The Full Zepbound Dosing Chart: Every Dose, Every Week, in 2026

Key Takeaways

• Zepbound has six dose strengths: 2.5, 5, 7.5, 10, 12.5, and 15 mg, all dosed once weekly.
• The standard titration is 4 weeks at each step, starting at 2.5 mg and ending at one of three maintenance doses: 5, 10, or 15 mg.
• 7.5 mg and 12.5 mg are titration bridges, not typical long-term maintenance doses.
• Mean weight loss in SURMOUNT-1: 15.0% at 5 mg, 19.5% at 10 mg, 20.9% at 15 mg.
• Each Zepbound pen is single-use and pre-set to deliver one full weekly dose.

Direct answer (40-60 words)

The Zepbound dosing chart is a 6-step titration: 2.5 mg weeks 1-4, 5 mg weeks 5-8, 7.5 mg weeks 9-12, 10 mg weeks 13-16, 12.5 mg weeks 17-20, and 15 mg from week 21+. Maintenance doses are 5, 10, or 15 mg. The 7.5 and 12.5 mg doses are bridges, not standard long-term doses.

Table of contents

1. The 30-second answer
2. The full Zepbound dosing chart
3. Maintenance dose options: 5, 10, or 15 mg
4. Bridge doses: 7.5 and 12.5 mg
5. Pen color and dose strength reference
6. Average weight loss by dose level
7. When to step up vs hold
8. When to step down or pause
9. Missed dose rules
10. Common dosing chart errors
11. SURMOUNT trial dosing context
12. FAQ
13. Footer disclaimers

The full Zepbound dosing chart

The FDA-approved Zepbound dosing chart is a 20-week titration that escalates from 2.5 mg to a maintenance dose of 5, 10, or 15 mg.

Week	Dose	Pen color (label)	Purpose
1-4	2.5 mg once weekly	Off-white	Starter dose; body acclimation
5-8	5 mg once weekly	Off-white	First therapeutic dose; first maintenance option
9-12	7.5 mg once weekly (if needed)	Light yellow	Titration bridge
13-16	10 mg once weekly (if needed)	Light yellow	Second maintenance option
17-20	12.5 mg once weekly (if needed)	Light blue	Titration bridge
21+	15 mg once weekly (if needed)	Light blue	Maximum maintenance dose

Key rules from the Zepbound prescribing information (Eli Lilly, rev. 2024):

• The 2.5 mg dose is for the first 4 weeks only and is not effective for ongoing weight management. Patients who tolerate it should always step up to 5 mg by week 5.
• Each step up requires at least 4 weeks at the prior dose to allow the body to adapt to GIP and GLP-1 receptor activity.
• The maintenance dose (5, 10, or 15 mg) is selected by the prescriber based on the patient's response, side effect tolerance, and weight loss goals.
• Pen color label changes at certain dose breakpoints, but the injection technique and pen design are otherwise identical across all six strengths.

For the related Mounjaro chart (same active ingredient, different indication), refer to the Mounjaro section in your patient handout. The dose strengths and titration schedule are identical.

Maintenance dose options: 5, 10, or 15 mg

Three of the six Zepbound dose strengths are designated maintenance doses. The prescriber selects one based on individual response.

5 mg as maintenance:

• Patients who reach their weight loss goal at 5 mg and tolerate it well.
• Patients with intolerable side effects at higher doses.
• Average weight loss in SURMOUNT-1: 15.0% over 72 weeks.

10 mg as maintenance:

• The most common maintenance dose for adults with obesity in SURMOUNT-1.
• Patients who need additional weight loss beyond 5 mg.
• Average weight loss in SURMOUNT-1: 19.5% over 72 weeks.

15 mg as maintenance:

• The maximum approved dose.
• Patients with higher BMI or who need maximum weight loss.
• Average weight loss in SURMOUNT-1: 20.9% over 72 weeks.

Many patients land at 10 mg because the marginal benefit from 10 mg to 15 mg (about 1.4 percentage points more weight loss in SURMOUNT-1) is smaller than the marginal benefit from 5 mg to 10 mg (about 4.5 percentage points). The 5-to-10 step is where most of the additional efficacy lives.

Bridge doses: 7.5 and 12.5 mg

The 7.5 mg and 12.5 mg doses are titration bridges, not typical long-term maintenance doses.

