starts at 2.5 mg once weekly for 4 weeks, then 5 mg. The dose may rise in 2.5 mg steps after at least 4 weeks on the current dose. Weight-management maintenance is 5, 10 or 15 mg weekly; OSA maintenance is 10 or 15 mg; the maximum is 15 mg.

Per label section 1, Zepbound is a GIP and GLP-1 receptor agonist indicated, with a reduced-calorie diet and increased physical activity, to reduce excess body weight and maintain weight reduction long term in adults with obesity, or with overweight plus at least one weight-related condition, and to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity. This page summarizes the current FDA prescribing information (revised 8/2026). It is not personalized medical advice; your prescriber sets your dose.

What is the Zepbound dose schedule?

The label's dosing schedule (label section 2.1; 2.2):

Dosing schedule as written in the FDA label (label section 2.1; 2.2).
PeriodDoseLabel note
Weeks 1–42.5 mg once weeklyInitiation dose; the label says 2.5 mg is not approved as a maintenance dosage
Weeks 5–85 mg once weeklyLowest weight-management maintenance dose
Weeks 9–127.5 mg once weeklyEscalation step (+2.5 mg after at least 4 weeks); not listed as a maintenance dose
Weeks 13–1610 mg once weeklyMaintenance dose option
Weeks 17–2012.5 mg once weeklyEscalation step; not listed as a maintenance dose
Week 21 onward15 mg once weeklyMaximum dosage for all indications

Maintenance: For weight reduction and long-term maintenance, the label lists 5 mg, 10 mg or 15 mg once weekly as maintenance dosages, chosen with treatment response and tolerability in mind. The maximum dosage for all indications is 15 mg once weekly (2.2).

  • Week numbers show the earliest possible schedule; the label says increases come after at least 4 weeks on the current dose, so steps can be later, and escalation stops once the maintenance dose is reached (2.1).
  • OSA: the label uses the same 2.5 mg start and escalation for all indications, but the recommended OSA maintenance dosage is 10 mg or 15 mg once weekly (2.1, 2.2).
  • The label says that if a maintenance dosage is not tolerated, a lower maintenance dosage can be considered (2.1).
  • The label says to follow the escalation schedule to reduce the risk of gastrointestinal adverse reactions (2.1).
  • In the 72-week weight trials (Studies 1 and 2), the escalation period lasted up to 20 weeks, followed by at least 52 weeks at the maintenance dose (14.1).
  • The label advises patients using oral hormonal contraceptives to switch to a non-oral method or add a barrier method for 4 weeks after initiation and for 4 weeks after each dose escalation (7.2, 8.3).

What does the Zepbound titration calendar look like?

Below is the label schedule laid out week by week, using the earliest timing the label allows. The label lets prescribers stay at a step longer, so a real calendar is often slower. The blank columns are for your own record.

Zepbound titration calendar from the label schedule (label section 2.1; 2.2). Not a personalized plan.
WeekLabel doseDateSite / timeWeightNotes
Week 12.5 mg once weekly
Week 22.5 mg once weekly
Week 32.5 mg once weekly
Week 42.5 mg once weekly
Week 55 mg once weekly
Week 65 mg once weekly
Week 75 mg once weekly
Week 85 mg once weekly
Week 97.5 mg once weekly
Week 107.5 mg once weekly
Week 117.5 mg once weekly
Week 127.5 mg once weekly
Week 1310 mg once weekly
Week 1410 mg once weekly
Week 1510 mg once weekly
Week 1610 mg once weekly
Week 1712.5 mg once weekly
Week 1812.5 mg once weekly
Week 1912.5 mg once weekly
Week 2012.5 mg once weekly
Week 2115 mg once weekly
Week 2215 mg once weekly
Week 2315 mg once weekly
Week 2415 mg once weekly
Week 2515 mg once weekly

Printing this page prints the schedule and calendar without the site navigation.

What strengths does Zepbound come in, and how many doses are in each pen?

