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Weeks 1–4

Starting Dose (2.5 mg)

Tirzepatide's starting dose is 2.5 mg weekly — significantly lower than the eventual maintenance dose. This low-and-slow start is intentional: it allows the GIP and GLP-1 receptors to adjust simultaneously. Some patients report earlier appetite changes than with single-agonist therapies, though individual responses vary.

Weeks 5–8

First Escalation (5 mg)

Your physician increases to 5 mg after 4 weeks if the starting dose was well-tolerated. The dual mechanism begins showing more pronounced effects on appetite, energy intake, and glycemic control. Monthly physician check-ins review tolerability and early weight response before escalating further.

Weeks 9–24

Escalation (7.5 mg → 10 mg)

Doses escalate every 4 weeks (7.5 mg, then 10 mg) as tolerated. The SURMOUNT-1 trial showed the steepest weight loss curve occurs in this phase for many participants. Your physician evaluates GI tolerability at each step — dose escalation can be paused or slowed based on your response.

Week 24+

Maintenance (up to 15 mg)

Maximum studied maintenance dose is 15 mg weekly. SURMOUNT-1 trial participants at 15 mg achieved ~20.9% mean body weight reduction at 72 weeks. Ongoing monthly monitoring continues throughout therapy. Your physician may hold at 10 mg or 12.5 mg if clinically appropriate for you.