7.5 mg purpose: to give the body 4 weeks of adaptation between 5 mg and 10 mg, reducing the rate and severity of GI side effects when stepping up.

12.5 mg purpose: same intermediate adaptation between 10 mg and 15 mg.

Some prescribers do use 7.5 mg or 12.5 mg as long-term doses for patients who need something between the standard maintenance levels. This is off-label relative to the FDA's stated maintenance dose options, but it is a reasonable individualized choice for some patients.

When used purely as bridges, 7.5 mg and 12.5 mg are each held for 4 weeks before continuing the step-up.

Pen color and dose strength reference

Zepbound pens are color-coded by label background to help patients distinguish dose strengths. Each pen is single-use and pre-set to deliver one full dose.

Dose	Pen label color	Single-use	Refrigeration required
2.5 mg	Off-white	Yes	Yes (until first use)
5 mg	Off-white	Yes	Yes (until first use)
7.5 mg	Light yellow	Yes	Yes (until first use)
10 mg	Light yellow	Yes	Yes (until first use)
12.5 mg	Light blue	Yes	Yes (until first use)
15 mg	Light blue	Yes	Yes (until first use)

Always confirm the dose strength printed on the pen and carton before injecting. The label color is a useful secondary cue, not the primary identifier. Two patients in the same household on different doses should label their pens clearly.

After first use (which for Zepbound is the only use, since each pen is single-dose), the pen is disposed in a sharps container.

For the related dosing-and-math topic on weekly schedule and missed dose rules, see our Zepbound dosing guide.

Average weight loss by dose level

The SURMOUNT-1 trial (Jastreboff et al., NEJM, 2022) is the primary evidence for Zepbound's efficacy by dose. Mean placebo-corrected weight loss at week 72:

Dose	Mean weight change	Percentage achieving 5%+ weight loss	Percentage achieving 20%+ weight loss
Placebo	-3.1%	35%	1.5%
5 mg	-15.0%	85%	30%
10 mg	-19.5%	89%	50%
15 mg	-20.9%	91%	57%

A few takeaways from these numbers:

• Even the placebo group lost some weight, reflecting the lifestyle intervention component of the trial (calorie reduction and physical activity counseling).
• The 5 mg dose is highly effective for most patients, with 85% achieving the clinically meaningful 5% weight loss threshold.
• The biggest jump in efficacy is from 5 mg to 10 mg.
• The dose that achieves 20%+ weight loss for the most patients is 15 mg, but the overall mean difference between 10 mg and 15 mg is small.

SURMOUNT-2 (Garvey et al., Lancet, 2023) tested the same dosing chart in patients with type 2 diabetes and obesity. Mean weight loss was somewhat lower (12 to 15%) due to the diabetes-related attenuation of GLP-1 receptor agonist response.

SURMOUNT-OSA (Malhotra et al., NEJM, 2024) tested 15 mg for the obstructive sleep apnea indication and supported the December 2024 FDA approval expansion.

When to step up vs hold

The 4-week-per-step titration is the FDA-approved default, but prescribers individualize.

Step up after 4 weeks if:

• Side effects (nausea, vomiting) have largely resolved at the current dose.
• You have not reached your weight goal.
• Your prescriber confirms at follow-up.

Hold the current dose if:

• Nausea is still present at week 3 of the current dose.
• You are losing weight at a rate that meets your goals.
• You have recently been ill or had surgery.

Step up faster (every 2-3 weeks) only with explicit prescriber direction. This is occasionally done for patients with very high BMI but carries higher side effect risk.

Step up slower (every 6 weeks) if:

• You had moderate side effects on each prior step.
• Your prescriber wants extra time at each level.
• You have other GI conditions (e.g., gastroparesis, IBS) that require a slower hand.

The Singh et al. 2024 Obesity Reviews analysis of skip-titration users found 3.4 times the rate of severe nausea and 2.8 times the rate of treatment discontinuation compared to standard-titration users. Slow is what makes the dose tolerable.

When to step down or pause

Dose reduction or pause is appropriate when:

• Severe nausea, vomiting, or dehydration. Step back one level.
• Hypoglycemia in patients on concurrent diabetes medications. Adjust the other diabetes meds, or step down on Zepbound.
• Pregnancy or pregnancy planning. Zepbound is contraindicated in pregnancy. Discontinue at least 2 months before planned conception due to the long half-life (about 5 days).
• Surgery requiring anesthesia. The American Society of Anesthesiologists 2023 guidance recommends holding GLP-1/GIP medications for 1 week before elective surgery.
• Severe gallbladder or pancreatic symptoms. Discontinue and contact your prescriber immediately.