Zepbound pen presentations (label section 3; 16.1).
ProductWhat it deliversDoses per pen / vialContents
Single-dose pen (carton of 4 pens)2.5, 5, 7.5, 10, 12.5 or 15 mg per injection1 dose per pen (4 pens = 4 weekly doses)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 or 15 mg/0.5 mL
Single-dose vial (carton of 1 or 4 vials)2.5, 5, 7.5, 10, 12.5 or 15 mg per injection1 dose per vial2.5 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 or 15 mg/0.5 mL
Single-patient-use KwikPen 2.5 mg2.5 mg per dose4 doses10 mg/2.4 mL (4.17 mg/mL)
Single-patient-use KwikPen 5 mg5 mg per dose4 doses20 mg/2.4 mL (8.33 mg/mL)
Single-patient-use KwikPen 7.5 mg7.5 mg per dose4 doses30 mg/2.4 mL (12.5 mg/mL)
Single-patient-use KwikPen 10 mg10 mg per dose4 doses40 mg/2.4 mL (16.7 mg/mL)
Single-patient-use KwikPen 12.5 mg12.5 mg per dose4 doses50 mg/2.4 mL (20.8 mg/mL)
Single-patient-use KwikPen 15 mg15 mg per dose4 doses60 mg/2.4 mL (25 mg/mL)
Multi-dose vial 2.5 mg2.5 mg/0.6 mL per dose4 doses10 mg/2.4 mL (4.17 mg/mL)
Multi-dose vial 5 mg5 mg/0.6 mL per dose4 doses20 mg/2.4 mL (8.33 mg/mL)
Multi-dose vial 7.5 mg7.5 mg/0.6 mL per dose4 doses30 mg/2.4 mL (12.5 mg/mL)
Multi-dose vial 10 mg10 mg/0.6 mL per dose4 doses40 mg/2.4 mL (16.7 mg/mL)
Multi-dose vial 12.5 mg12.5 mg/0.6 mL per dose4 doses50 mg/2.4 mL (20.8 mg/mL)
Multi-dose vial 15 mg15 mg/0.6 mL per dose4 doses60 mg/2.4 mL (25 mg/mL)
  • Each strength is a separate product: the label lists a single-dose pen, single-dose vial, multi-dose vial and KwikPen for each of the six doses (3, 16.1).
  • Per the label, the multi-dose vial and single-patient-use KwikPen each contain 4 weekly doses; they are discarded after 4 weekly doses, 30 days after first use, or a total of 30 days at room temperature, even if medicine is left (16.2).
  • Single-dose pens and vials may be kept unrefrigerated up to 30°C (86°F) for a total of 21 days, per the label (16.2).
  • For vials, the label refers to a syringe appropriate for the dose (e.g., a 1 mL syringe capable of measuring a 0.5 mL or 0.6 mL dose), with a new syringe and needle for each injection (2.4).
  • The label says the KwikPen is not recommended for self-administration by people who are visually impaired, and a KwikPen is never shared between patients (2.4, 5.10).

What are the most common Zepbound side effects?

The label reports these rates from placebo-controlled trials (label section 6.1, Table 1). Percentages are the share of trial participants who reported each reaction.

Adverse reactions in ≥2% of Zepbound-treated adults with obesity or overweight and more often than placebo, pool of two placebo-controlled weight-reduction trials (Study 1 and Study 2), up to 72 weeks (label Table 1).
Adverse reactionPlacebo (N=958)Zepbound 5 mg (N=630)Zepbound 10 mg (N=948)Zepbound 15 mg (N=941)
Nausea8%25%29%28%
Diarrhea (incl. frequent bowel movements)8%19%21%23%
Vomiting2%8%11%13%
Constipation (incl. feces hard)5%17%14%11%
Abdominal pain (grouped terms)5%9%9%10%
Dyspepsia4%9%9%10%
Injection site reactions (grouped terms)2%6%8%8%
Fatigue (incl. asthenia, lethargy, malaise)3%5%6%7%
Hypersensitivity reactions3%5%5%5%
Eructation1%4%5%5%
Hair loss1%5%4%5%
Gastroesophageal reflux disease2%4%4%5%
Flatulence2%3%3%4%
Abdominal distension2%3%3%4%
Dizziness2%4%5%4%
Hypotension (incl. blood pressure decreased, orthostatic hypotension)0%1%1%2%

When do they happen? Per the label, the majority of nausea, vomiting and/or diarrhea events occurred during dose escalation and decreased over time; gastrointestinal adverse reactions overall occurred in 56% at each Zepbound dose versus 30% on placebo. Most patients who stopped Zepbound for adverse reactions did so during the first few months, due to gastrointestinal reactions (6.1).

The label also carries warnings that are not in this table (for example, a boxed warning or pancreatitis and gallbladder warnings where applicable). Read the full label linked under Sources, and report side effects to your prescriber.

What if you miss a dose of Zepbound?

Per the label, a missed dose is given as soon as possible within 4 days (96 hours); if more than 4 days have passed, the missed dose is skipped and the next dose is given on the regular day. The weekly day can be changed if the two doses are at least 3 days (72 hours) apart. (label section 2.3) The full walk-through is on the Zepbound missed-dose page.

How is Zepbound taken?

The label describes once-weekly subcutaneous injection at any time of day, with or without meals, together with a reduced-calorie diet and increased physical activity. Sites are the abdomen or thigh, or the back of the upper arm when another person injects, rotated with each dose. (label section 2.4)

What should you track on Zepbound?