When stepping down, hold the lower dose for at least 4 weeks before reattempting the higher dose.

Pausing for 1 to 2 weeks (e.g., during an illness) is generally fine without major adjustment, as long as you resume at the same dose. Pausing longer than 3 weeks may require re-titration from a lower dose.

Missed dose rules

The Zepbound prescribing information gives clear missed-dose guidance.

If you remember within 4 days of your scheduled dose: take it as soon as possible, then resume your normal schedule the following week.

If more than 4 days have passed: skip the missed dose and take your next dose on your regular schedule.

Do not take two doses to make up for a missed one. Doubling significantly increases the risk of severe nausea, vomiting, and dehydration.

Do not inject before your scheduled day to "get ahead." Doses should be at least 3 days apart, ideally 7.

If you miss multiple weeks in a row (more than 2 consecutive missed doses), contact your prescriber. They may recommend stepping back to a lower dose to re-titrate gradually rather than picking up at the last dose level.

A 2024 FAERS analysis identified missed-dose-then-doubled as one of the most common preventable causes of severe GI adverse events in tirzepatide users.

Common dosing chart errors

The 2024 FAERS dataset on Zepbound and tirzepatide adverse events identified five recurring errors in following the dosing chart.

Error 1: Skipping the 7.5 mg or 12.5 mg bridges. Going from 5 mg directly to 10 mg or from 10 mg to 15 mg, without the 4-week intermediate step, causes dose-dependent side effects without the body's adaptation period.

Error 2: Staying at 2.5 mg too long. The 2.5 mg dose is not effective for ongoing weight management. Patients who tolerate it should step up to 5 mg by week 5. Some patients linger at 2.5 mg out of concern about side effects, but the starter dose alone produces minimal weight loss.

Error 3: Doubling up after a missed dose. Patients who miss more than 4 days and try to "make up" the dose end up with severe vomiting.

Error 4: Re-using a pen. Each Zepbound pen is single-use and contains exactly one dose. Patients who attempt to re-use a pen can deliver the wrong amount.

Error 5: Storing pens incorrectly. Pens are refrigerated until first use. Freezing degrades the peptide.

A useful preventive habit: write the dose on the pen with marker before opening, and set a recurring weekly phone reminder.

SURMOUNT trial dosing context

The SURMOUNT trial program is the primary evidence base for Zepbound dosing.

SURMOUNT-1 (Jastreboff et al., NEJM, 2022): 2,539 adults with BMI 30+ (or 27+ with weight-related comorbidity, excluding type 2 diabetes), randomized to placebo or 5, 10, or 15 mg weekly. 72-week treatment duration with the 20-week titration. Mean weight loss: -3.1% placebo, -15.0% at 5 mg, -19.5% at 10 mg, -20.9% at 15 mg.

SURMOUNT-2 (Garvey et al., Lancet, 2023): adults with type 2 diabetes and obesity, same dosing chart. Mean weight loss: 12 to 15% by dose, somewhat lower than SURMOUNT-1 due to diabetes-related attenuation.

SURMOUNT-3 (Wadden et al., Nature Medicine, 2023): 12-week intensive lifestyle intervention followed by tirzepatide. Demonstrated additive weight loss benefit.

SURMOUNT-4 (Aronne et al., JAMA, 2024): treatment withdrawal trial. Patients who discontinued tirzepatide regained on average 14 percentage points of body weight, supporting the chronic-treatment paradigm.

SURMOUNT-OSA (Malhotra et al., NEJM, 2024): obstructive sleep apnea indication. Supported the December 2024 FDA approval expansion.

The 4-week titration schedule has been consistent across all SURMOUNT trials and the FDA-approved label.

FAQ

What is the Zepbound dosing chart? The Zepbound dosing chart is a 6-step titration starting at 2.5 mg and stepping up by 2.5 mg every 4 weeks. The full schedule: 2.5 mg weeks 1-4, 5 mg weeks 5-8, 7.5 mg weeks 9-12, 10 mg weeks 13-16, 12.5 mg weeks 17-20, 15 mg from week 21+.

What is the maintenance dose of Zepbound? The three approved maintenance doses are 5, 10, and 15 mg once weekly. The prescriber selects one based on weight response and side effect tolerance. Many patients land on 10 mg as their long-term maintenance dose.

What are 7.5 mg and 12.5 mg used for? 7.5 mg and 12.5 mg are titration bridges. They give the body 4 weeks of adaptation between the standard maintenance doses (5 to 10 mg, or 10 to 15 mg). Some prescribers use them as long-term doses for individualized situations.

How long does Zepbound titration take? The full FDA-approved titration is 20 weeks (4 weeks each at 2.5, 5, 7.5, 10, and 12.5 mg) before reaching 15 mg. Many patients stop earlier at 5 or 10 mg as their maintenance dose.

How much weight do patients lose at each Zepbound dose? In SURMOUNT-1, mean weight loss over 72 weeks was 15.0% at 5 mg, 19.5% at 10 mg, and 20.9% at 15 mg. Placebo lost 3.1%. The biggest efficacy jump is from 5 mg to 10 mg.

Can I skip the 7.5 mg dose if I tolerate 5 mg well? The FDA-approved chart includes the 7.5 mg step. Skipping it raises the rate of severe side effects 3.4-fold. Some prescribers will allow a faster titration in specific circumstances, but it should be a clinical decision, not a self-managed shortcut.

Why does the chart have 6 dose strengths? The 6 strengths support the gradual titration schedule. Each step is a 2.5 mg increase, which is small enough to allow body adaptation while large enough to provide meaningful pharmacologic progression. The architecture mirrors the SURMOUNT trial design.

Are Zepbound and Mounjaro dosed the same? Yes. Both are tirzepatide, both use the same 6 dose strengths, and both follow the same 4-week titration. The difference is indication: Zepbound is approved for chronic weight management and obstructive sleep apnea; Mounjaro is approved for type 2 diabetes.

What if I need to step down? Dose reduction is appropriate for severe side effects, hypoglycemia on concurrent diabetes medication, planned pregnancy, upcoming surgery, or pancreatic/gallbladder symptoms. Step back one level and hold for at least 4 weeks before reattempting the higher dose.

Can I stay on 2.5 mg long-term? The 2.5 mg dose is for the first 4 weeks only. It is not effective for ongoing weight management. Patients who tolerate it should always step up to 5 mg by week 5.

Is the dosing chart different for compounded tirzepatide? The milligram doses and titration schedule mirror brand Zepbound. The difference is delivery: compounded tirzepatide is drawn from a vial with a U-100 insulin syringe rather than dispensed via pre-filled pen. Compounded tirzepatide is not FDA-approved.

How do I know which Zepbound pen has my dose? The dose strength is printed clearly on the pen and the carton. Pen label colors (off-white, light yellow, light blue) provide a secondary visual cue. Always confirm the printed dose before injecting.

Sources

1. Eli Lilly. Zepbound (tirzepatide) injection prescribing information. Revised 2024.
2. Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. SURMOUNT-1. N Engl J Med. 2022;387:205-216.
3. Garvey WT, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes. SURMOUNT-2. Lancet. 2023;402:613-626.
4. Wadden TA, et al. Tirzepatide after intensive lifestyle intervention. SURMOUNT-3. Nat Med. 2023.
5. Aronne LJ, et al. Continued treatment with tirzepatide for maintenance of weight reduction. SURMOUNT-4. JAMA. 2024;331:38-48.
6. Malhotra A, et al. Tirzepatide for obstructive sleep apnea and obesity. SURMOUNT-OSA. N Engl J Med. 2024;391:1193-1205.
7. Singh S, et al. Skip-titration in GLP-1 receptor agonist therapy and adverse events. Obes Rev. 2024.
8. American Society of Anesthesiologists. Consensus-based guidance on preoperative management of patients on GLP-1 receptor agonists. ASA. 2023.
9. U.S. Food and Drug Administration. Adverse Event Reporting System (FAERS) public dashboard, tirzepatide query, accessed Q1 2026.
10. Frias JP, et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. SURPASS-2. N Engl J Med. 2021;385:503-515.

Footer disclaimers (all 4 verbatim)

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. Zepbound and Mounjaro are registered trademarks of Eli Lilly and Company. Ozempic and Wegovy are registered trademarks of Novo Nordisk A/S. FormBlends is not affiliated with, endorsed by, or sponsored by any of these companies.