A simple log makes each titration step easier to talk through with your prescriber. These are the things worth writing down, and how Dose Track handles them:

  • Dose and date. Each injection with its amount, so the titration steps above line up with what you actually took. Dose Track keeps the full history of every dose change.
  • Injection site. The label lists the abdomen, thigh and upper arm. Dose Track records the site with each shot so rotation is easy to follow.
  • Weight. Logged by hand or synced from Apple Health or Android Health Connect, and charted alongside your dose changes.
  • Side effects. A note of what you felt and when, so you can see whether it settles after a dose step and bring the record to your prescriber.
  • Reminders. A notification on your injection day.

Your log stays on your phone. See GLP-1 tracking in Dose Track for the full feature list.

Mounjaro dose scheduleOnce weekly injection, FDA label Missed a dose of Zepbound?What the label says, by how late you are Storage and pens left out of the fridgeFridge, room-temperature limits, travel Semaglutide vs tirzepatideSide-by-side comparison and switching Ozempic vs MounjaroTrial results and pharmacology compared Compounded vial units chartmg to syringe units for compounded tirzepatide How long tirzepatide stays in your systemHalf-life and washout from the label Tirzepatide compound guideHalf-life, pen strength and tracking Half-life calculatorEstimate levels after your last dose Injection site rotationWhy it matters and how to map it GLP-1 tracking in Dose TrackDoses, titration, weight and sites

Zepbound questions people ask

What's the highest dose of Zepbound?+
The label lists 15 mg injected once weekly as the maximum dosage for all indications (2.2). For weight management the maintenance options are 5, 10 or 15 mg; for obstructive sleep apnea they are 10 or 15 mg. Each strength comes as its own single-dose pen, single-dose vial, multi-dose vial or KwikPen (3).
How long does it take for Zepbound to work?+
The label reports weight results at week 72 in Studies 1 and 2, where Zepbound was escalated over up to 20 weeks and then held for at least 52 weeks at the maintenance dose; mean body weight change in Study 1 was −15.0%, −19.5% and −20.9% on 5, 10 and 15 mg versus −3.1% on placebo (14.1, Table 2). OSA results were measured at week 52 (14.2). Steady-state levels are reached after 4 weeks (12.3).
Can you skip the 2.5 mg starter dose of Zepbound?+
The label says the starting dosage for all indications is 2.5 mg once weekly for 4 weeks, that 2.5 mg is for treatment initiation and not approved as a maintenance dosage, and that the escalation schedule is meant to reduce the risk of gastrointestinal adverse reactions (2.1). This is general label information, not personalized advice; dosing changes are for the prescriber.
What is the Zepbound dose for sleep apnea?+
Per the label, OSA uses the same 2.5 mg start and 2.5 mg step-ups as weight management, with a recommended maintenance dosage of 10 mg or 15 mg once weekly and a maximum of 15 mg (2.1, 2.2). The OSA trials (Studies 5 and 6) ran 52 weeks and measured change in apnea-hypopnea index at week 52 (14.2).
How many doses are in a Zepbound vial or KwikPen?+
Per the label, single-dose pens and single-dose vials hold one 0.5 mL dose each. Multi-dose vials and single-patient-use KwikPens hold 4 doses of one strength, from 10 mg/2.4 mL (four 2.5 mg doses) to 60 mg/2.4 mL (four 15 mg doses) (3, 16.1). Those are discarded after 4 weekly doses or 30 days, even if medicine remains (16.2).
What time of day should you take Zepbound?+
The label says Zepbound is administered once weekly at any time of day (2.4). The weekly day can be changed if needed, as long as at least 3 days (72 hours) separate the two doses (2.3). The label gives the elimination half-life of tirzepatide as approximately 5–6 days in patients with overweight or obesity and in patients with OSA and obesity (12.3).
Do you take Zepbound with food?+
The label says Zepbound can be given with or without meals, and is used in combination with a reduced-calorie diet and increased physical activity (2.4). It is an injection under the skin, so there are no food or water timing rules like those for oral tablets. The label notes that Zepbound delays gastric emptying (5.9, 12.2).
What are the most common side effects of Zepbound?+
The label lists nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, hypersensitivity reactions, eructation, hair loss and GERD as the most common (≥5%). Nausea was reported by 25%, 29% and 28% on 5, 10 and 15 mg versus 8% on placebo; most GI events occurred during dose escalation and decreased over time (6.1).

Sources

Reviewed as of . Section numbers above refer to the FDA prescribing information.

  1. Zepbound (tirzepatide) injection — FDA label, DailyMed (revised 8/2026)

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